Four-month-old Sudanese boy with TGA gets new lease of life

A four and a half months old Sudanese national suffering from transposition of the great arteries (TGA), a congenital heart defect, has been cured at a hospital here, hospital authorities said on Tuesday.

The boy, diagnosed with TGA in Sudan, was brought to the BLK Super Specialty Hospital since a surgery for this defect was not available in his native country.

According to medical science, the incidence of TGA is about 20 to 30 in 1,000 live births. About four cases out of the total happen to be serious defects, requiring palliative or corrective surgery in the first few weeks to prevent death.

The defect is due to abnormal development of the foetal heart during the first eight weeks of pregnancy.

In TGA, the large vessels that carry blood from the heart to the lungs, and to the body are connected improperly. If surgery is delayed, the left ventricle becomes progressively weaker and incapable of taking the load off the arterial system.

After examining the patient, the doctors decided to perform Atrial Switch or Senning's Operation, a strong medical procedure to cure TGA.

Explaining the procedure Sushant Srivastava, Director of Cardiothoracic & Vascular Surgery at BLK Heart Centre, said that in this operation, three incisions are made, two in the walls of the right and left atria, and one in the atrial septum.

"They are re-sutured in a way that superior vena cava (SVC) and inferior vena cava (IVC) blood is diverted into the left ventricle, the pulmonary artery and oxygenated pulmonary venous blood is diverted into the right ventricle and aorta," said Srivastava.

The patient was operated through mid sternotomy.

Initially, the patient was put on the heart lung machine and cooled to 28 degrees.

"The aorta was clamped and the heart was stopped. Both atria were opened and the atrial septum was divided. A synthetic gore-tex patch was used to redirect pulmonary venous blood through the left atrium incision into the right atrium and right ventricle and through it into the aorta," said Srivastava.

"The remaining right atrial wall was used to create a baffle to divert SVC-IVC blood into the left ventricle and pulmonary artery."

Once the surgery was complete, the child was put under observation and had a smooth recovery.

"The recovery of the child was uneventful. Cyanosis disappeared and the baby was discharged on the eighth post-operative day," said Srivastava, adding that the child's health improved dramatically and he gained weight within a fortnight after which he was taken back home to Sudan.

--IANS

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