Mumbai docs give save preterm baby suffering from critical heart condition 

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Doctors in Mumbai have successfully treated a premature baby weighing just for a patent ductus arteriosus (PDA), a critical heart condition, after prolonged dependence on ventilator support.  
                             
The 800-gram baby, born at just 23 weeks of gestation, recently underwent a minimally invasive precision heart procedure at Narayana Health SRCC Children’s Hospital after spending more than a month on repeated ventilator support at another hospital.

According to Dr Priya Pradhan, who is the senior consultant paediatric cardiologist at the hospital, the baby was extremely premature and had been on prolonged ventilator support. Attempts to wean the baby off the ventilator had been made several times, but without success. 
                            
The critical condition happened because of an underlying heart defect known as patent ductus arteriosus (PDA)—an extra connection between two major blood vessels, one of which carries blood to the lungs (pulmonary artery), while the other to the rest of the body (aorta).

The medical team came together to save the baby. For such a critically small preterm baby, the success of the procedure depended not only on the intervention itself, but also on careful preparation, coordination and teamwork.

The team successfully placed a Piccolo device, a groundbreaking medical device which is specifically designed for use in preterm babies with PDA, which is a dangerous opening in the heart.

Following the procedure, the baby was shifted to the ICU and subsequently weaned off ventilator support to a significant extent. The baby was shifted back to the parent hospital with only minimal ventilation.

“PDA usually closes within the first two to three days of life in a full-term baby. However, this baby was born at just 23 weeks of gestation, and the PDA did not close. For this extremely tiny baby, closing the PDA was essential because of the constant requirement for ventilator support,” explained Dr Pradhan.

Managing the challenges of treating an 800-gram baby

Performing a procedure on a baby weighing only 800 grams requires meticulous planning and attention to even the smallest details. According to Dr. Pradhan, the key protocols for the procedure included minimal and gentle handling, temperature regulation and infection control.

Temperature management was particularly important when transferring the baby to the catheterisation laboratory. Since the cath lab is maintained at a low temperature, every effort had to be made to keep the baby warm. Linen, painting solutions, flushing solutions and IV fluids required for the procedure had to be warmed appropriately.

Securing IV access was another major challenge. Dr. Pradhan credited the anaesthesia team for helping to first establish the required access and ensuring the baby could safely undergo the procedure. 

The procedure was supported by a multidisciplinary team. Fellow Cardiologist Dr. Supratim Sen assisted Dr. Pradhan during the procedure. A surgeon was kept on standby in case the catheter-based procedure was unsuccessful or surgical intervention became necessary.                           

Reflecting on the case, Dr. Pradhan said that treating extremely premature babies requires meticulous planning, seamless teamwork and attention to minute details.

The case highlights how careful temperature management, infection control, gentle handling, anaesthesia support, cardiology expertise and surgical backup can come together to safely and successfully manage complex cardiac interventions in extremely small preterm babies.