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Mar 16, 2009

15mm Dia Hole In The Heart

Pandeswari (second left) with Chief Cardiac Surgeon S.K. Varma (left) at the K.G. Hospital after the surgery. Heart surgeons at the K.G. Hospital in the city have performed what they call a risky surgery for more than six hours to close a hole of 15 mm diameter in the lower chamber of a 14-year-old girl’s heart.


The girl, Pandeswari, who hails from a village near Theni in the southern part of the State had been suffering from perimembranous ventricular septal defect -- a hole between the lower chambers of the heart since birth. Hospital Chairman G. Bakthavathsalam has said in a press release that the girl had undergone two surgeries to correct this defect at another hospital. After the first surgery in March, 2004, symptoms of congestive cardiac failure resurfaced. She was examined again in the same hospital and was told that she had an additional muscular ventricular septal defect, apart from the one closed earlier. She was operated again in that hospital in 2005 and the additional defect was closed.



Pandeswari developed symptoms of congestive heart failure again. She underwent further tests and was told that she had a large residual muscular ventricular septal defect and was again advised a costly high risk operation. As the precise location and size of the residual hole was not clear on echocardiography and cardiac catheterisation, the family members were warned that the third operation might not be a success. The family was also informed that the location of the residual defect was such that access to it and precise surgical closure was uncertain.



With all their financial resources drained and two previous failures haunting them, the patient and her parents approached K.G. Hospital for a second opinion in January this year. She was investigated by a multi-disciplinary team of specialists. Along with routine tests such as echocardiography, she underwent a cardiac magnetic resonance imaging (MRI). The precise location, size and other important details about the residual defect were accurately delineated. The residual defect measuring about 15 mm in diameter was found to be a rare “flap valve defect”, which was evident only on the cardiac MRI. Its exact location and borders were not seen clearly with the help of routine echocardiography or cardiac catheterisation.



Dr. Bakthavathsalam said he discussed the case with a team of cardiologists, cardiac surgeons, cardiac anesthesiologists, cardiac radiologists. Considering her background, Pandeswari was enrolled in the Chief Minister’s free heart surgery scheme and the entire procedure was done free of cost. A team led by Chief Cardiac Surgeon S.K. Varma corrected the flap valve defect in the surgery on February 7. The release said the patient was making a speedy recovery. The surgeon said precise imaging facility and a skilled team of doctors helped in detecting and correcting the problem.

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