CHENNAI: A team of doctors from Chennai has successfully implanted a permanent pacemaker in an infant weighing less that one kilogram. With only three such reported cases in the world, this is the fourth successful surgery to be documented. The surgery was performed by a team of doctors from Sooriya hospital headed by Dr. Deepa Hariharan, Senior Consultant, Neonatologist and Paediatrician, Sooriya hospital.
The baby born on May 10 this year weighed just one kilogram at birth. Having been born with a low heartbeat rate the baby required resuscitation and life-support measures as soon as it was born, said doctors. Speaking to Deccan Chronicle, Dr. Deepa Hariharan recalls, “ When the baby was brought to us, it had extremely low heartbeat rate- about 55 to 60 per minute, whereas the normal rate is 150 -160 per minute. In the following three weeks, we had given supportive treatment for lung growth, maintenance of heart function and nutrition. Despite this, the baby’s weight and health progressively deteriorated. The heartbeat rate dropped to 40 per minute, which is extremely low and cause severe complications such as cardiac arrest. “
Following this, the doctors were left with no choice but to implant a permanent pacemaker. “ There have only been three such prior surgeries. Considering this, the technical and surgical expertise about this procedure is very limited.” says Dr. Deepa Hariharan. To learn more about the surgery, the doctors had got in touch with surgeons from abroad who had performed this procedure and had also informed the family about the complications which might arise.
However, the surgery was not an easy one, say doctors. As the baby was very small, the pacemaker could not be accommodated in its lungs and had to be implanted in the abdomen, with wires connecting the pacemaker to the heart. Following the success of the surgery, the doctors were then faced with postoperative complications such as fluid accumulation in the chest and brain. As the baby’s digestive system too was not completely developed at that time, the doctors had to supplement its nutrition intake through injections.
Subsequently, the baby gained weight and was removed from the ventilator after 70 days. At the time of discharge, the baby was on oral feed and weighed of 2.7kg.
However, such cases are extremely rare, say, doctors. In this case, the baby’s mother had been diagnosed with lupus, an auto-immune disease. While premature birth and its associated complications were earlier caused due to high blood pressure, diabetes and stress in the past, premature birth due to auto-immune diseases is increasing in the country, says Dr.Deepa.” This trend is common in the West. Unfortunately, of late, we are observing this in our country. While the reasons for auto-immune diseases are unknown, it could be partly attributed to genetic factors and lifestyle “, she adds.
“ Creating awareness on lupus, related premature births and the lack of adequate technical and surgical expertise in India is of utmost importance, keeping in mind how lupus and related ailments due to premature births are on the rise,” she concludes.
The baby is now doing well and weighs 3.5 kilograms, informed doctors.
