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First Critical Congenital Heart Defect Repair in Maldives. Coarctation of Aorta

June 30, 2020

First Critical Congenital Heart Defect Repair in Maldives: Coarctation of Aorta

On 21st of June, ADK Hospital received a 12 day old baby with a diagnosis of severe, critical Coarctation of Aorta; a life-threatening congenital cardio-vascular defect.
Coarctation of Aorta is a narrowing of the main blood vessel outlet from the heart. This defect is often found after the origin of branches that supply blood to the head, neck and arms. The narrowing causes limitation of blood flow to the lower part of the body and vital abdominal organs. The body tries to compensate for this by increasing blood pressure to try to force blood flow through the narrowed segment in the Aorta. The heart work in the strained condition, risking heart failure. The upper part of the body is thus exposed to critically high blood pressure while the lower half has lower blood pressure and in critical Coarctation, compromised blood flow. Both the high blood pressure in the upper part of body and the lower pressure in the lower part of the body could potentially cause organ system damage from bleeding and low perfusion respectively.
Most incidents of Coarctation of Aorta are not identified in antenatal scans. Babies are often well at birth and show little or no symptoms. They are detected by careful, specific screening examination that include measurement of both oxygen level and blood pressure in all 4 limbs. The difference in blood pressure of the upper versus the lower limb is the indicative feature of Coarctation of aorta. The diagnosis is confirmed by a detailed echocardiography.
On arrival to ADK Hospital, critically compromised blood flow to the lower body was confirmed. Baby was prepared for urgent corrective surgery and care managed by a multidisciplinary team led by Cardio-Thoracic surgeons supported by Pediatric Cardiologist, Anesthetists, Perfusionist, Pediatricians, Cardiac Theater team, CCU team and NICU team.
With the grace and blessings of Allah, the surgery was completed by resecting the constricted segment and primary repair with end-to-end anastomoses augmented with a PTF patch. Good blood flow to the lower half of body was achieved and blood pressure gradient corrected.
Baby was initially managed in CCU by the multidisciplinary team using cardiovascular and respiratory life-support. Following gradual weaning from life-support and intensive care, baby was transferred to NICU where he is in the final phases of recovery.

Cardithoracic and Vascular Surgeons 

    - Dr Mohamed Shafiu
    - Dr. Kaushal Kishore Tiwari


    -Dr. Dusooma Abdul Razzag
    - Dr. Puja Sharma


    - Mr. Sujit Bamne

Pediatric Cardiologist:

    - Dr Aishath Eleena


    - Dr Abdulla Niyaf
    - Dr Santosh Adhikari

24h Cardiac Medical Officer team

Nursing team:

    - HITECC OT Cardiac Surgical Nurses
    - Cardiac Critical Care Nurses
    - Neonatal Intensive Care Nurses


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