2-Year-old Baby With Complex Heart Deformity Undergoes Major Open Heart Surgery at Wockhardt Hospitals, Bangalore - (now a Network Hospital of Fortis) Without any Blood Transfusion

By Wockhardt Hospitals Bangalore now A Network Hospital Of Fortis, PRNE
Monday, January 18, 2010

Faith by Their Side, This Case Challenged Medical Excellence

BANGALORE, India, January 19 - A team of cardiac experts led by Dr. N S Devananda, Consultant
Cardiac Surgeon, Wockhardt Hospitals, Bangalore (Now a Network Hospital of
Fortis) has performed a major open heart surgery on a 2-year-old baby from
Nigeria. Baby Brendan was suffering from congenital heart defect called -
Tetralogy of Fallot or complex blue baby syndrome.

"Baby Brendan was brought to us in a condition which was
complicated and need surgical intervention to correct the anomaly. In this
syndrome the pure and impure blood gets mixed in the heart and the amount of
blood flow to the lungs is decreased. It is the most common complex heart
defect, representing 55-70%, and the most common cause of blue baby syndrome.
It can prove fatal if it is not treated in time," said Dr. N S Devananda,
Consultant Cardiac Surgeon, Wockhardt Hospitals, Bangalore (Now a Network
Hospital of Fortis).

The other bigger challenge which came before the surgery was
the fact that the baby's parents belonged to the Jehovah Witness community
and as per their religious belief they oppose to any form of transfusion of
blood and any blood products however they could accept other from of
treatment. This made the case all the more complicated.

"Babies with Tetrology of Fallout have two treatment options -
the first is palliative where no open heart surgery is done and the defect is
treated with shunt operation. The second is complete repair - which is
definitive treatment where the patient undergoes an open heart surgery with a
heart lung machine. In the case of Baby Brendan we obviously chose the second
option due to its curative value. But the problem we faced was that the heart
lung machine requires 500 ml of blood by itself to drive away the air and
still haemoglobin at acceptable level. The challenge was with the baby
weighed only 11 kgs and his blood volume was 800 - 900 ml and to conduct an
open heart proved difficult without additional usage of blood" said Dr.
Devananda.

The team devised many things technically to make operative
time shorter and do the best possible ways so that re-operation or
re-exploration can be avoided and the ICU stay is reduced. The heart lung
machine circuit was modified in such a way that total priming volume was
reduced to the least possible; the haemo-filteration technique was used in
such a way that excess water from the body is removed and it gives back the
RBC's to the body. We also had to reduce the sampling to the least possible
for various tests.

"We did everything technically possible to reduce the
requirement of blood. With all these modifications the baby underwent the
open heart surgery and was out of ICU within 24 hours and is flying back to
his native on the 7th post operative day. In an era where a lot of talking is
happening around blood transfusion and adults have been undergoing surgery
without blood transfusion, the same thing on a child is quite complicated.
However with technical modification and surgical skills it is definitely
possible and should be encouraged so that no child from the community remains
untreated" said Dr. Devananda.

Brendan can live an active life like any other child of his
age as this is a one time complete correction and his post op ECHO is
satisfactory.

Brendan's mother Ettieh's faith in Jehovah has strengthened
after this incident. She says, "Everybody should give proper attention to
their child and keep monitoring the health of the baby time and again. Till
one year when Brendan was not keeping too well and was not gaining weight we
got very concerned and kept taking to the local physicians in Nigeria.
However nobody could give us a proper answer to his continuous ill health
until last year August, 09 Brendan complained of breathlessness and pain on
his left chest. A thorough examination indicated that my baby has some heart
complication which needed to be treated immediately. Being a member of the
Jehovah Witness community our challenge was to take Brendan to the right
hands where surgery was possible without using blood transfusion. That's when
one of our friends at Nigeria who knew about Wockhardt Hospitals, Bangalore
(Now a Network Hospital of Fortis) and their expertise in performing surgery
without blood transfusion suggested us and we finally decided to fly Brendan
down here for treatment. Initially when we decided to come to India for
treatment I was engulfed with mixed feelings, but with the kind of care and
response we received here I was quite confident that I have brought my baby
to the right place."

    For more information please contact:

    Priyam Bortamuli
    PR & Communication
    Wockhardt Hospitals, Bangalore - Now a Network Hospital of Fortis
    Mobile - +91(0)984555-8559
    Email: priyam.bortamuli@fortishospitals.in

    www.wockhardthospitals.net/

For more information please contact: Priyam Bortamuli, PR & Communication, Wockhardt Hospitals, Bangalore - Now a Network Hospital of Fortis, Mobile - +91(0)984555-8559, Email: priyam.bortamuli at fortishospitals.in

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