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Wednesday, June 22, 2005

Eight-month-old Apoorva with weak heart gets rare cure at AIMS

KOCHI: Amrita Institute of Medical Sciences (AIMS) has added another first to its credit by giving a new lease of life to an eight-month-old baby after supporting its circulation and respiratory systems for over two days using state-of-the-art machinery.

The baby, Apoorva Parte of Mumbai, underwent a complex open-heart surgery on June 1 to repair a hole in her heart. After an uneventful operation she was transferred to the ICU in a stable condition.

But 12 hours later she developed severe heart failure and a near cardiac arrest on two occasions, the cause of which was unclear.

After all resuscitative measures failed, the only hope for this child was mechanical circulatory support by a technique called Extra Membrane Oxygenation (ECMO). And in two days her condition came back to normal and she was discharged from the hospital on Tuesday.

“We have been reading a lot about such cases, but using the machine required a lot of practice. However, when our team worked together we could make it a success,” said Dr Suresh G Rao, who led the pediatric and congenital heart surgical team.

Though this modality of support is fairly commonplace in the West, the prohibitive cost of materials, maintenance of support, dearth of trained personnel and non-availability of hardware suitable for a small baby have been preventing its widespread use in India.

A few centres in Delhi, Chennai and Bangalore have earlier attempted to salvage patients after cardiac surgery with this technique, but in vain.

What made Apoorva’s case unique is that it was for the first time that a baby weighing below 5-kg has had its heart and lungs artificially supported for more than two days, followed by full recovery.

This form of support is most gratifying in reversible ventricular dysfunctions as it can save lives. It involves close co-ordination among cardiology, cardiac surgical, anaesthesia and perfusion teams.

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