sairam palaparthi

Lead pediatric cardiothoracic Surgeon, Star Hospitals

[sairam palaparthi @drpsairam]

❤️ 𝐇𝐞𝐚𝐫𝐭 𝐒𝐭𝐨𝐫𝐲 #𝟐𝟒 – 𝐀 𝐓𝐢𝐧𝐲 𝐇𝐞𝐚𝐫𝐭 𝐖𝐢𝐭𝐡 𝐓𝐰𝐨 𝐕𝐚𝐥𝐯𝐞𝐬 𝐓𝐨 𝐑𝐞𝐩𝐚𝐢𝐫

𝐏𝐚𝐞𝐝𝐢𝐚𝐭𝐫𝐢𝐜 𝐂𝐚𝐫𝐝𝐢𝐚𝐜 𝐒𝐮𝐫𝐠𝐞𝐫𝐲 𝐂𝐨𝐦𝐩𝐥𝐞𝐱 𝐏𝐚𝐭𝐢𝐞𝐧𝐭 𝐒𝐭𝐨𝐫𝐢𝐞𝐬 #𝟐𝟒

#StarHospitals
#HrudayaGivesNewLife
#FreeHeartSurgery

𝐒𝐮𝐦𝐦𝐚𝐫𝐲:

Baby Ma was just 𝟓 𝐦𝐨𝐧𝐭𝐡𝐬 𝐨𝐥𝐝 & weighed only 𝟑.𝟓 𝐤𝐠 when baby was brought with complex congenital heart defect called 𝐂𝐨𝐦𝐩𝐥𝐞𝐭𝐞 𝐀𝐭𝐫𝐢𝐨𝐯𝐞𝐧𝐭𝐫𝐢𝐜𝐮𝐥𝐚𝐫 𝐂𝐚𝐧𝐚𝐥 𝐃𝐞𝐟𝐞𝐜𝐭 (𝐀𝐕𝐂𝐃).

This has large defects involving both the upper and lower chambers of the heart, along with an abnormal common valve between the atria and ventricles.

Baby Ma also had 𝐃𝐨𝐰𝐧 𝐬𝐲𝐧𝐝𝐫𝐨𝐦𝐞, 𝐛𝐢𝐥𝐚𝐭𝐞𝐫𝐚𝐥 𝐬𝐮𝐩𝐞𝐫𝐢𝐨𝐫 𝐯𝐞𝐧𝐚 𝐜𝐚𝐯𝐚𝐞 and significant leakage of right & left-sided atrioventricular valves.

The baby had already developed 𝐬𝐞𝐯𝐞𝐫𝐞 𝐩𝐮𝐥𝐦𝐨𝐧𝐚𝐫𝐲 𝐡𝐲𝐩𝐞𝐫𝐭𝐞𝐧𝐬𝐢𝐨𝐧, making heart condition particularly challenging.

Goal was not simply to close holes in heart.
Abnormal valves also needed to be repaired so that they could function properly after surgery.

Baby was taken to operating room for complete repair.

A 𝐭𝐰𝐨-𝐩𝐚𝐭𝐜𝐡 𝐫𝐞𝐩𝐚𝐢𝐫 of atrioventricular canal defect was performed, along with repair of both 𝐫𝐢𝐠𝐡𝐭 & 𝐥𝐞𝐟𝐭 𝐚𝐭𝐫𝐢𝐨𝐯𝐞𝐧𝐭𝐫𝐢𝐜𝐮𝐥𝐚𝐫 𝐯𝐚𝐥𝐯𝐞𝐬.

Procedure was uneventful, and the heart recovered well with 𝐧𝐨𝐫𝐦𝐚𝐥 𝐛𝐢𝐯𝐞𝐧𝐭𝐫𝐢𝐜𝐮𝐥𝐚𝐫 𝐟𝐮𝐧𝐜𝐭𝐢𝐨𝐧 and 𝐧𝐨𝐫𝐦𝐚𝐥 𝐬𝐢𝐧𝐮𝐬 𝐫𝐡𝐲𝐭𝐡𝐦.

Postoperative echocardiography showed 𝐧𝐨 𝐫𝐞𝐬𝐢𝐝𝐮𝐚𝐥 𝐀𝐒𝐃 𝐨𝐫 𝐕𝐒𝐃.

Most importantly, there was 𝐧𝐨 𝐫𝐞𝐬𝐢𝐝𝐮𝐚𝐥 𝐥𝐞𝐚𝐤𝐚𝐠𝐞 of either right or left atrioventricular valve.

Baby was successfully extubated on 𝐟𝐢𝐫𝐬𝐭 𝐩𝐨𝐬𝐭𝐨𝐩𝐞𝐫𝐚𝐭𝐢𝐯𝐞 𝐝𝐚𝐲 and supported with CPAP.

By 𝐬𝐞𝐜𝐨𝐧𝐝 𝐝𝐚𝐲, respiratory support was further reduced to nasal-prong oxygen.

Feeding was gradually transitioned to 𝐨𝐫𝐚𝐥 𝐟𝐞𝐞𝐝𝐬, and the baby continued to recover steadily.

Just 𝐟𝐢𝐯𝐞 𝐝𝐚𝐲𝐬 after surgery, Baby Ma was well enough to go home.

For a baby weighing only 𝟑.𝟓 𝐤𝐠, with a complete atrioventricular canal defect, significant valve leakage and severe pulmonary hypertension, this was a challenging operation.

But with a carefully planned repair, meticulous valve reconstruction and coordinated postoperative care, this tiny heart recovered beautifully.

