In an extraordinary feat of medical excellence and a testament to the brilliance of pediatric cardiac surgery, surgeons at SafeMedTrip’s prestigious network hospital laboured for five hours to save the life of a two-year-old boy from Iraqi, diagnosed with a rare and severe form of Kawasaki disease.

At just two years of age, this young warrior’s heart had been ravaged by advanced coronary artery disease, with a staggering 75% loss in heart function. A five-hour surgery, involving an unorthodox yet life-saving approach, unfolded—a coronary artery bypass grafting (CABG) using both internal thoracic arteries (ITAs), a technique scarcely employed in pediatric cases.

Kawasaki Disease: A Silent Destroyer of Childhood Hearts

Also known as mucocutaneous lymph node syndrome, Kawasaki disease is an inflammatory affliction that predominantly targets blood vessels in children under five. Its ferocious ability to damage coronary arteries can lead to catastrophic heart conditions, with a disturbing 5% of children developing giant coronary artery aneurysms and severe arterial narrowing. The disease’s origins remain mysterious, though many suspect it arises from an abnormal immune reaction to an infection, triggering widespread inflammation.

For this particular child, diagnosed with Kawasaki at a tender age of eight months, the road to recovery was riddled with uncertainty. Initial treatments offered some relief, but his condition deteriorated rapidly. Breathlessness, overwhelming fatigue, and an inability to engage in normal play isolated him from his peers. Consultations with local doctors led to a pivotal decision: a referral to one of India’s foremost cardiac hospitals for advanced pediatric care.

Heartbreak at Two: A Deteriorating Lifeline

By the time this little patient reached the hospital, his heart was failing at an alarming rate. A battery of tests revealed severely compromised heart function—his left ventricular ejection fraction (LVEF) had plummeted to a perilous 25%. CT coronary angiography painted a grim picture, revealing massive blockages and aneurysms in both the left and right coronary arteries. Furthermore, a PET scan illuminated regions of the heart muscle—where blood flow had ceased—yet still held the potential for revival, a phenomenon known as hibernating myocardium.

Faced with the formidable challenge of addressing both complete coronary artery blockages and a heart rapidly losing its ability to function, the surgical team—led by top pediatric cardiac experts—decided on a pioneering approach: coronary artery bypass grafting using both internal thoracic arteries. This technique, rarely attempted on such young patients, would be crucial in restoring the heart’s lifeblood.

World Class Brilliance of Paediatric cardiac surgery in India: Double Artery Bypass on a Tiny Heart suffering from Kawasaki Disease

In adults, using internal thoracic arteries (ITAs) for bypass is a well-established method, but performing it on a child presents a unique set of challenges. Children’s arteries are tiny, their growth rapid, and their hearts require long-term solutions that can adapt as they grow. The internal thoracic arteries, however, are favored for their ability to grow alongside the child, providing a reliable, lifelong graft.

What made this case even more exceptional was the need to utilize both internal mammary arteries (IMAs)—an intricate maneuver almost never undertaken on pediatric patients due to the complexity of the procedure. The meticulous five-hour surgery required a level of microsurgical precision, with every move calibrated to ensure the grafts would hold, ensuring blood would flow efficiently through the newly created pathways.

A Heartfelt Success Against the Odds: Child’s Life Restored

Against all odds, the surgery was a resounding success. Postoperative imaging confirmed the restoration of healthy blood flow to the heart, signaling a new lease on life for this brave young patient. As the days passed, his heart function began to improve steadily, and the child’s once-weak body showed signs of vitality. His energy surged, as he began to engage in activities that had previously been unthinkable. The medical team, while cautiously optimistic, expects continued recovery in the coming months.

Most Advanced Paediatric Cardiac Treatments in India

India offers some of the most advanced and affordable pediatric cardiac treatments in the world, with expert teams specializing in congenital heart defects found in newborns, infants, and children. Successful outcomes rely on experienced surgeons, nurses, and support staff, as well as psychological care for both patients and families throughout the treatment process.

Common conditions treated include Atrial Septal Defect (ASD), Ventricular Septal Defect (VSD), and Tetralogy of Fallot (TOF). ASD can be treated with traditional open-heart surgery or minimally invasive transcatheter closure, offering faster recovery. VSD, a hole between the heart’s ventricles, can also be treated through open surgery or catheter-based techniques, helping restore normal heart function and growth. TOF involves multiple defects and is the most common complex congenital condition treated.

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