Three-day-old with protruding heart battles for life

August 29th, 2009 - 5:07 pm ICT by IANS  

New Delhi, Aug 29 (IANS) A three-day-old boy born with his heart outside the chest — “a rarest of rare defects” — continued to battle for life at the All India Institute of Medical Sciences Saturday, with doctors keeping their fingers crossed.
Doctors say the boy is crying incessantly for his mother Vibha Manjhi, a poor woman who is warded in a hospital in Chapra in Bihar after a cesarean section.

“The boy is on liquid diet. He is stable and is being treated for infection. Once the infection goes, we will do the surgery,” A.K. Bisoi, a cardiologist and additional professor at the Cardiothoracic and Vascular Surgery Department, told IANS.

“He is completely dehydrated. We will only do the surgery once we rule out infection.”

Bisoi said the child’s blood was infected. “His parents are lucky the baby is still alive even after infection as it has spread to all body parts. We are trying our best to save the baby.”

Kept in the ICCU (intensive cardiac care unit) of the Cardio-Thoracic Sciences Centre, the infant was brought to the institute Friday from Bihar by his father Chander Manjhi, a farmer.

“Born two days back with his heart outside his chest, the child was brought here wrapped in an unclean cloth,” Bisoi said. He was infected as he was exposed to outside elements during his night-long train journey.

Explaining his condition, Bisoi said the infant was suffering from a disease known as Thoracic Ectopia Cordis, which is a birth defect.

“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.

As the news about the child spread, doctors, nurses, paramedics and hospital staff flocked to the ICCU to take a look at the child.

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

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 providing medical aid 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, 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,” Bisoi 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.”

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, in his early 20s, was unaware of the complications involved and 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 he will be fine,” Manjhi told IANS. “They told me the operation is very complicated. I hope to take him back soon.”

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