𝐒𝐨𝐦𝐞𝐭𝐢𝐦𝐞𝐬, 𝐭𝐡𝐞 𝐦𝐨𝐬𝐭 𝐢𝐦𝐩𝐨𝐫𝐭𝐚𝐧𝐭 𝐫𝐞𝐩𝐚𝐢𝐫 𝐢𝐬 𝐧𝐨𝐭 𝐣𝐮𝐬𝐭 𝐜𝐥𝐨𝐬𝐢𝐧𝐠 𝐚 𝐡𝐨𝐥𝐞 — 𝐢𝐭 𝐢𝐬 𝐫𝐞𝐬𝐭𝐨𝐫𝐢𝐧𝐠 𝐭𝐡𝐞 𝐡𝐞𝐚𝐫𝐭 𝐬𝐨 𝐭𝐡𝐚𝐭 𝐢𝐭 𝐜𝐚𝐧 𝐠𝐫𝐨𝐰 𝐰𝐢𝐭𝐡 𝐭𝐡𝐞 𝐜𝐡𝐢𝐥𝐝. ❤️

Every child deserves this chance — not just those who can afford it. At Star Hospitals, our charity pediatric cardiac surgery program provides completely free heart surgery for children from economically disadvantaged families.

One successful operation doesn't just repair a heart. It gives a child the opportunity to grow, play and live a healthier life. ❤️

━━━━━━━━━━━━━━━━━━━━━━━━━━━━

𝐂𝐚𝐬𝐞 𝐨𝐟 𝐭𝐡𝐞 𝐖𝐞𝐞𝐤 (𝟏𝟓/𝟎𝟔/𝟐𝟔 – 𝟐𝟏/𝟎𝟔/𝟐𝟔)

• 𝐏𝐚𝐭𝐢𝐞𝐧𝐭: Baby Ma
• 𝐀𝐠𝐞: 5 months
• 𝐖𝐞𝐢𝐠𝐡𝐭: 3.5 kg

𝐃𝐢𝐚𝐠𝐧𝐨𝐬𝐢𝐬:
• Complete atrioventricular canal defect
• Down syndrome
• Bilateral SVC
• Moderate right AV valve regurgitation
• Moderate left AV valve regurgitation
• Severe pulmonary hypertension

𝐏𝐫𝐨𝐜𝐞𝐝𝐮𝐫𝐞 – 𝐂𝐨𝐦𝐩𝐥𝐞𝐭𝐞 𝐀𝐕𝐂𝐃 𝐑𝐞𝐩𝐚𝐢𝐫:
• Two-patch repair of AVCD
• Right AV valve repair
• Left AV valve repair
• Primary chest closure

𝐏𝐨𝐬𝐭𝐨𝐩𝐞𝐫𝐚𝐭𝐢𝐯𝐞 𝐂𝐨𝐮𝐫𝐬𝐞:
• Uneventful procedure
• Normal biventricular function
• Sinus rhythm
• No residual ASD or VSD
• No residual MR or TR
• Good arch and DTA flows
• Extubated on POD 1 to CPAP
• Gradually weaned to nasal-prong oxygen by Day 2
• Transitioned to oral feeds
• Discharged home on POD 5

𝐓𝐡𝐚𝐧𝐤 𝐲𝐨𝐮, 𝐭𝐞𝐚𝐦! ❤️

[sairam palaparthi @drpsairam]

❤️ 𝐇𝐞𝐚𝐫𝐭 𝐒𝐭𝐨𝐫𝐲 #𝟐𝟑 – 𝐖𝐡𝐞𝐧 𝐚 𝐓𝐢𝐧𝐲 𝟑-𝐃𝐚𝐲-𝐎𝐥𝐝 𝐇𝐞𝐚𝐫𝐭 𝐍𝐞𝐞𝐝𝐞𝐝 𝐚 𝐌𝐢𝐝𝐧𝐢𝐠𝐡𝐭 𝐑𝐞𝐬𝐜𝐮𝐞

𝐏𝐚𝐞𝐝𝐢𝐚𝐭𝐫𝐢𝐜 𝐂𝐚𝐫𝐝𝐢𝐚𝐜 𝐒𝐮𝐫𝐠𝐞𝐫𝐲 𝐂𝐨𝐦𝐩𝐥𝐞𝐱 𝐏𝐚𝐭𝐢𝐞𝐧𝐭 𝐒𝐭𝐨𝐫𝐢𝐞𝐬 # 𝟐𝟑

#StarHospitals
#HrudayaGivesNewLife
#FreeHeartSurgery

𝐒𝐮𝐦𝐦𝐚𝐫𝐲:

Baby Sy was just 𝟑 𝐝𝐚𝐲𝐬 𝐨𝐥𝐝 & 𝐰𝐞𝐢𝐠𝐡𝐞𝐝 𝐨𝐧𝐥𝐲 𝟐.𝟓 𝐤𝐠 & was brought with serious heart problem called 𝐓𝐫𝐚𝐧𝐬𝐩𝐨𝐬𝐢𝐭𝐢𝐨𝐧 𝐨𝐟 𝐭𝐡𝐞 𝐆𝐫𝐞𝐚𝐭 𝐀𝐫𝐭𝐞𝐫𝐢𝐞𝐬 (𝐓𝐆𝐀).

In TGA, two major arteries leaving heart are connected to wrong ventricles, causing oxygen-poor blood to circulate through body.

Baby was referred to Star Hospitals on 𝟐𝐧𝐝 𝐝𝐚𝐲 𝐨𝐟 𝐥𝐢𝐟𝐞 𝐰𝐢𝐭𝐡 𝐬𝐞𝐯𝐞𝐫𝐞 𝐝𝐞𝐬𝐚𝐭𝐮𝐫𝐚𝐭𝐢𝐨𝐧.

Despite intubation, mechanical ventilation, good asd & high-dose prostaglandin, oxygen levels remained dangerously low.

