Tam Anh Hospital saves the life of a 6-day-old baby with a severe heart defect

On the 8th day after the complicated heart surgery at Tam Anh General Hospital in Ho Chi Minh City, the baby was taken off the ventilator and started to eat milk. The coarctation of the aorta was completely resolved, now there is only a small 2mm ventricular septal defect, which will likely close on its own when the baby is 3-6 months old. The baby was discharged from the hospital, 1 week earlier than expected.

Ngoc Khanh and her husband happily welcomed their healthy baby home after his first major surgery. Photo: Tam Anh General Hospital

4 years after giving birth to her first child, Ms. Nguyen Thi Ngoc Khanh was happy to receive the good news of 2 lines. The journey seemed to be smooth for the mother in her 30s, but then the incident happened when the doctor announced that the fetus had a heart abnormality through a morphological ultrasound in the second trimester. The fetus was diagnosed with hypoplastic aortic arch and severe coarctation of the aorta. This is a serious congenital heart disease, in which the aortic arch does not develop normally but is atrophied. In the fetus, thanks to the ductus arteriosus, the fetus develops almost normally. However, after birth, if the ductus arteriosus closes, the newborn may fall into a state of acute heart failure and cardiogenic shock. If not detected early, closely monitored and treated immediately after birth, the child's life may be threatened.

“When the doctor told me that my child had a congenital heart defect, I was heartbroken, didn't know what to do, couldn't think of anything. But I still hoped that my child's condition was mild. After giving birth, I heard that my child had to have surgery within 7 days and spent 5 hours on the operating table. My husband and I hugged each other and cried, feeling sorry for our child because he was so young," said Nguyen Thi Ngoc Khanh, the patient's mother.

Dr. Nguyen Ba My Nhi - Director of the Obstetrics and Gynecology Center, Tam Anh General Hospital, Ho Chi Minh City said: "The pregnant woman was very lucky to detect the congenital malformation early. Thanks to that, we have a plan to closely monitor her throughout the pregnancy. A very detailed protocol was established with the coordination of many specialties including Obstetrics, Anesthesia - Resuscitation, Pediatrics - Neonatology, Cardiology and the entire Cardiovascular Surgery system... to welcome the baby to birth safely and quickly intervene to repair the heart" .

On April 21, Ms. Khanh gave birth by cesarean section at nearly 39 weeks of pregnancy. The baby cried loudly after birth, with pink lips, and was immediately transferred to the neonatal intensive care unit for respiratory support, to keep the SpO2 index (oxygen saturation) above 95%, ensure hemodynamics, and detect conditions that could cause the baby to have heart failure, cardiogenic shock, etc. as soon as possible. Doctors also established a special nutritional care regimen to ensure the baby's health as he entered his first major surgery.

MSc. Dr. Nguyen Minh Tri Vien - Surgeon at the Cardiovascular Center of Tam Anh General Hospital, Ho Chi Minh City, said that the baby had aortic arch stenosis, so when the ductus arteriosus closed, the baby was at risk of lack of blood supply to important organs such as the liver, kidneys, intestines, lower limbs, etc. If not detected and treated promptly, the child would almost certainly not survive. Therefore, surgery should be performed on the baby as soon as possible.

“We chose to perform the surgery within a week after birth so that the baby's organs could mature and his health could stabilize, creating the foundation for a safe surgery,” said Dr. Vien.

The doctor set up an extracorporeal circulation system for the surgery. Photo: Tam Anh General Hospital

The biggest difficulty is that the baby is still very young, only 6 days old and weighs less than 3kg. The baby's blood vessels are very small, requiring doctors to have very high microsurgery skills. In particular, babies under 2 weeks old face the risk of affecting the function of the heart, kidneys, and lungs when the organs are not yet stable.

The anesthesia, surgery, and post-operative resuscitation stages were all carefully prepared for the surgery to go smoothly and safely. After 5 hours of careful consideration, the doctor successfully cut and reconnected the narrowed area, and the aortic coarctation was widened. The baby was transferred to the intensive care unit for post-operative care.

The first three days, the baby's hemodynamics were unstable, requiring very high doses of vasopressors and intensive care via mechanical ventilation. On the fourth day, the baby's condition stabilized, the cardiac support drugs could be gradually reduced, and kidney function recovered, the baby began to produce urine and was able to urinate on his own.

On the 7th day, the baby was completely extubated and had much less vasomotor activity. On the 8th day, the baby left the resuscitation room and was transferred to the neonatal department.

On May 17, 20 days after the first heart surgery, the baby was breathing on his own, breastfeeding well, and was discharged from the hospital.

MSc. Dr. Van Thi Thu Huong - Cardiovascular Center, Tam Anh General Hospital, Ho Chi Minh City informed: "Resuscitation after heart surgery is already complicated, now it is even more difficult when the patient is a baby just a few days old. Therefore, we have to be very careful and thorough. If just one of the baby's organs is damaged, it will affect the baby's entire body as well as its vital functions. From the concentration of drugs, the baby's nutritional fluid..., we have to calculate very carefully, at the same time closely monitor the blood vessels, temperature, SpO2..., ensuring that no mistakes occur" .

The baby was cared for at the Neonatal Center and gained weight well (reaching nearly 3.2 kg at the time of discharge). Photo: Tam Anh General Hospital

Master, Doctor Nguyen Minh Tri Vien said that the success of the surgery came from many factors. First, Tam Anh General Hospital has a full range of specialties. The interdisciplinary cooperation took place very well in the spirit of mutual support to bring the best results for patients. Second, the hospital is equipped with the most modern machinery, from diagnostic imaging equipment such as MRI, MSCT, ultrasound..., surgical equipment to anesthesia and resuscitation equipment such as ventilators, circulatory machines... Finally, the high level of expertise of the medical team helped closely monitor the baby's condition from the time in the womb, after birth, during surgery, the postoperative period and closely monitor health later.

Thu Ha

Source: https://www.congluan.vn/benh-vien-tam-anh-cuu-song-em-be-6-ngay-tuoi-mac-di-tat-tim-nang-post248814.html