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Hybrid Procedure for Vsd Closure on Four Month Old Baby

Team of docs at Sahyadri Hospitals perform hybrid procedure for VSD closure on four month old baby.

  • One of the smallest baby hybrid interventions in Maharashtra.
  • Hospital helps arrange funds for the treatment.

Pune July 21: A team of doctors at Sahyadri Super Speciality Hospital , Deccan recently conducted a hybrid procedure on a four month old 4.2 Kg baby for VSD closure.

This is one of the smallest baby hybrid interventions in Maharashtra and a complicated one with a 12mm muscular VSD device being deployed / implanted across the defect for the closure.

( A ventricular septal defect (VSD), a hole in the heart, is a common heart defect that’s present at birth (congenital). The hole (defect) occurs in the wall (septum) that separates the heart’s lower chambers (ventricles) and as a result allows blood to pass from the left to the right side of the heart. Thus the oxygen rich and oxygen poor blood mix with each other and cause significant issues to baby.

Explaining the case Cardiac surgeon at Sahyadri Hospitals , Dr Rajesh Kaushish and interventional Paediatric cardiologist Dr Pankaj Sugaonkar said that a four month fifteen days old baby who was diagnosed to have large 10 mm Midmuscular VSD at day 10 of life was brought to us by his parents with complaints of recurrent cough and cold . The baby was 4.2 kg and was not gaining weight. Initially the boy was undergoing medication but without any effect and sign of improvement.

Interventional pediatric cardiologist Dr. Pankaj Sugaonkar said that VSD closure was necessary and we opted for a hybrid approach.The hybrid approach is a fairly recent technique/ modality where cardiac surgeons and interventionalists collaborate thereby facilitating vascular access , avoiding pulmonary bypass and its complications.

Cardiac Surgeon Dr Kaushish performed sternotomy , after that puncture was taken at the center body of Right ventricle . The rest of the procedure which included a complicated procedure of implanting the device was done by a team led by interventional pediatric cardiologist Dr. Pankaj Sugaonkar. To close the 10mm muscular VSD , a 12 mm muscular VSD device was deployed defect under epicardial echo guidance which was one of the major challenges in the procedure. The other important aspect of the procedure was that we did not use the regular heart lung machine and did the procedure on beating heart. This small baby was extubated ( ventilation removed ) within three hours and kept in IcU for two days under observation said Dr Sugaonkar.

Regular percutaneous VSD device was not possible because larger size of sheath required to close such defects which was not possible in small baby.

The team consisted of Interventional Pediatric Cardiologist Dr. Pankaj Sugaonkar, Cardiac surgeon Dr Rajesh Kaushish, cardiac anaesthetists Dr. Shantanu Shastri, Dr Suhas Sonawane and Dr Priti Adate, Paediatrician Dr Prashant Khandgave, nurses and sisters in the OT and post-operative team.

Since the family was not in a position to pay for the surgery and treatment, a team at Sahyadri Hospital Deccan Unit led by social worker Shilpa Mahajan helped arrange for funds.

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