Then, baby had 𝐛𝐫𝐢𝐞𝐟 𝐜𝐚𝐫𝐝𝐢𝐚𝐜 𝐚𝐫𝐫𝐞𝐬𝐭 𝐫𝐞𝐪𝐮𝐢𝐫𝐢𝐧𝐠 𝐂𝐏𝐑.

There was no time to wait.

Baby was taken to OR at 𝐦𝐢𝐝𝐧𝐢𝐠𝐡𝐭 𝐨𝐧 𝟏𝟏 𝐉𝐮𝐧𝐞 𝟐𝟎𝟐𝟔 for an emergency 𝐀𝐫𝐭𝐞𝐫𝐢𝐚𝐥 𝐒𝐰𝐢𝐭𝐜𝐡 𝐎𝐩𝐞𝐫𝐚𝐭𝐢𝐨𝐧.

Operation was completed successfully and chest was closed primarily.

Tiny heart recovered with 𝐧𝐨𝐫𝐦𝐚𝐥 𝐟𝐮𝐧𝐜𝐭𝐢𝐨𝐧 𝐨𝐟 𝐛𝐨𝐭𝐡 𝐯𝐞𝐧𝐭𝐫𝐢𝐜𝐥𝐞𝐬 𝐚𝐧𝐝 normal 𝐫𝐡𝐲𝐭𝐡𝐦.

Baby was taken off ventilator on first postoperative day and gradually weaned from NIV to CPAP & then to nasal prongs.

Feeding also progressed gradually to oral feeds.

During recovery, however, another problem became apparent. L𝐞𝐟𝐭 𝐬𝐢𝐝𝐞 𝐨𝐟 𝐭𝐡𝐞 𝐝𝐢𝐚𝐩𝐡𝐫𝐚𝐠𝐦 𝐰𝐚𝐬 𝐞𝐥𝐞𝐯𝐚𝐭𝐞𝐝.

Baby underwent 𝐥𝐞𝐟𝐭 𝐡𝐞𝐦𝐢𝐝𝐢𝐚𝐩𝐡𝐫𝐚𝐠𝐦 𝐩𝐥𝐢𝐜𝐚𝐭𝐢𝐨𝐧 𝐨𝐧 𝐭𝐡𝐞 𝟏𝟓𝐭𝐡 𝐩𝐨𝐬𝐭𝐨𝐩𝐞𝐫𝐚𝐭𝐢𝐯𝐞 𝐝𝐚𝐲.

Baby continued to recover and was finally 𝐝𝐢𝐬𝐜𝐡𝐚𝐫𝐠𝐞𝐝 𝐡𝐨𝐦𝐞 𝐨𝐧 𝐃𝐚𝐲 𝟏𝟖.

From severely cyanosed newborn who required CPR & emergency midnight operation, to baby going home after successful repair — this was journey that required every member of team.

𝐒𝐨𝐦𝐞𝐭𝐢𝐦𝐞𝐬, 𝐭𝐢𝐧𝐢𝐞𝐬𝐭 𝐡𝐞𝐚𝐫𝐭𝐬 𝐚𝐫𝐞 𝐚𝐥𝐬𝐨 𝐭he 𝐨𝐧𝐞𝐬 𝐭𝐡𝐚𝐭 𝐫𝐞𝐪𝐮𝐢𝐫𝐞 𝐦𝐨𝐬𝐭 𝐮𝐫𝐠𝐞𝐧𝐭 𝐫𝐞𝐬𝐩𝐨𝐧𝐬𝐞. 𝐀 𝐭𝐢𝐦𝐞𝐥𝐲 𝐬𝐮𝐫𝐠𝐢𝐜𝐚𝐥 𝐢𝐧𝐭𝐞𝐫𝐯𝐞𝐧𝐭𝐢𝐨𝐧 𝐜𝐚𝐧 𝐭𝐮𝐫𝐧 𝐜𝐫𝐢𝐭𝐢𝐜𝐚𝐥𝐥𝐲 𝐢𝐥𝐥 𝐧𝐞𝐰𝐛𝐨𝐫𝐧 𝐢𝐧𝐭𝐨 𝐚 𝐜𝐡𝐢𝐥𝐝 𝐰𝐡𝐨 𝐜𝐚𝐧 𝐠𝐨 𝐡𝐨𝐦𝐞 𝐰𝐢𝐭𝐡 𝐧𝐞𝐰 𝐜𝐡𝐚𝐧𝐜𝐞 𝐚𝐭 𝐥𝐢𝐟𝐞. ❤️

Every child deserves this chance — not just those who can afford it. At Star Hospitals, our charity pediatric cardiac surgery program provides completely free heart surgery for children from economically disadvantaged families.

One successful operation doesn't just save a child. It gives a family their future back. ❤️

━━━━━━━━━━━━━━━━━━━━━━━━━━━━

𝐂𝐚𝐬𝐞 𝐨𝐟 𝐭𝐡𝐞 𝐖𝐞𝐞𝐤 (𝟎𝟖/𝟎𝟔/𝟐𝟔 – 𝟏𝟒/𝟎𝟔/𝟐𝟔)

• 𝐏𝐚𝐭𝐢𝐞𝐧𝐭: Baby Sy
• 𝐀𝐠𝐞: 3 days
• 𝐖𝐞𝐢𝐠𝐡𝐭: 2.5 kg

𝐃𝐢𝐚𝐠𝐧𝐨𝐬𝐢𝐬:
• TGA with intact ventricular septum
• Good-sized ASD
• Severe neonatal desaturation
• Persistent desaturation despite high-dose PGE, intubation and ventilation
• Brief cardiac arrest requiring CPR

