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Manipal, 2nd December 2021: Dr Guruprasad Rai, Associate professor of Cardio Thoracic and vascular Surgery said that, “A young Indian couple residing in the Middle East were happy to know that they will become Parents very soon. However, their happiness was short-lived, as soon as they came to know that baby had suspected a heart defect. It was confirmed in due course of pregnancy with high certainty that the newborn will require complex cardiac surgery for survival in the first few days of life. The family approached Kasturba Hospital Pediatric Cardiology and Cardiac surgery team and shared their scan report.

We reassured the family about the feasibility of surgery and near-normal life expectancy. The couple came back to India and delivered the baby at Kasturba Hospital. The Pediatric Cardiology Team led by Dr. Gunjan Banga did a confirmatory scan and a CT scan to confirm the antenatal diagnosis. The baby had Aortic Arch Interruption with a ventricular septal defect, which can be fatal very soon if not treated in time. The baby was stabilized with medications by Neonatologist Dr. Leslie Lewis and Team and operated on by chief Cardiac surgeon Dr. Arvind Bishnoi in the first week of life. The baby tolerated the operation and was discharged to home in 10 days.

A newborn baby was transferred to Kasturba Hospital, Manipal from Shimoga district due to suspicion of heart disease. The mother had a normal pregnancy and unfortunately, the heart condition was missed during the antenatal scan. After delivery, the baby was noted to be appearing blue and was not having normal oxygen in the body and was hence transferred here.

At Kasturba hospital, he was evaluated by the neonatology team led by Dr. Leslie Lewis and pediatric cardiology team led by Dr. Gunjan Banga and was noted to have a congenital heart disease known as Tetralogy of Fallot with pulmonary atresia wherein there is a large hole in the heart causing mixing of blood in the heart along with the absent flow to the lung artery from the heart. The blood goes to the lungs due to the presence of a connection called PDA (the connection between lung artery and aorta) in newborn babies. However, PDA tends to close gradually after birth making this an extremely fatal condition if not intervened upon in the first week of life. The baby was started on medicine to keep the PDA open temporarily and then cardiac catheterization was performed by a team led by Dr. Padmakumar R, an interventional cardiologist, and Dr. Arvind Bishnoi, a pediatric cardiothoracic surgeon. This procedure could be performed without needing an open heart surgery through a needle hole in a small blood vessel in his leg. A stent was then placed in the PDA to keep it open and the patient was discharged within a week with a plan for future surgery around 6 months. PDA stenting in newborns is a very sophisticated procedure performed at a limited number of super-specialty centers. This offers a better alternative without needing open-heart surgery in small babies.

Dr. Arvind Bishnoi, Professor and chief Cardiac surgeon at Kasturba Hospital, Manipal said that, “Newborn with heart disease are very fragile and need expert tender care. They need care from a big team of professionals from various interrelated domains. I feel blessed to be a part of this team.”

Dr. Leslie Edward Lewis, Professor and Head department of Neonatology and paediatrics said,”

Earlier we used to refer infants with complex congenital heart diseases to Bangalore for cardiac surgery through either flight or road. We have the bitter experience of losing these infants on the way to travel to Bangalore due to their illness and we were helpless.  This was our dream to develop a ‘Pediatric Cardiac’ team at KH Manipal to handle complex congenital heart disease in Neonates and young infants and the management has wholeheartedly supported us in providing the required infrastructure and excellent multidisciplinary team. Today we are proud to say we take care of infants with complex congenital heart disease from neighboring 8 districts, we have excellent results comparable to any advanced Pediatric Cardiac Care Centre. This was possible entirely because of the teamwork from Obstetrics, Pediatrics, Cardiology, Cardiac Surgery, Anesthesia Department, and Department of Cardiovascular technology.

We also place on record the service rendered by the Department of cardiovascular technology over the years in identifying critical congenital heart disease and helping us to provide early intervention. 

"It is very exciting to see how far we have come in India providing care comparable to any cardiac center in the world"- says Dr. Gunjan Banga, a US-trained Paediatric Cardiologist. "We now routinely see such babies at Kasturba Hospital, Manipal both antenatal and after birth who have complex heart disease and are able to provide special care to these babies that they need. It is important to remember, the sooner these defects can be picked up, and better the outcomes are for the babies", she added.

Dr. Avinash Shetty, Medical Superintendent said that, "It is one of many stories which is a testament to the facilities available in the region at Kasturba Hospital. Today Kasturba hospital, Manipal is a leader in Cardiology and Cardiac Surgery services in coastal and Middle Karnataka. Institute offers all types of cardiac treatment available at any other center in the world to adults, children and newborns.  All together we can conquer congenital heart disease".

 *Medical Superinrendent