A four-and-a-half-year-old boy with Atrial septal defect (ASD), a congenital heart disease referring to a hole in the wall bifurcating two upper chambers of the heart, was successfully cured through mini-sternotomy, a minimally invasive open-heart surgery at Devadoss Multispeciality Hospital here recently.
S. Akash, son of a couple working as wage labourers at a farm in Cumbum in Theni district, was often suffering from respiratory tract infection because of the disease. According to the parents, though the disease was diagnosed earlier, doctors at the local government hospital asked them to wait for a few years since it was too complex to perform the surgery on the young boy.
On the advice of a relative working as a paramedic, Akash was later taken to a free medical camp organized by Little Moppet Heart Foundation, where the doctors referred him to Devadoss hospital since waiting for more years could worsen the situation.
Gopi Nallaiyan, Consultant Paediatric Cardiac Surgeon at the hospital, said that his team initially explored the option of ASD Device Closure, a non-surgical procedure similar to angioplasty. “However, we had to drop the option since the hole was too large for it,” he said.
The team later decided to do an open heart surgery. “For adults with such a symptom, we usually do it through two incisions - one through the side chest wall and another in thigh. The incision in the thigh will be to connect the heart-lung machine to femoral veins during the surgery since functioning of the heart will be temporarily stopped,” he said.
He added that, since the boy’s body, weighing just 16 kilograms, was too tender for the procedure, the doctors had to manage with a single incision in the middle of the chest.
“The surgery was performed and the tubes for heart-lung machine were connected through this single incision, which requires an extremely delicate approach,” he said.
Contrary to adults where the full-length of the chest bone (sternum) will be cut open for the surgery, he said that only half the chest bone was cut for the boy.
“That is why it is called mini-sternotomy. This is advantageous for the boy since the healing will be quick and risks will be low if the boy has to undergo any heart surgeries in future,” he also added.
Hospital authorities said that this was the first such procedure performed on a child in the southern part of Tamil Nadu. They added that the entire surgery was covered under Chief Minister’s Comprehensive Health Insurance Scheme.