𝐏𝐫𝐨𝐜𝐞𝐝𝐮𝐫𝐞 – 𝐄𝐦𝐞𝐫𝐠𝐞𝐧𝐜𝐲 𝐀𝐫𝐭𝐞𝐫𝐢𝐚𝐥 𝐒𝐰𝐢𝐭𝐜𝐡 𝐎𝐩𝐞𝐫𝐚𝐭𝐢𝐨𝐧:
• ASO performed at midnight on 11/06/2026
• Usual coronary pattern
• Patch closure of OS ASD
• Primary chest closure

𝐏𝐨𝐬𝐭𝐨𝐩𝐞𝐫𝐚𝐭𝐢𝐯𝐞 𝐂𝐨𝐮𝐫𝐬𝐞:
• Uneventful procedure
• Normal biventricular function
• Sinus rhythm
• No RVOTO
• Mild RPA flow acceleration with laminar LPA flow
• No LVOTO
• Mild neo-AR
• No residual ASD or VSD
• Trivial TR
• Good arch and DTA flows

• Extubated on POD 1 to NIV
• Gradually weaned from NIV to CPAP and subsequently to nasal prongs by Day 8
• Gradual transition from NG feeds to oral feeds
• Elevated left hemidiaphragm noted during recovery
• No improvement with observation
• Fluoroscopy confirmed left hemidiaphragm palsy
• Left hemidiaphragm plication performed on POD 15
• Discharged on POD 18

𝐓𝐡𝐚𝐧𝐤 𝐲𝐨𝐮, 𝐭𝐞𝐚𝐦! ❤️

[sairam palaparthi @drpsairam]

❤️ 𝐇𝐞𝐚𝐫𝐭 𝐒𝐭𝐨𝐫𝐲 #𝟐𝟐 – 𝐅𝐢𝐧𝐝𝐢𝐧𝐠 𝐭𝐡𝐞 𝐏𝐚𝐭𝐡 𝐭𝐨 𝐚 𝐓𝐰𝐨-𝐕𝐞𝐧𝐭𝐫𝐢𝐜𝐥𝐞 𝐑𝐞𝐩𝐚𝐢𝐫

𝐏𝐚𝐞𝐝𝐢𝐚𝐭𝐫𝐢𝐜 𝐂𝐚𝐫𝐝𝐢𝐚𝐜 𝐒𝐮𝐫𝐠𝐞𝐫𝐲 𝐂𝐨𝐦𝐩𝐥𝐞𝐱 𝐏𝐚𝐭𝐢𝐞𝐧𝐭 𝐒𝐭𝐨𝐫𝐢𝐞𝐬 # 𝟐𝟐

#StarHospitals
#HrudayaGivesNewLife
#FreeHeartSurgery

𝐒𝐮𝐦𝐦𝐚𝐫𝐲:

A 1-year-old baby girl came to us with a very complex heart problem.

The heart had an unusual arrangement of its major blood vessels, with the main artery arising from the right ventricle and the great arteries positioned abnormally. There was also a large and difficult-to-reach hole between the ventricles, severe narrowing below the aortic valve, and significant narrowing of the aortic arch.

She had already undergone major surgery to repair the aortic arch and had procedures to maintain blood flow to the lungs.

But she had two good-sized ventricles — and that meant there was a possibility of restoring her circulation to a normal two-ventricle pathway.

After careful assessment, we decided to pursue a biventricular repair.

The operation required several complex steps. The severe obstruction below the aortic valve was removed, the ventricular hole was carefully routed to the aorta, the previous surgical pathways were taken down, and the pulmonary arteries were reconstructed. The tricuspid valve was also repaired, and a small opening was intentionally left between the atria to allow pressure relief during recovery.

The operation went smoothly.

After surgery, both ventricles were functioning normally. There was no significant obstruction to blood leaving the right ventricle, and the pathway from the left ventricle to the aorta was almost completely unobstructed.

The baby was breathing independently with only nasal-prong oxygen by the next morning, moved to the ward on the second day, and went home just 4 days after surgery.

𝐒𝐨𝐦𝐞 𝐜𝐨𝐦𝐩𝐥𝐞𝐱 𝐡𝐞𝐚𝐫𝐭𝐬 𝐚𝐫𝐞 𝐧𝐨𝐭 𝐝𝐞𝐟𝐢𝐧𝐞𝐝 𝐛𝐲 𝐭𝐡𝐞𝐢𝐫 𝐟𝐢𝐫𝐬𝐭 𝐬𝐮𝐫𝐠𝐞𝐫𝐲. 𝐖𝐡𝐞𝐧 𝐭𝐰𝐨 𝐠𝐨𝐨𝐝 𝐯𝐞𝐧𝐭𝐫𝐢𝐜𝐥𝐞𝐬 𝐚𝐫𝐞 𝐩𝐫𝐞𝐬𝐞𝐧𝐭, 𝐟𝐢𝐧𝐝𝐢𝐧𝐠 𝐚 𝐩𝐚𝐭𝐡 𝐭𝐨 𝐮𝐬𝐞 𝐭𝐡𝐞𝐦 𝐛𝐨𝐭𝐡 𝐜𝐚𝐧 𝐦𝐚𝐤𝐞 𝐚 𝐩𝐫𝐨𝐟𝐨𝐮𝐧𝐝 𝐝𝐢𝐟𝐟𝐞𝐫𝐞𝐧𝐜𝐞.

Every child deserves this chance — not just those who can afford it. At Star Hospitals, our charity pediatric cardiac surgery program provides completely free heart surgery for children from economically disadvantaged families.

