Two-day-old with protruding heart to be operated on

August 28th, 2009 - 10:18 pm ICT by IANS  

New Delhi, Aug 28 (IANS) A two-day-old born with his heart protruding from his chest is posing a challenge to doctors at the All India Institute of Medical Sciences (AIIMS) as they battle to save the infant suffering from the “rarest of rare defects”.
Kept in the ICCU (intensive cardiac care unit) of the Cardio-Thoracic Sciences Centre, the infant was brought to the premier institute Friday morning from Chapra in Bihar by his father Chander Manjhi, a farmer.

“Born two days back with his heart outside his chest, the child was brought to the hospital wrapped in an unclean cloth,” A.K. Bisoi, a cardiologist and additional professor at the Cardiothoracic and Vascular Surgery Department, told IANS.

“He is completely dehydrated and there are chances of infection as he travelled 24 hours in a train. We will do the surgery once we rule out infection,” he said.

Bisoi said the child is suffering from a disease known as Thoracic Ectopia Cordis, which is a birth defect.

In this, the heart is abnormally located. In most cases, the heart protrudes from the chest, while in some cases, it is situated in the abdominal cavity or neck.

“This defect occurs in five to nine cases per one million births and the mortality rate is very high. In such cases, there are mostly stillbirths or they die shortly after birth,” he said.

Given that it is a rare surgery, the institute has formed a team of five doctors, including pediatrics cardiologists.

The child, born after a Cesarean section at a hospital in Chhapra, was brought to the institute after doctors detected the defect.

As the mother Vibha Manjhi is still in hospital, the father brought the child with him.

Once the father brought him here, doctors and nurses were surprised to see such a “rarest of the rare” case.

Bisoi said these cases can be treated surgically but in general, involve lengthy and very complicated pediatric cardiothoracic surgery.

Seeing the poor economic condition of the parent, the institute is conducting the surgery free of cost.

“The surgery is a multi-layered procedure and might take months. We have to create space step by step and the chest wall has to be reconstructed. So far, about 227 such cases have been reported in the world and of these, only three to four have survived. In India, no infant with such a defect has survived,” he added.

“Usually, the doctors come to know about the abnormality in three to four weeks of foetal life when the heart starts developing. The heart usually shifts to its original position. But in this case, it did not happen,” Bisoi pointed out.

He said in most cases when doctors detect the abnormality, they counsel the parents, especially the mother, whether they want to continue with the pregnancy or abort.

“If they decide to go with the pregnancy, they are referred to hospitals that are equipped to handle such cases,” Bisoi said.

The infant’s father Chander, unaware of the complications involved, sat quietly outside the ward.

“I am very poor and my wife is still in hospital. They have admitted my child and they are treating him. They have told me that he would be fine. I hope to take him back soon,” he told IANS.

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