New Delhi: Doctors at Fortis Escorts Heart Institute, Okhla successfully conducted a rare procedure to save the life of a 1.5-month-old newborn weighing mere 1.8 kgs, who was suffering from patent ductus arteriosus (PDA) – a hole in the heart. The team of doctors led by Dr Neeraj Awasthy, Director, Paediatric Cardiology at Fortis Escorts Heart Institute, Okhla conducted the procedure by using the Piccolo Device closure to seal the hole, saving the newborn’s life.
Traditionally, PDA closures are surgical, but in this case, a non-surgical method was adopted due to the newborn’s multiple comorbidities and critical condition, which made surgery too risky. The procedure lasted an hour, and the patient was discharged after four days in a stable condition.
Upon admission to the hospital, the newborn was in a critical condition, had trouble breathing with symptoms of sepsis, exhibited symptoms of heart failure, increased heart rate, excessive sweating, not able to feed, liver enlargement along with failure to gain weight. An echocardiogram revealed PDA. In most babies who have an otherwise normal heart, the PDA will shrink and close on its own in the first few days of life. If it stays open longer, it may cause extra blood to flow to the lungs, thus causing multi-organ dysfunction. Despite being administered antibiotics and other medications, the newborn’s condition continued to deteriorate due to respiratory distress. Post which the doctors adopted a Piccolo Device closure procedure, a challenging procedure considering her low weight with associated features of sepsis. The procedure was successful and in follow-up after six weeks, the child was doing well, had gained weight and exhibited normal cardiac functions.Giving details of the case, Dr Awasthy said, “Patent Ductus Arteriosus is a congenital condition in children and is often underdiagnosed. This condition in infants can lead to blood stealing from systemic circulation, causing multi organ dysfunction. In this case, the baby was in very critical condition with a very low weight. The challenge here was to consider for closure of the hole at such a low weight with associated features of systemic inflammation. However, in this case, we chose to opt for PDA device closure that helped close the hole without surgery. There are a very few high-risk cases where this particular procedure has been performed. Had the child not been treated on time, it would have been difficult to save her life. Similarly, Another newborn with 1.6 kgs body weight with huge PDA 3.5 mm had presented with breathing difficulties in heart failure underwent Piccolo Device closure and was discharged post successful treatment.”Dr Vikram Aggarwal, Facility Director, Fortis Escorts Heart Institute said, “This case was challenging considering the age and critical condition of the newborn. Despite all the odds, the patient survived, owing to the correct medical assessment and successful procedure.”