One successful operation doesn't just save a child. It gives a family their future back. ❤️

━━━━━━━━━━━━━━━━━━━━━━━━━━━━

𝐂𝐚𝐬𝐞 𝐨𝐟 𝐭𝐡𝐞 𝐖𝐞𝐞𝐤 (𝟎𝟏/𝟎𝟔/𝟐𝟔 – 𝟎𝟕/𝟎𝟔/𝟐𝟔)

• 𝐏𝐚𝐭𝐢𝐞𝐧𝐭: Baby Ni
• 𝐀𝐠𝐞: 1 year 1 month
• 𝐒𝐞𝐱: Female
• 𝐖𝐞𝐢𝐠𝐡𝐭: 7 kg

𝐃𝐢𝐚𝐠𝐧𝐨𝐬𝐢𝐬:
• Situs solitus, levocardia
• DORV with d-malposed great arteries (DMGA)
• Remote VSD
• Hypertrophic subaortic conus with severe subaortic stenosis
• Unprotected pulmonary blood flow
• Two good ventricles
• Severe coarctation of aorta with arch hypoplasia
• Previous arch repair, DKS and bilateral BTT shunts

𝐏𝐫𝐨𝐜𝐞𝐝𝐮𝐫𝐞 – 𝐁𝐢𝐕 𝐑𝐞𝐩𝐚𝐢𝐫:
• Subaortic resection
• Complex VSD baffling to aorta
• DKS takedown
• Bilateral BTT shunt takedown
• Branch pulmonary artery reconstruction with PA root-to-bifurcation anastomosis
• Tricuspid valve repair
• Fenestrated ASD closure
• Primary chest closure

𝐏𝐨𝐬𝐭𝐨𝐩𝐞𝐫𝐚𝐭𝐢𝐯𝐞 𝐂𝐨𝐮𝐫𝐬𝐞:
• Uneventful procedure
• Normal biventricular function
• Sinus rhythm
• No RVOTO
• Near-laminar LVOT with PPG of 12 mmHg
• Tiny residual VSD
• Trivial TR
• Good arch and DTA flow
• Good flow in RPA and LPA

• Extubated 12 hours after surgery on POD 1 to nasal prongs
• Uneventful postoperative course
• Shifted to ward on POD 2
• Discharged on POD 4

𝐓𝐡𝐚𝐧𝐤 𝐲𝐨𝐮, 𝐭𝐞𝐚𝐦! ❤️

[sairam palaparthi @drpsairam]

❤️ 𝐇𝐞𝐚𝐫𝐭 𝐒𝐭𝐨𝐫𝐲 #𝟐𝟏 – 𝐀 𝐃𝐢𝐟𝐟𝐞𝐫𝐞𝐧𝐭 𝐏𝐚𝐭𝐡 𝐟𝐨𝐫 𝐚 𝐃𝐢𝐟𝐟𝐞𝐫𝐞𝐧𝐭𝐥𝐲 𝐑𝐨𝐭𝐚𝐭𝐞𝐝 𝐇𝐞𝐚𝐫𝐭

𝐏𝐚𝐞𝐝𝐢𝐚𝐭𝐫𝐢𝐜 𝐂𝐚𝐫𝐝𝐢𝐚𝐜 𝐒𝐮𝐫𝐠𝐞𝐫𝐲 𝐂𝐨𝐦𝐩𝐥𝐞𝐱 𝐏𝐚𝐭𝐢𝐞𝐧𝐭 𝐒𝐭𝐨𝐫𝐢𝐞𝐬 # 𝟐𝟏

#StarHospitals
#HrudayaGivesNewLife
#FreeHeartSurgery

𝐒𝐮𝐦𝐦𝐚𝐫𝐲:

A 4-year-old boy came to us for the next stage of surgery for his complex congenital heart disease.

His heart and major blood vessels were arranged differently from usual. He had tricuspid atresia, meaning one of the heart's valves had not developed, leaving him dependent on a single effective pumping chamber. He had already undergone a Glenn procedure as an earlier stage of treatment.

Now, it was time for the final stage — the Fontan operation.

But his unusual anatomy created an important challenge. Imaging suggested that the usual type of Fontan operation could potentially compress the pulmonary veins and the Fontan conduit.

So, instead of following the usual route, we chose a different path that was better suited to his anatomy.

We performed a lateral tunnel Fontan, enlarged the existing Glenn pathway, and closed abnormal collateral blood vessels.

The operation went smoothly. His heart function was normal, his rhythm remained stable, and the Fontan pressure was 12–14 mmHg.

Just 2 hours after surgery, he was breathing on his own with only nasal-prong oxygen.

His recovery was remarkably smooth, and he went home just 4 days after surgery.

𝐒𝐨𝐦𝐞𝐭𝐢𝐦𝐞𝐬, 𝐜𝐨𝐦𝐩𝐥𝐞𝐱 𝐡𝐞𝐚𝐫𝐭𝐬 𝐝𝐨𝐧'𝐭 𝐟𝐨𝐥𝐥𝐨𝐰 𝐭𝐡𝐞 𝐮𝐬𝐮𝐚𝐥 𝐩𝐚𝐭𝐡. 𝐓𝐡𝐞 𝐜𝐡𝐚𝐥𝐥𝐞𝐧𝐠𝐞 𝐢𝐬 𝐭𝐨 𝐟𝐢𝐧𝐝 𝐭𝐡𝐞 𝐫𝐢𝐠𝐡𝐭 𝐩𝐚𝐭𝐡 𝐟𝐨𝐫 𝐞𝐚𝐜𝐡 𝐜𝐡𝐢𝐥𝐝.

Every child deserves this chance — not just those who can afford it. At Star Hospitals, our charity pediatric cardiac surgery program provides completely free heart surgery for children from economically disadvantaged families.

