A 16-day-old male baby was referred to KLES Dr. Prabhakar Kore Hospital Belagavi from a private hospital with less than 2.5 kg of weight with complaints of bluish skin, lips & nails. The baby was not receiving enough oxygen-rich blood. The baby was not accepting feeds, had a rapid heart rate with a weak pulse & restless. Dr. Danish Memon, Paediatric Cardiologist made a diagnosis of Dextro- Transposition of the Great Arteries (d-TGA) in this baby. It is a very rare birth heart defect that is less frequently diagnosed when the baby is in the mother’s womb.
In a normal heart, we get normal connections of the great arteries, meaning the aorta arises from the left ventricle, and the pulmonary artery arises from the right ventricle. But in d-TGA, the great arteries have wrong connections (interchanged). The aorta arises from the right ventricle, so it carries the deoxygenated blood returning to the right ventricle back to the body, and the pulmonary artery arises from the left ventricle, so it carries the oxygenated blood returning from the lungs back to the lungs. This arrangement in blood circulation is not sustainable for life unless there is a site of temporary mixing of the oxygenated and deoxygenated.
However, the permanent solution is surgical repair of the defect, known as the Arterial Switch Operation (ASO). This is a neonatal cardiac operation, ideally done within 3 weeks of life, where we switch the great arteries back to their normal connection to their chamber. It is considered one of the most critical and technically demanding operations in neonatal cardiac surgery. The complex & critical surgery was performed by Dr. Gananjay Salve, Paediatric Cardiac Surgeon trained in Bangalore, Mumbai and then in Sydney, Australia. The surgery lasted for 8 hours and child withstood the surgery very well.
Thanks to the excellent anesthesia back-up offered by Dr. Anand Vagrali & Dr. Sharangouda Patil. Post-surgical management is even more demanding as the baby was on a ventilator & was expertly managed by Paediatric Intensivist Dr. Nidhi Goel Manvi. The case was closely monitored by a team of experienced Paediatric Cardiologists Dr. Veeresh Manvi & Dr. Danish Memon.
The jubilant parents are extremely happy with the outcome of the surgery, baby was discharged on the 10th day of surgery, and have expressed their gratitude to Dr. Gananjay Salve and the entire team of nursing staff for the successful outcome of the surgery. Dr. Gananjay Salve opined if not operated on in time, these babies usually succumb to this congenital heart defect. KLES Hospital has created world-class medical facilities to handle any complex newborn children said Dr. Richard Saldanha, Chief of Cardiac Surgery, & Dr. Mohan Gan, HOD, dept. of CVTS. Dr. Prabhakar Kore Hospital, Chairman KLE Society & Dr. (Col) Dayanand, Medical Director of the hospital congratulated the team for excellent teamwork & giving new lease life to the baby.