Neonatal ductal stenting for Blue baby syndrome

The last day of the earlier year was almost the last day in the life of a precious child.

December 31, 2008. I was eagerly waiting to celebrate the dawn of the New Year. Just then I got a call from the MIOT Center of Children’s Cardiac Care. A newborn’s life was in danger. The mother, Mrs. Malar from Vellore had rejoiced at the birth of her baby girl, after many years of infertility. Her happiness was short-lived – the child was born with the ‘Blue baby syndrome’. The pulmonary valve that allows blood flow to the lungs was totally under developed in the baby – there was no oxygenation in the body and the newborn was struggling to breathe.

Sinking quickly

The baby was rushed to a nearby University Hospital and put on a life saving drug called Prostaglandin. This permits blood supply to the lungs for a short period. Meanwhile the baby developed sepsis, a blood stream infection that posed a high risk for surgery. So, on the last day of the year, when the efficiency of the drug was reducing and oxygen levels were plummeting to critically low levels, the doctors in MIOT were called in. Still, we were determined that the parents of the little baby girl should have a Happy New Year.

A Brave Decision

As soon as the ambulance arrived, we rushed the baby to the cardiac Cath Lab for an emergency procedure. A small stent was introduced through a pinhole in the right groin of the baby to permanently open a duct that would allow blood flow to the lungs. This procedure, Neonatal ductal stenting is not routinely performed worldwide and is extremely rare in India. Any mistake would prove fatal to the baby. Also, the stenting would have to last long enough for the baby to grow to her next surgery. Would we get it right?

We knew the answer, soon enough. The entire Cath Lab team errupted with joy when oxygen saturations shot up to 95% from critical levels of less than 50%. The baby recovered quickly and was discharged on January 2nd .Shortly after her first birthday, we implanted a new pulmonary valve in her heart, solving her problem permanently. Yet every six months, when she visits MIOT, we doctors remember that desperate New Year’s Eve when we helped her make a heroic bid for life.

Dr. K. Sivakumar, MD.DM.DNB
Paediatric Cardiologist
MIOT Centre for Children’s Cardiac Care