One successful operation doesn't just save a child. It gives a family their future back. ❤️

━━━━━━━━━━━━━━━━━━━━━━━━━━━━

𝐂𝐚𝐬𝐞 𝐨𝐟 𝐭𝐡𝐞 𝐖𝐞𝐞𝐤 (𝟐𝟓/𝟎𝟓/𝟐𝟔 – 𝟑𝟏/𝟎𝟓/𝟐𝟔)

• 𝐏𝐚𝐭𝐢𝐞𝐧𝐭: Mr D
• 𝐀𝐠𝐞: 4 years 5 months
• 𝐒𝐞𝐱: Male
• 𝐖𝐞𝐢𝐠𝐡𝐭: 11 kg

𝐃𝐢𝐚𝐠𝐧𝐨𝐬𝐢𝐬:
• Situs inversus with mesocardia
• Tricuspid atresia
• Left-sided IVC with ventricles overlying the IVC
• Large ASD
• Small VSD
• Previous left-sided SVC to LPA Glenn with Glenn stenosis

𝐂𝐥𝐢𝐧𝐢𝐜𝐚𝐥 𝐂𝐨𝐮𝐫𝐬𝐞:
Admitted electively for completion Fontan.

Imaging showed that an extracardiac Fontan would be difficult because of the possibility of pulmonary vein and conduit compression.

𝐏𝐫𝐨𝐜𝐞𝐝𝐮𝐫𝐞:
• Lateral tunnel Fontan
• Glenn augmentation with patch
• Surgical ligation of collaterals
• Primary chest closure

𝐏𝐨𝐬𝐭𝐨𝐩𝐞𝐫𝐚𝐭𝐢𝐯𝐞 𝐂𝐨𝐮𝐫𝐬𝐞:
• Uneventful procedure
• Normal ventricular function
• Sinus rhythm
• Fontan pressure: 12–14 mmHg
• Extubated 2 hours after surgery to nasal prongs
• Uneventful postoperative recovery
• Discharged on POD 4

𝐓𝐡𝐚𝐧𝐤 𝐲𝐨𝐮, 𝐭𝐞𝐚𝐦! ❤️

[sairam palaparthi @drpsairam]

❤️ 𝗛𝗲𝗮𝗿𝘁 𝗦𝘁𝗼𝗿𝘆 #𝟮𝟬 – 𝗪𝗵𝗲𝗻 𝗮 𝗕𝗹𝘂𝗲 𝗕𝗮𝗯𝘆'𝘀 𝗖𝗼𝗿𝗼𝗻𝗮𝗿𝘆 𝗔𝗿𝘁𝗲𝗿𝗶𝗲𝘀 𝗧𝗮𝗸𝗲 𝗮𝗻 𝗨𝗻𝘂𝘀𝘂𝗮𝗹 𝗥𝗼𝘂𝘁𝗲

𝐏𝐚𝐞𝐝𝐢𝐚𝐭𝐫𝐢𝐜 𝐂𝐚𝐫𝐝𝐢𝐚𝐜 𝐒𝐮𝐫𝐠𝐞𝐫𝐲 𝐂𝐨𝐦𝐩𝐥𝐞𝐱 𝐏𝐚𝐭𝐢𝐞𝐧𝐭 𝐒𝐭𝐨𝐫𝐢𝐞𝐬 # 𝟐𝟎

#StarHospitals
#HrudayaGivesNewLife
#FreeHeartSurgery

𝗦𝘂𝗺𝗺𝗮𝗿𝘆:

A 15-day-old baby girl arrived at Star Hospitals with a serious heart defect that had left her struggling with heart failure.

She was born with 𝗧𝗿𝗮𝗻𝘀𝗽𝗼𝘀𝗶𝘁𝗶𝗼𝗻 𝗼𝗳 𝘁𝗵𝗲 𝗚𝗿𝗲𝗮𝘁 𝗔𝗿𝘁𝗲𝗿𝗶𝗲𝘀, a condition in which the two major blood vessels leaving the heart are connected incorrectly. She also had a hole between the lower chambers of her heart and, unusually, a 𝘀𝗶𝗻𝗴𝗹𝗲 𝗰𝗼𝗿𝗼𝗻𝗮𝗿𝘆 𝗮𝗿𝘁𝗲𝗿𝘆 𝘄𝗶𝘁𝗵 𝗰𝗼𝗺𝗽𝗹𝗲𝘅 𝗯𝗿𝗮𝗻𝗰𝗵𝗶𝗻𝗴—making the surgical correction more challenging.

Our team performed an arterial switch operation to reconnect the major blood vessels correctly, close the hole in her heart, and carefully transfer her complex coronary artery anatomy.

The operation and initial recovery were smooth.

Her heart regained normal function and rhythm, with good blood flow through the newly reconstructed coronary arteries and pulmonary arteries. She was taken off the ventilator within 𝟮𝟬 𝗵𝗼𝘂𝗿𝘀 and gradually progressed from non-invasive breathing support to breathing completely on her own.

She started oral feeds, transitioned to room air, and was discharged home 𝟵 𝗱𝗮𝘆𝘀 𝗮𝗳𝘁𝗲𝗿 𝘀𝘂𝗿𝗴𝗲𝗿𝘆.

She continues to be followed for reduced movement of the left side of her diaphragm.

𝗔𝗻𝗼𝘁𝗵𝗲𝗿 𝘁𝗶𝗻𝘆 𝗵𝗲𝗮𝗿𝘁 𝗴𝗶𝘃𝗲𝗻 𝗮 𝗰𝗵𝗮𝗻𝗰𝗲 𝘁𝗼 𝗴𝗿𝗼𝘄, 𝗵𝗲𝗮𝗹, 𝗮𝗻𝗱 𝘁𝗵𝗿𝗶𝘃𝗲. ❤️

Every child deserves this chance—not just those who can afford it. At Star Hospitals, our charity pediatric cardiac surgery program provides 𝗰𝗼𝗺𝗽𝗹𝗲𝘁𝗲𝗹𝘆 𝗳𝗿𝗲𝗲 𝗵𝗲𝗮𝗿𝘁 𝘀𝘂𝗿𝗴𝗲𝗿𝘆 for children from economically disadvantaged families.

