[Ramesh]

Hello everyone,

This is for you information that doctors at an Indian hospital AIIMS successfully operated on the eight-day-old infant who was born with a rare medical condition with his heart protruding out of his chest.

After a three-and-a-half-hour-long surgery, doctors said that the procedure was successful and the condition of the baby was stable.
"The baby has been shifted to the ICU after the surgery. His condition is stable but this is a critical phase. “We have to see how he responds to the surgery. Every minute is important," Dr A K Bisnoi, cardiothoracic surgeon, AIIMS, who led the team, said. He said, "Only when he goes back home hale and hearty, can we conclude that this is a successful path-breaking surgery in the history of AIIMS."
Born on August 26, the infant was brought to the hospital by his parents, hailing from Bihar, with his heart protruding out of the chest. The condition is known as Ectopia cordis* in medical terms.

Wrapping the baby in a dirty cloth by his parents led to septicaemia* which further complicated the condition. Detailing about the surgery, Dr Bisnoi said, "We decided to do the surgery without suspending his body functions as was planned earlier. As there was no space in his body to accommodate the heart, we created a window between the chest and abdomen to place the heart. Then gradually rotated the heart and put it back in the newly created space."
Doctors had earlier planned to put the baby on a heart-and-lung machine and lower his body temperature to 18 degrees Celsius, thereby suspending his body functions for 30 minutes.

"Our biggest achievement is that this child has survived for eight days. Generally, babies born with such conditions die immediately after birth," Bisnoi said. "Worldwide, 230 such cases have been reported and only three have survived this condition," he said.
With this, the institute has conducted fifth such surgery. The team of doctors which conducted the surgery included a paediatric anaesthetist, a paediatric surgeon and a cardio-thoracic surgeon.


* Ectopia cordis is a birth defect wherein the heart is abnormally located. It occurs in five to nine cases per million births and the mortality rate is very high.

*Septicaemia- What is septicaemia?

Septicaemia is a potentially life-threatening infection in which large amounts of bacteria are present in the blood. It is commonly referred to as blood poisoning.

What causes it?

Septicaemia usually arises as a result of localised infection in the body. The primary site of infection may occur in the respiratory system, the skin, the gastrointestinal system or the genitourinary system. It may coincide with very aggressive infections such as meningitis.
Bacteria usually spill over from the primary infection site into the blood and are carried throughout the body thereby spreading infection to various systems of the body.

Infection spreads throughout the body via the blood stream.

What are the symptoms?

The affected person may have symptoms of the associated condition that triggered the septicaemia such as symptoms of pneumonia or severe urinary infection.
The condition usually begins with fever and chills. Drenching sweats may occur. The heart rate and respiratory rate (number of breaths per minute) rise in association with the rising fever. The affected individual will feel very ill indeed with profound feelings of weakness.
As the condition evolves the person may begin to feel very cold and clammy. The blood pressure starts to fall and the person may lapse into unconsciousness.
The skin becomes very pale and the person may exhibit petechiae. Petechiae are tiny spots on the skin, which do not blanch when a glass tumbler is applied to the skin.

How is it diagnosed?

Septicaemia requires admission to an acute general hospital and may necessitate admission to an intensive care unit. The definitive test for diagnosing the condition is called a blood culture. This involves the taking of a small sample of blood and incubating it in the laboratory. If septicaemia is present bacteria will be detected and these can be studied further to establish which antibiotics will be effective against them.

How is it treated?

Septicaemia is a rapidly progressive condition and the sufferer usually looks very ill even to the non-medical person. If the person does not receive urgent medical care the condition can evolve very rapidly into irreversible toxic shock.
Septicaemia usually requires intravenous treatment. This facilitates the speedy administration of antibiotics and other drugs. Intravenous fluids also help to maintain the blood pressure.

It is necessary to begin antibiotic treatment while waiting for the blood culture results. Broad-spectrum antibiotics are usually used, which are antibiotics that are effective against a wide variety of bacteria. Once the results of the blood culture are available the antibiotic being prescribed may be changed to one more specific for the particular bacteria causing the septicaemia.

Ramesh

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[admin]

Hello Ramesh

For your information. The 20 day old baby which did not even have a name died yesterday. This operation may not have helped the baby. Any way that's life. And yes this is an ECP forum and we would appreciate if members at the forum stick the topic of IECP.

Thanks for all the posting

Admin