2-year-old with 25 per cent heart function gets new lease of life with complex surgery

New Delhi, Jun 4 (PTI) A two-year-old child from Iraq with just 25 per cent heart function due to advanced Kawasaki disease underwent a five-hour surgery at a private hospital, officials said.

The coronary artery bypass graft (CABG) surgery was performed at the Medanta Hospital in Gurugram on the child from Iraqi Kurdistan who had developed life-threatening coronary complications.

Kawasaki disease, also known as mucocutaneous lymph node syndrome, is an inflammatory condition that affects blood vessels in children under the age of five and can severely damage the heart, said a statement from the hospital.

This can lead to serious heart complications, with around five per cent of affected children developing large coronary artery aneurysms and severe vessel narrowing, it added.

The child was diagnosed with Kawasaki disease when he was eight months old. His condition progressively worsened. He became breathless, was fatigued easily and was unable to play with other children.

Doctors at Medanta found his heart function had dropped to just 25 per cent and imaging revealed severely dilated and blocked coronary arteries.

A CT coronary angiogram confirmed aneurysms and complete blockages of both left and right coronary arteries, while a PET scan showed hibernating myocardium -- areas of the heart muscle receiving inadequate blood flow but still viable.

A team led by Dr Anil Bhan, chairman, Cardiac Surgery, Cardiac Care, Medanta, Gurugram opted for a rare surgical approach -- coronary artery bypass grafting using both internal thoracic arteries (ITAs).

The internal thoracic arteries (ITAs) are preferred in such surgeries because they grow as the child grows and remain functional for life, the statement added.

"Kawasaki disease is not very rare but advanced coronary artery involvement requiring surgery is uncommon in children. The challenge in this case lay not just in the small size of the child's arteries but in the fact that both the left and right coronary arteries were severely diseased," he said.

Explaining the procedure, he said the surgery involved using both internal mammary arteries (IMAs) as grafts, which is technically complex.

"We harvested the arteries and created new pathways to restore blood flow to the heart. The five-hour procedure required meticulous precision," he added.

The child's heart function is steadily improving and his energy levels have increased. The medical team expects his cardiac health to continue improving in the coming months, allowing him to lead a more active and normal childhood. No second surgery is anticipated to revise or remove the graft, it said.

This was the second youngest Kawasaki-related coronary artery bypass surgery performed by the senior doctor, the first being in 2008 on a one-and-a-half-year-old child, which was at the time recognised in world literature as the youngest CABG ever done, the hospital claimed. PTI SLB SLB KSS KSS