One successful operation doesn't just save a child. 𝗜𝘁 𝗴𝗶𝘃𝗲𝘀 𝗮 𝗳𝗮𝗺𝗶𝗹𝘆 𝘁𝗵𝗲𝗶𝗿 𝗳𝘂𝘁𝘂𝗿𝗲 𝗯𝗮𝗰𝗸.

━━━━━━━━━━━━━━━━━━━━

𝗖𝗮𝘀𝗲 𝗼𝗳 𝘁𝗵𝗲 𝗪𝗲𝗲𝗸 (𝟭𝟴/𝟬𝟱/𝟮𝟲 – 𝟮𝟰/𝟬𝟱/𝟮𝟲)

𝗕/𝗼 𝗦𝗵 𝗙𝗮
15 days, Female child, 3.3 kg

𝗗𝗶𝗮𝗴𝗻𝗼𝘀𝗶𝘀:

• D-Transposition of the great arteries
• Apical VSD
• Single coronary artery with complex branching

Admitted to Star Hospitals with signs of heart failure.

𝗣𝗿𝗼𝗰𝗲𝗱𝘂𝗿𝗲:

• Arterial switch operation with apical VSD closure
• Complex coronary transfer
• Primary chest closure

𝗣𝗼𝘀𝘁𝗼𝗽𝗲𝗿𝗮𝘁𝗶𝘃𝗲 𝗖𝗼𝘂𝗿𝘀𝗲:

Uneventful procedure.

Postoperative echocardiography showed:

• Normal biventricular function
• Sinus rhythm
• Trivial neo-aortic regurgitation
• Tiny residual apical VSD
• Good coronary flow
• Good branch pulmonary artery flow following the LeCompte maneuver

Extubated 𝟮𝟬 𝗵𝗼𝘂𝗿𝘀 after surgery to NIPPV.

Gradually weaned to CPAP and then nasal-prong oxygen.

Successfully transitioned to oral feeds and room air.

Reduced left hemidiaphragm movement noted and is being followed medically.

𝗗𝗶𝘀𝗰𝗵𝗮𝗿𝗴𝗲𝗱 𝗼𝗻 𝗣𝗢𝗗 𝟵.

𝗧𝗵𝗮𝗻𝗸 𝘆𝗼𝘂, 𝘁𝗲𝗮𝗺! ❤️

[sairam palaparthi @drpsairam]

𝐇𝐞𝐚𝐫𝐭 𝐒𝐭𝐨𝐫𝐲 #𝟏𝟗: 𝐅𝐫𝐨𝐦 𝐚 𝟔𝟎𝟎-𝐤𝐦 𝐀𝐦𝐛𝐮𝐥𝐚𝐧𝐜𝐞 𝐉𝐨𝐮𝐫𝐧𝐞𝐲 𝐭𝐨 𝐚 𝐂𝐨𝐦𝐦𝐞𝐫𝐜𝐢𝐚𝐥 𝐅𝐥𝐢𝐠𝐡𝐭 𝐇𝐨𝐦𝐞 ✈️❤️

Paediatric Cardiac Surgery Complex Patient stories #19

#StarHospitals
#HrudayaGivesNewLife
#FreeHeartSurgery

𝐒𝐮𝐦𝐦𝐚𝐫𝐲:

At just 1.9 kg, this tiny baby was born prematurely at 34 weeks and had already endured a difficult start to life.

He had a severely narrowed aortic arch, multiple holes in heart, and very high pressure in lungs. During his stay in NICU, he had also suffered brain bleed and seizures.

When his condition became critical, his family travelled nearly 600 kilometres by ambulance, with oxygen support, to reach Star Hospitals.

Despite his very small size and complexity of his heart condition, our team successfully repaired narrowed aortic arch and closed multiple holes in his heart during same operation.

His recovery was smooth.

He was off ventilator next day, gradually started breathing without support, and began oral feeds. By fourth day, he was well enough to leave ICU.

Just six days after surgery, weighing only 1.7 kg, he went home breathing comfortably on room air.

Instead of another long ambulance journey, this tiny baby was well enough to fly home on a regular commercial passenger flight. ✈️❤️

Every child deserves this chance—not just those who can afford it. At Star Hospitals, our charity pediatric cardiac surgery program provides completely free heart surgery for children from economically disadvantaged families. One successful operation doesn't just save a child. It gives a family their future back.

𝐂𝐚𝐬𝐞 𝐨𝐟 𝐭𝐡𝐞 𝐖𝐞𝐞𝐤 (𝟏𝟏/𝟎𝟓/𝟐𝟔 – 𝟏𝟕/𝟎𝟓/𝟐𝟔)

Baby of Re
1 month 7 days, MCh, 1.9 kg
Born prematurely at 34 weeks GA with a birth weight of 1.5 kg.

𝐃𝐢𝐚𝐠𝐧𝐨𝐬𝐢𝐬:
Bovine arch, severe arch hypoplasia and severe coarctation of the aorta
Large PDA
Multiple VSDs: large apical VSD, large anterior muscular VSD and multiple small mid-muscular VSDs
Severe pulmonary arterial hypertension
History of germinal matrix hemorrhage and seizures during NICU stay

Travelled 600 km by ambulance to Star Hospitals with oxygen support.

