Mumbai opens heart for tot, scores India’s first baby valve-switch operation

MUMBAI: When Wardha resident Anita Wakekar spent a night under a tree near KEM Hospital in Parel with her severely ailing 18-day-old boy, she set off a chain-reaction of goodness that enveloped CM Devendra Fadnavis’s wife Amruta and several city hospitals and doctors.
On the fourth day that ‘Baby of Anita’ spent in Mumbai, he had undergone a novel heart surgery performed on a child for the first time in India, that too at no cost to the family.
Doctors said it’s a marvel that a child, whose heart was malformed, managed to breathe till the surgery. “It was an eight-hour surgery on a grape-sized heart that involved switching his valves and adding a tube to normalize his aortic arch,’’ said cardiac surgeon Dr Suresh Rao, from Kokilaben Ambani Hospital, Andheri.
But the main highlight of Anita’s baby’s story is that Mumbai has a large heart. The boy, born on February 21 in Wardha, was moved to Nagpur 10 days later and then to Mumbai for treatment. First the BPL family couldn’t find a bed, then a doctor who would handle the case. Word reached the CM’s wife, who set off a chain of doing good. On April 8, the baby left hospital, a robust 3kg in weight.

After the boy was found to be unwell, Anita’s husband Pravin’s brother, who lives in Nagpur, brought the family to Mumbai on March 7, but they found no NICU (neo-nate intensive care) bed. Doctors in ICUs near Parel began calling up each other for an NICU bed for the baby, but the family got one only the next morning at Nair Hospital in Mumbai Central. “I slept with my baby under a tree that night. He clearly needed help breathing but he bravely persevered,” said Anita, who holds a BPL ration card. The Nair Hospital team too told the parents that they couldn’t operate on the child and would help arrange a transfer.
Around the same time on March 8, the chief minister’s wife Amruta was in Wadia Hospital to inaugurate a human milk bank. “I got a call from a party worker in Nagpur saying this child was too unwell and needed surgery immediately,” she told TOI. “We keep getting such requests, but every active politician and his family are familiar with the drill. We must remember that it is the right of people to get treatment,’’ she added.
She asked Wadia Hospital CEO Dr Minnie Bodhanwala to help facilitate the child’s transfer to a hospital that could operate on the boy. “As we are in the process of setting up a heart unit, we know about doctors specializing in this sphere. So we called up Kokilaben Hospital, which was willing to help,’’ said Dr Bodhanwala. Anita and her son were moved to the Andheri hospital on March 9, where the operation took place next morning. “The child’s aortic valve was 3mm in diameter, less than half the usual size. Moreover, the arch of his aorta was incompletely formed,’’ said Dr Rao. The only solution was to perform a surgery called the Ross-Konno surgery, which had been performed on grownups but never in underweight neonates in India.
“As it was the only way, we began by replacing his malformed aortic valve with his pulmonary valve,” said Dr Rao. This ‘switch’ is done because the pulmonary valve, which closes the lower right chamber of the heart, doesn’t witness ‘heavy traffic’ or blood pressure. The aortic valve, on the other hand, closes off the lower left chamber and witnesses high blood flow and pressure. The space of the pulmonary valve was taken by a synthetic conduit or valve. As the child had an incomplete aortic arch, the doctors had to use a synthetic tube to recreate it.
On April 8, when Anita and her son left the hospital, he weighed almost 3kg. “The doctor asked us to return in a month for a follow-up. We also realize that our son will need another surgery when he is five years old,” said Pravin.
Incidentally, although Mumbai is the health destination for adult heart operations, it has lagged behind southern cities in pediatric heart operations. There are now six hospitals in the city and its suburbs offering pediatric heart surgeries, most have come up in the last five years. Moreover, pediatric surgeries cost a lot and parents are invariably too young to have adequate savings to fund them. Kokilaben Hospital executive director Dr Ram Narain said, “We manage to offer free surgeries to at least 20-25% of the children referred to us with the help of funders and government help.’’ For Anita, the Mumbai experience has been a great one. “We got good help,’’ she said.