Jaipur, 12 April, 2019.
In yet another first, Fortis Escorts Hospital in the city has conducted a Pulmonary Root Transfer (PRT) surgery on a Master Manish, a 2.5-year-old child suffering from transposition of the great arteries (TGA) with a ventricular septal defect (VSD) and pulmonary stenosis (PS), a rare and complex mix of congenital diseases, found in only 2 per cent of the children suffering from heart diseases.
He was brought to the emergency of the hospital with acute breathing problem and reduced food consumption, and was diagnosed (with TGA VSD PS ) that hinders the functioning of the heart and lungs. The oxygen supply to the system was poor and, consequently, the body had turned blue,. Thanks to his alert relatives and the concerted efforts of the doctors of the paediatric ward at the hospital, Master Manish underwent the path breaking surgery in time and recovered completely.
Manish was brought to the hospital post the symptoms of blue body were apparent. Earlier, with the diagnosis he would required three to four operations with interval that would have put unnecessary burdens like financial risk, emotional trauma, health risk and social trauma on the patient and his family. Yet, modern healthcare has evolved to such an advanced state that revolutionary surgeries such as Pulmonary Root Transfer (PRT) have saved countless lives at one go.
“Pulmonary Root Transfer (PRT) has become popular across the world in past few months and we are proud to introduce this world-class surgical process in Rajasthan. This a peerless procedure was administered in this sensitive case, to reduce the risk factors and increase the chances of a rapid recovery. In India, for every 100 children suffering from heart diseases, 2 children suffer from TGA VSD PS, making it a burgeoning issue, especially when it comes to diagnosis. Earlier, treating such conditions would have required 3 to 4 surgeries, spanned out over years, that led to a prolonged life of difficulty, especially for the families. PRT reduced it to a great extent. During the surgery, we did not face any complications and the patient was discharged in 7-8 days” says Dr Sunil K Kaushal, Director, Paediatric Cardiac Surgery, Fortis Escorts Hospital, Jaipur.
Transposition of the great arteries is a congenital heart defect that occurs due to abnormal development of the foetal heart, during the first 8 weeks of pregnancy. This results in an improper connection of the large vessels that carry blood from the heart to the lungs and to the body. Transposition creates a situation where the systemic (to the body) and pulmonary (to the lungs) circulations are in parallel rather than in series, creating a state of malfunctioning of the body. A collection of subsequent heart issues often follows. About 25 per cent of children with transposition will also have a ventricular septal defect (VSD) and in nearly a third, the branching pattern of the coronary arteries as they leave the transposed aorta is unusual. Such cases are known to have conditions of narrowing below the pulmonary valve that blocks blood flow from the left ventricle to the lungs.
“After a Pulmonary Root Transfer surgery, there are 80- to 90% per cent changes that the surgery will not require. We use natural tissues, i.e. patient’s own viable tissues, in PRT whereas, in earlier surgeries, artificial materials were used. After the procedure of PRT, the patient can lead a regular life, which was not possible in earlier surgeries as patients were often socially handicapped due to the perception in people around them and did not allow their child to play or eat as per wish, and always feared of adverse consequences). We are the first to roll out this surgery in Rajasthan and the positive recovery has added another feather on our cap,” says Dr Kaushal.
The survival of children with transposition has improved dramatically over recent decades. When there are no unusual risk factors identified, over 95 per cent of infants successfully undergo surgery in the newborn period. In later years, patients with the arterial switch operation have good quality of life and usually can participate in physical activity and sports without any difficulty or restrictions.