Fortis Hospitals Mulund (formerly Wockhardt Hospitals) performs complex beating heart coronary artery bypass surgery on an infant.

Wednesday, January 20, 2010

A team of cardiac experts at Fortis Hospitals Mulund (formerly Wockhardt Hsopitals) performs complex beating heart coronary artery bypass surgery on an infant.

Fortis Hospitals Mulund (formerly Wockhardt Hospitals) marks a feat in the field of pediatric cardio-thoracic surgery by performing a complex beating heart coronary artery bypass surgery on an infant. A team of cardiac experts led by Dr. Suresh Joshi, Consultant Pediatric Cardiac Surgeon, Fortis Hospitals Mulund has successfully corrected a complicated and rare congenital deformity called ALCAPA (Anomalous Left Coronary Artery From the Pulmonary Artery) giving the baby a new lease of life.

Baby Sharon was born with normal delivery without any specific symptoms of heart defect during her birth. However after 4 months she suffered from severe cold and cough and was admitted in a city hospital as she was diagnosed of pneumonia. The baby seemed to suffer from increased breathlessness with a very high heart rate. On further investigation the baby was diagnosed of having an enlarged heart and the parents were advised to consult a pediatric cardiac surgeon.

“Baby Sharon was brought to us in a severe condition where she was suffering from severe breathlessness, excessive crying and was extremely feeble due to poor intake of feed. Upon further investigation we diagnosed her with a congenital heart defect called ALCAPA (Anomalous Left Coronary Artery from the Pulmonary Artery). ALCAPA is a rare birth malformation where the positions of the arteries are switched and the left coronary artery comes out of the pulmonary artery. It occurs in approximately in 1 in 4-5 lakh live births (0.25% - 0.5% of the total birth defects) and if not treated at the appropriate time accounts for 65 % - 85 % of deaths with in 1st yr of life from congestive cardiac failure,” said Dr. Suresh Joshi, Consultant Pediatric Cardiac Surgeon, Fortis Hospitals Mulund.

At the time of birth babies born with such deformities remain active like any normal child but as the child grow the symptoms manifests into breathlessness, inactivity and weak intake of food and they grow very weak and uncontrollable.

“ALCAPA is a serious problem and requires surgery immediately after the birth or as soon as the diagnosis is confirmed. The aim of surgery is to connect the Anomalous left coronary artery with the aorta. The precise surgery depends on the exact location of the Anomalous left coronary artery. Sometimes, it can be moved, along with a button of tissue, from the pulmonary artery and sewn into the aorta. If the Anomalous left coronary artery is located too far away from the aorta to move, a "tunnel" is made from the aorta to the Anomalous left coronary artery or by pass surgery is done by using artery of left arm.”

“Usually to perform such complex surgery heart lung machine is required which is also commonly called On-pump bypass surgery. However in the case of Baby…. we performed the surgery successfully without using heart lung machine, which means, off pump Coronary artery Bypass Graft (CABG) procedure with the self equipped instruments. Off pump bypass surgery are much common in the adult procedure group, but in neonates such procedure till date is only heard off” added Dr. Suresh Joshi, Consultant Pediatric Cardiac Surgeon, Fortis Hospitals Mulund.
The challenges that involve in this surgery were:

1. Grafting vessels on a moving heart which needs small compact stabilizer. Stabilizer for small neonate is not devised till date.

2. Left coronary artery was not appropriate for the graft

3. Poor functioning heart of the baby, Ejection fraction = 25%

Beating heart surgery was performed on the baby to avoid the post operation complication like fluid retention, kidney failure, lung injuries, and acute inflammatory reaction with mild to moderate heart dysfunction, hence helping the baby for the easy & early recovery. The surgery was done without using any stabilizer as such small size stabilizer for newborn babies is not manufactured by any company in the world. It is with the skill of the surgeon who has managed out the surgery without the stabilizer. Baby Sharon’s story showcases the expertise the country has in correcting the most complex congenital defects in the rarest of condition with a combination of skillful hands and technical finesse.

