Rectified Rare Heart Disease (ALCAPA (Anomalous Left Coronary Artery from the Pulmonary Artery) in 4 month old baby
Since birth Baby Rizan had always suffered from persistent cough and cold. At two months, he was found to have upper respiratory tract infection and 'murmur', and was referred to a cardiologist. An echo cardiogram was advised and it came as a shock to his parents: it showed that their baby had a very rare kind of heart defect called ALCAPA (Anomalous Left Coronary Artery from the Pulmonary Artery) coupled with severe dysfunction of the left ventricle.
Normally, the left coronary artery arises from the aorta. However, in an individual with ALCAPA, it arises from the pulmonary artery. This condition requires surgery to correct it, without which the baby's chances of survival are slim.
When his parents brought little Rizan to Dr Devananda N. S., HOD, Cardio-thoracic and Vascular Surgery, Manipal Hospital, they had almost given up hope of their baby's recovery. On April 30, Dr Devananda carried out the ALCAPA repair surgery, attaching the left coronary artery to the aorta. However, there were complications. Following persistent bleeding, the baby had to be put back on CPB or cardiopulmonary bypass (a technique that temporarily takes over the function of the heart and lungs during surgery), and a small injury in the left auricle roof was repaired. The sternum or breastbone was not closed " only the skin was " and the baby was moved to the ICU. The chest was closed 48 hours after the surgery.
However, there were more hurdles. On the second post-op day, the baby suffered from lung collapse, and required continued ventilation and other supportive measures. Thereafter however, Rizan gradually recovered, and on the fourth post-op day was started on oral feeds.
When he was discharged, Rizan was gurgling like any other four-and-a-half-month old and feeding well; his chest was clear and the wound was healing well. The congenital heart defect that had brought so much suffering to his tiny body was finally a thing of the past.
14 year old born with a rare congenital heart defect and surviving with a blue baby syndrome
Despite all odds and challenges they had to face almost every day since his birth, 14 year old Mohammed Arshad Sheikh's parents never gave up hope. He was born with a rare congenital heart defect (with only about 30% of his left ventricle functioning and both arteries arising from right ventricle) and was surviving with a blue baby syndrome. His case was very complicated and out of surgical limits. No surgeon wanted to touch the boy's heart for fear of making the situation worse. The parents were so persistent that after much deliberation, we decided to take up the case, said Dr Devananda N S, HOD and Consultant, Cardiothoracic and Vascular Surgeon, Manipal Heart Institute.
Dr. Devanand: Both his arteries rise from the right ventricle. In a regular normal heart, the pulmonary artery which carries impure blood to the lungs arises from the right ventricle, while the aorta, which carries pure blood to all parts of the body, arises from the left.
During surgery, the failing left ventricle was switched to low pressure lung circulation and the trained right ventricle was made to take the load of the entire body circulation (the reverse of what happens in a regular person). In addition, load on the sick left ventricle was reduced even further by diverting one third of the impure blood directly to the lungs.
An elated Mohammad Sheik, Arshad's father says, "For the past fourteen years, it wasn't easy to watch my son get bluer day by day. After countless appointments with top cardiac surgeons in the country, finally a hospital in Chennai agreed to operate on Arshad. He was four years old then. But within four months, his condition deteriorated and he was constantly breathless"
"We consulted almost every renowned cardiac surgeon in the country. They asked us to wait and watch for some time. Finally we came to Manipal Hospital and the surgery was done successfully." Dr Devananda said, "This is a unique case and it took us almost 8 hours to complete the entire surgical procedure. Arshad is now doing fine after undergoing strenuous surgery at Manipal Hospital.
Kyphoplasty miracle for the elderly with Spinal Fractures
Mr. Nagesh (name changed), aged 83-years had an accidental slip and fall at home and was unable to get up and even the slightest of movement was very painful in his mid-back. He was taken to the nearby hospital and was diagnosed with wedge compression fracture L1. He was suggested bed rest for 6 weeks and put on anti-osteoporosis medications. After 6-weeks, the patient hardly felt any change in his symptoms and was still unable to even change his position on bed. He was continued on bed rest for another 6 weeks and when his condition was unchanged, he was motivated to take a second opinion. At Manipal Hospital, he was evaluated by an MRI to find that his spinal fracture had not healed. Taking into consideration his age and co-morbidities, the general anesthesia was risky. He was offered an option of Percutaneous Balloon Kyphoplasty under Local Anesthesia and Sedation. He underwent the proposed procedure with complete relief of pain in two hours post-surgery and was able to walk independently. He was discharge home on the same evening. Presently he is going to a nearby park and taking a walk on a daily basis.
Osteoporosis has become a major public health concern worldwide. It is believed that the associated healthcare costs are growing in parallel with increase in elderly population, and it is expected that the number of osteoporotic fractures will double over the next 50 years. The global incidence of osteoporotic spinal compression fractures, also known as vertebral compression fractures (VCFs), is currently estimated at 7,00,000 annually and is expected to increase fourfold over the next 50 years.
VCFs are the most common fractures in patients with osteoporosis. They occur when the bones of the spine break due to trauma, and affect an estimated 25 per cent of all post-menopausal women in the US. VCFs occur in two age groups with different causes. In old people, the commonest cause is osteoporosis of bones followed by metastatic cancers from breast and prostate. In the young, it occurs due to traumatic injury to spine due to vehicular accidents and fall from height.
Kyphoplasty, well known as Percutaneous Balloon Kyphoplasty, is a minimally invasive procedure where balloons are first introduced into the fractured vertebral body through a needle. These balloons are then inflated under pressure to correct the collapse/deformity and create a cavity. Bone cement is then introduced through the same needle into the cavity already created to maintain the position and hold the fractured bone pieces together.
Kyphoplasty treats spinal compression fractures by stabilizing the fracture and reducing back pain. It has additional benefit of restoring vertebral height. As it is a day-care procedure, it has possibility of minimal blood loss, almost immediate mobilization, no need of brace, better reduction of fracture and better control of pain under loading. The success rate of this procedure in relieving pain due to osteoporotic fractures exceeds 90 per cent.
Posterior Lumbar Interbody fusion for senior|Best Spine Surgeon|Manipal Hospital
A 69 year old ale from Nigeria had lower back ache with right lower limb radiculopathy since 5 years diagnosed with Degenerative Spondylolisthesis. He underwent posterior Lumbar Interbody fusion and decompression at Manipal Hospitals. He is now relieved of Pain, Happy with surgery, enroute speedy recovery
"I wish to sincerely thank Dr Vidya and his able team at Manipal Spine Care Centre at Manipal Hospital Bangalore for the professional surgery that was performed with precision on July 16, 2014, which turned out to be a "miraculous" termination of the nagging pains l had been experiencing over the years. Following your positive encouragement and using meticulously the drugs you prescribed, l am assured of permanent wellness. My wife, family and l are very grateful.
We are also very grateful to Sumathi and the staff at the International Patient Care. These are hardworking and diligent public relation staff."