Free Complex Pediatric Heart Surgery On Blue Child

In Covid 19 Era Dr Ashwani Bansal, AIIMS trained pediatric heart surgeon along with his skilled team has performed a complex pediatric heart surgery under Ayushman scheme on a 9 kg (2.5 years) BLUE child. 
Parents of the kid were from poor socio economic background and were not charged any money for this complex operation.  

At NABH accredited Indus International hospital, we routinely accept Ayushman cards for even high risk cardiac surgery cases. This case was special as facility of complex pediatric heart surgeries under Ayushman scheme are not available outside government centres. 
In this time of COVID pandemic, government facilities are overburdened and heart surgery patients are suffering due to long waiting list. Father of this child has also suffered for two long years, he went from one government centre to another but the surgery could not be done. 
Child got malnourished due to long pending heart surgery as evident from his 9 kg weight at 2.5 years age. He started getting more blue day by day and parents were extremely worried for their only child,briefed Dr Ashwani at Chandigarh Press Club.

After surgery now the child has become pink, he is now eating better than before and his breathing pattern has also normalised. Father is happy to see his child smiling for the first time in this 2.5 years. 
TEAM Dr Ashwani Bansal, Chief adult & pediatric heart surgeon, MCh CTVS (AIIMS Delhi) Dr SPS Bedi, Director Clinical Services MD,AnesthesiaDr Ranvijay Rana, Neonatologist and PICU incharge, MD (Pediatrics) Dr Jogesh Aggarwal, Intensivist incharge, MD Anesthesia (PGI, Chd) Many of OT staff, medical officers and trained nurses.

Dr. Ashwani Bansal, has received more than 13 years of exhaustive training at AIIMS Delhi. He has experience of more than 16000 cardiac surgeries including very complex pediatric and neonatal heart surgeries. He has also received training in Europe for Minimally invasive heart surgery. He headed department of cardiac surgery in SIMS  hospital Bengaluru before joining Indus International hospital, Derabassi Mohali (Punjab) in April 2019. 

• From which disease child was suffering ?TOF (Tetrology of Fallot), in this disease child  has hole in heart and blood flow to lungs is reduced. This disease is present since birth but child gradually becomes more and more blue as treatment is delayed.
• Why TOF is called complex heart disease ? Blood flow to lungs is limited in this disease, so child has very less oxygen levels in body. This lead to abnormal blood clotting, damage to lungs or even to brain many times. Growth of such children is retarded. Surgical correction is challenging as hole in heart of these children is not easy to close, it require special skills and lot of patience for perfect closure. Restoring blood flow to lungs also require detailed pre operative planning and perfect execution in OT.  Even in best centers of world, this disease carries 3 times higher mortality than routine pediatric heart surgery operation. 
• Why facilities for such operation are limited ? Surgeon alone is not sufficient to give best outcome for such complex heart surgery. For pre operative planning, cardiologist needs to do detailed echo. He identifies area where blood flow is restricted to lungs and guide for surgical planning. Pediatrician need to optimize nutrition of child. In OT trained anesthesia team is required to put lines for this small child. Even after surgery anesthesia team has very active role in management. Pediatric ICU incharge and trained nurses team are important for care of child after surgery. Such facilities cost huge amount of money to establish and most parents are not able to pay for them.
• What are other common pediatric heart diseases, which require surgery ? ASD (atrial septal defect) – child will have frequent cough, fever  and poor weight gain VSD (ventricular septal defect) – child will have recurrent pneumonia and often require admissions for iv antibiotics PDA (patent ductus arteriosus) – large PDA will lead to increase in lung pressure and breathing difficulty
• How is Indus International hospital, Derabassi is equipped for dealing such cases Pre operative planning – we have latest echo machine, trained cardiologist and radiologist for help in diagnosis OT management – Our anesthesia team is trained for such complex pediatric heart surgery cases. Equipments in theatre are specially procured for this pediatric age group. For running bypass machine we have AIIMS trained perfusionist. Post op management – Our pediatrician has received special training for pediatric ICU management and his team of PICU staff is fully trained for handling complex pediatric cases.
• Other heart surgery facilities at this centre ? Bypass heart surgery Heart valve replacement and repair surgery Aortic root surgery like Bentall operation Lung surgery like Hydatid disease, Apergillosis, lung tumor resection.