Five-Year-Old with a Hole in His Heart and Leaking Valve Treated in a 10-Hour-Long Surgery
Five-year-old baby Moe with parents. (Photo Credit: Apollo Hospitals)

Five-year-old baby Moe’s parents would have never thought that they will have to revisit India for treatment of their little one. But this time again, Dr Muthu Jothi, Senior Consultant, Pediatric Cardiothoracic Surgeon, Indraprastha Apollo Hospitals along with his team came to their respite by successfully treating their child. Baby Moe, a resident of Myanmar, had a big hole in his heart with a leaking valve on the left side of the heart since the time of his birth. The same was treated 2.5 years back after which baby Moe recovered very quickly and returned to his country with his parents. But, last year in September he suffered from high fever again because of infection on the mitral valve and high pressure in the lungs. Delhi AIIMS Puts Four-Month-old Baby With Hole in Heart in Waiting, Asks to Come in 2023 For Surgery. 

Explaining about baby Moe’s complications Dr Muthu Jothi said, “I had operated Moe around two and half years back because he had a big hole in his heart. Apart from this, there was a leakage in his mitral valve which was repaired. Post this, his condition improved and he went back to his country, but last year in September, he again had a high fever. Post investigation by the doctors in Myanmar, it was found that the repaired mitral valve was severely infected. After consulting with us, local cardiologists gave him intravenous antibiotics for six weeks to stabilise his infection and to prevent it from spreading further. This made him well enough to travel to India, and for this, the support that we got from doctors in Myanmar is really applaudable.”

“When Moe came to our hospital in December last year his heart was grossly enlarged. There was a severe leak in the mitral valve (left side of the heart). The right side of the heart was also dilated, and there was a leakage in the tricuspid valve (right side of the heart) too. When this happens whatever blood goes to the left ventricle, which is the main pumping chamber, comes back to the left atrium and lungs. Due to this, the pressure in his lungs was very high, almost equal to the body pressure. In normal cases, the pressure in lungs is just 1/5th of the body pressure. He couldn't breathe properly, and his heart increased nearly to two and half times of a normal heart. So, the only option left was to replace the left-sided valve and repair the right one. This surgery involved high risk, and this was well explained to Moe’s parents also,” Dr Jothi further added.

Talking about the complexity of the surgery, Dr Jothi further said, “His heart was so enlarged that it was right below the sternum, or the chest bone. To reopen the chest bone, we used an electric saw, and there was a huge risk that the saw might hit the heart because it was hugely dilated. For the very first time, we did a bypass in a small baby by cannulating the groin blood vessels. The baby was connected to the heart-lung machine to reduce the size of the heart and to open the chest. But, to our surprise, the heart was still badly stuck to the back of the sternum, and it took us almost two hours just to open the chest without injuring the heart. There were areas where the heart was stuck to the under the surface of the bone and using very fine knife we had to shave off the heart from the under the surface of the sternum and then had to dissect out all the heart tissues. We replaced the valve which was grossly infected and leaking with a prosthetic valve, and we also repaired the right side of the valve. The surgery took us almost eight to ten hours.”

“He had a very stormy post-operative course. He had a lot of rhythm problems with his heart. His heart rate was going up to 200 to 220 beats per minute sometimes. On the second day after the operation, we had to shock him 20 – 25 times to get him back to his normal rhythm. He was on heavy medications to control the heart rate and was on a ventilator for nearly a week. But now, after staying in the hospital for another week, the child’s condition has improved. He is eating properly and is responding well to the treatment course. He has also put on some weight. The child needs to be on medication for at least six more months, and echo should be done on a regular basis,” Dr Jothi added.

Mr Aungmyowin, the father of baby Moe, said, “I am really thankful to Dr Muthu Jothi who once again saved my child. Doctors in Myanmar told me that my child has a severe infection in heart and he needs to be operated urgently. I got in touch with Dr Jothi who had earlier operated on Moe. He told me that he needs to undergo heart surgery again, but it will involve a very high risk. But, I had full confidence in him and knew that only he could save my child. Today, if my child is alive and well, it is due to the tireless efforts of Dr Jothi and his team at Apollo hospital.”