Mumbai Doctors Close Heart Defect In 800-Gram Baby Born At Just 23 Weeks Using Minimally Invasive Procedure
· Free Press Journal
Mumbai: An 800-gram baby born at just 23 weeks of gestation has successfully undergone a minimally invasive heart procedure for patent ductus arteriosus (PDA) at Narayana Health SRCC Children’s Hospital, after spending more than a month on repeated ventilator support at another hospital.
The extremely premature infant was diagnosed with PDA, a congenital heart defect in which an abnormal connection between the aorta and pulmonary artery fails to close after birth. The condition can increase blood flow to the lungs and make it difficult for critically premature babies to come off ventilator support.
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Doctors opt for catheter procedure
According to Dr Priya Pradhan, Senior Consultant Paediatric Cardiologist at Narayana Health SRCC Children’s Hospital, repeated attempts to wean the baby from ventilator support had failed because of the persistent PDA. The medical team decided to close the defect through a catheter-based procedure.
The doctors successfully implanted a Piccolo device, a specialised device designed to close PDA in premature and very low-weight babies. Following the procedure, the infant was shifted to the ICU and subsequently showed significant improvement in respiratory status. The baby was later transferred back to the parent hospital with only minimal ventilatory support.
“PDA usually closes within the first two to three days of life in a full-term baby. However, this baby was born at just 23 weeks of gestation, and the PDA did not close. For this extremely tiny baby, closing the PDA was essential because of the constant requirement for ventilator support,” said Dr Pradhan.
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The procedure presented several challenges because of the baby's extremely low weight. Doctors had to ensure minimal and gentle handling, strict temperature regulation and infection control. Maintaining body temperature while shifting the baby to the catheterisation laboratory was particularly challenging, as the procedure room is maintained at a lower temperature.
The medical team warmed linen, painting solutions, flushing solutions and intravenous fluids to prevent heat loss. Establishing intravenous access was another challenge, with the anaesthesia team playing a key role in preparing the infant safely for the procedure.
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Multidisciplinary team performs intervention
Dr Supratim Sen, fellow cardiologist, assisted Dr Pradhan during the intervention, while a surgeon remained on standby in case catheter-based treatment was unsuccessful.
Dr Pradhan said the case demonstrated the importance of meticulous preparation, multidisciplinary coordination and specialised expertise while performing complex cardiac procedures on extremely premature and low-birth-weight infants.
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