Bloodless heart surgery saves infant
CHENNAI: The joy of having a baby was short-lived for young Deborah of Nigeria when doctors said her daughter, Yvonne Omolola Ariyo, had a hole in the heart and would have to undergo a surgery.
The fact that the family belonged to Jehovah’s witnesses, a community that shunned blood transfusions, complicated matters. But a team of doctors at MIOT hospitals performed a bloodless open heart surgery on 7-month-old Yvonne last week giving her a new lease of life.
When she was 3-month-old, Yvonne started having breathing problems and her growth came to a halt. “She refused to eat and would breathe very heavily. Her name means ‘child is wealth’, but it was very difficult to see her suffer so much when she was so little.” recalls Deborah.
Keeping cost issues in mind, Deborah decided to get Yvonne treated in India and was referred to MIOT where two similar surgeries were done earlier.
When Yvonne landed in Chennai last month she had severe respiratory infections and diarrhea. Tests showed that she was suffering from ventricular septal defect — there was a large hole between the right and left ventricle and blood was getting shunted to the lungs causing congestion.
“It was doubly complicated to do a bloodless surgery on her as she was too young and underweight. So we had to bring her haemoglobin levels up and make some technical adjustments before operating,” said Dr Robert Coelho, chief pediatric cardiac surgeon, who performed the surgery.
Dr Coelho says that he had a tough time counselling the child’s parents.
“There were too many risks involved as Yvonne’s haemoglobin levels were already low but her parents refused a transfusion. Jehovah’s witnesses do not prefer even autologous blood donation, where blood is collected from a patient weeks ahead and banked for later use,” said the doctor.
During the surgery on July 4, the doctors stopped her heart and used a heart lung machine for artificial circulation and made sure the blood did not get diluted. “We used a miniature heart lung machine and prevented excessive priming of blood when it mixed with saline. Haemo filters were used to remove plasma from the blood so the blood cells remain concentrated and also used drugs to control bleeding,” said Dr Coelho.
Smaller incisions were made and the surgery was completed faster to prevent blood loss. Yvonne was resuscitated later and weaned off the ventilator the next day. The baby’s condition is stable and she would return to Nigeria in the next two days. “Blood transfusions have their own liabilities like adverse reactions and transmission of infections like Hepatitis and HIV. So we encourage our patients to go for bloodless surgeries whenever possible,” said Dr Coelho.