“The diagnosis of Sharon suffering from congenital heart problem came to us as a surprise. When Sharon was not keeping too well, we had the remotest thought of having anything to do with her heart. In fact before this I had very less awareness on congenital heart problems. In our country many kids succumb to faith due to lack of awareness on the defects and availability of expertise to correct such deformities. We need to create more and more awareness on congenital heart disease in India and the facilities provided by hospitals like Fortis Hospitals Mulund to operate upon the most complex cases. We are immensely thankful to Dr. Suresh Joshi and the entire team at Fortis Hospitals Mulund who came to us as saviors and gave a new life to our baby” says Mr. Bonni D’Souza (father of Sharon).

Medical Travel Quality Alliance (MTQUA) Ranks Fortis Hospitals ,Bangalore(formerly Wockhardt Hospitals) The Best Medical Tourism Hospital

The Bangkok based Medical Travel Quality Alliance (MTQUA) which promotes standards and practices for medical traveler's has recognized Fortis Hospitals, Bangalore (formerly Wockhardt Hospitals) as the most preferred destination in the world for medical tourists from America. The hospital was ranked # 1 in the first list of the top 10 world's best hospitals for medical tourists which was released at a press conference held in Bangkok on January 19, 2010.

According to MTQUA, the top five hospitals are: Fortis Hospitals, Bangalore (formerly Wockhardt Hospital), Gleneagles Hospital, Singapore, Prince Court Medical Centre, Kuala Lumpur, Shouldice Hospital, Toronto and Shoen-Kliniken, Munich.

"It gives us great pride to make India get the top slot as the world's leading destination for International patients" said Mr. Vishal Bali, CEO, Fortis Hospitals Group, India." By providing a strong foundation of quality in all our patient care processes along with affordability we have delivered to both our domestic and International patients' exceptional value" he said.

MTQUA recognized Fortis Hospitals, Bangalore (formerly Wockhardt Hospitals) as the # 1 on its list of Top 10 World's Best Hospitals for Medical Tourists on the following criteria:

1. Medical Quality - The hospital is an excellent surgery option for medical travelers seeking joint replacement, particularly hip resurfacing and replacement. It's also strong in cardiac surgery and neurosurgery. The hospital is internationally accredited by JCI.

2. International Patient Management -Fortis Hospitals has been sensitive to the needs of patients and families for their cultural, language, and religious requirements, their medical needs and emotional support. As the majority of its international caseload is either life-saving or life enhancing procedures, their honesty and integrity provides outstanding case management and better patient understanding.

3. International Patient Marketing - The Hospital actively supports web-based social networks, including Youtube, Facebook, and Twitter. It has its own blog. The hospital has a dedicated team of men and women available 24/7 with access to treating physicians who can respond to qualified patient inquiries.

4. Value For Services - India's hospitals are positioned to provide value for services and will continue to do so because the number of hospitals in India seeking the American or international patient market nurtures a competitive cost structure.

5. Patient Safety And Security - The Hospital wraps the traveling patient from America in a security blanket. From the initial hospital response, Fortis assigns dedicated staff representatives to the patient throughout their hospital stay and a treating physician who directly discusses procedures and outcomes before the patient leaves their home country. Communication with the patient's family physician is encouraged. Patients may stay in the hospital for their full recovery period to avoid moving to a hotel.

6. Transparency - Every effort is extended to ensure transparency of care, from cost to outcomes data. Patients receive a portfolio of their medical file and surgery documents including CT scans, MRI and X-rays, and operative notes to take back to their home country.

7. Attention To The Unique Needs Of The Medical Traveler - According to reports, more than 50% of Hospital's international patients are Americans. It offers prompt scheduling of pre-surgery preparation. It provides exemplary follow up care and services to monitor American medical travelers once they return home.

MTQUA's top 10 list of the World's best hospitals has 6 hospitals out of Asia, 2 from Europe and 2 from North America.


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