𝐏𝐫𝐨𝐜𝐞𝐝𝐮𝐫𝐞:

Coarctation repair with arch augmentation
Pericardial patch closure of anterior muscular VSD
Pericardial patch closure of apical muscular VSD
Direct closure of additional apical and mid-muscular VSDs
Closure of OS ASD

𝐏𝐨𝐬𝐭𝐨𝐩𝐞𝐫𝐚𝐭𝐢𝐯𝐞 𝐂𝐨𝐮𝐫𝐬𝐞:
Uneventful.

Postoperative echo showed:

• Laminar flow across reconstructed arch and descending thoracic aorta
• Intact anterior muscular, mid-muscular and apical VSD patches
• Tiny residual apical VSD with a 4% step-up

Uneventful postoperative recovery.

Extubated on POD 1 to NIV and gradually weaned off respiratory support.

Oral feeds started.

Shifted to ward on POD 4.

Discharged on POD 6 on room air, with a discharge weight of 1.7 kg.

The baby subsequently travelled home by a regular commercial passenger flight.

𝐓𝐡𝐚𝐧𝐤 𝐲𝐨𝐮, 𝐭𝐞𝐚𝐦! ❤️

[sairam palaparthi @drpsairam]

❤️ Heart Story #18 – When One Surgical Plan Wasn't Enough

𝗣𝗮𝗲𝗱𝗶𝗮𝘁𝗿𝗶𝗰 𝗖𝗮𝗿𝗱𝗶𝗮𝗰 𝗦𝘂𝗿𝗴𝗲𝗿𝘆 𝗖𝗼𝗺𝗽𝗹𝗲𝘅 𝗣𝗮𝘁𝗶𝗲𝗻𝘁 𝗦𝘁𝗼𝗿𝗶𝗲𝘀 #𝟭𝟴

#𝗦𝘁𝗮𝗿𝗛𝗼𝘀𝗽𝗶𝘁𝗮𝗹𝘀
#𝗛𝗿𝘂𝗱𝗮𝘆𝗮𝗚𝗶𝘃�#𝗛𝗿𝘂𝗱𝗮𝘆𝗮𝗚𝗶𝘃𝗲𝘀𝗡𝗲𝘄𝗟𝗶𝗳𝗲
#𝗙𝗿𝗲𝗲𝗛𝗲𝗮𝗿𝘁𝗦𝘂𝗿𝗴𝗲𝗿𝘆
#𝗙𝗿𝗲𝗲𝗛𝗲𝗮𝗿𝘁𝗦𝘂𝗿𝗴𝗲𝗿𝘆

Summary:

A 1-year-10-month-old girl came to us with a rare and severe congenital heart disease called Ebstein’s anomaly, in which the tricuspid valve and the right side of the heart are poorly developed. Her heart was unable to pump blood effectively to the lungs, leaving her with severe cyanosis and dangerously low oxygen levels.

Our initial plan was to restore normal two-ventricle circulation by reconstructing her tricuspid valve. Although the valve repair was successful, her right ventricle remained too weak to support the circulation on its own. During surgery, our team made the critical decision to modify the operation by adding a Glenn shunt, allowing part of the blood flow to reach the lungs without overloading the weakened right ventricle.

The first few days after surgery were challenging. She required inhaled nitric oxide to reduce pressure in the lungs and was briefly re-intubated after developing lung collapse. With careful intensive care management, she gradually improved, came off all respiratory support, and was discharged home on the 11th day after surgery.

Her recovery continued even after leaving the hospital. An MRI performed two months later showed that the pumping function of her right ventricle had improved significantly, demonstrating the heart’s remarkable ability to recover after successful surgery.

Every child deserves this chance—not just those who can afford it. At Star Hospitals, our charity pediatric cardiac surgery program provides completely free heart surgery for children from economically disadvantaged families. One successful operation doesn’t just save a child. It gives a family their future back.

𝐂𝐚𝐬𝐞 𝐨𝐟 𝐭𝐡𝐞 𝐖𝐞𝐞𝐤 (𝟬𝟰/𝟬𝟱/𝟮𝟲 – 𝟭𝟬/𝟬𝟱/𝟮𝟲)

𝗕𝗮𝗯𝘆 𝗡𝗮𝗞
𝟭 𝘆𝗲𝗮𝗿 𝟭𝟬 𝗺𝗼𝗻𝘁𝗵𝘀, 𝗙𝗲𝗺𝗮𝗹𝗲 𝗰𝗵𝗶𝗹𝗱, 𝟭𝟬 𝗸𝗴

Diagnosis: Ebstein’s anomaly with large ASD
Carpentier type C with severe right ventricular dysfunction and large atrialized right ventricle
𝗦𝗲𝘃𝗲𝗿𝗲 𝗰𝘆𝗮𝗻𝗼𝘀𝗶𝘀

Procedure:
1.5 ventricle repair with Cone reconstruction of the tricuspid valve
ASD Closure with 4 mm fenestration
Bidirectional Glenn shunt with intrapulmonary artery septation and 3 mm fenestration

Operative Course: Initial attempt at biventricular repair was not successful because of severe right ventricular dysfunction. Bidirectional Glenn shunt with fenestrated intrapulmonary artery septation was added.
Weaned from cardiopulmonary bypass with fair hemodynamics and elevated Glenn pressures (20 mmHg). Inhaled nitric oxide was commenced in the operating room.

Postoperative echocardiography showed:
𝗡𝗼 𝘁𝗿𝗶𝗰𝘂𝘀𝗽𝗶𝗱 𝘀𝘁𝗲𝗻𝗼𝘀𝗶𝘀
𝗠𝗶𝗹𝗱 𝘁𝗿𝗶𝗰𝘂𝘀𝗽𝗶𝗱 𝗿𝗲𝗴𝘂𝗿𝗴𝗶𝘁𝗮𝘁𝗶𝗼𝗻
𝗦𝗲𝘃𝗲𝗿𝗲 𝗿𝗶𝗴𝗵𝘁 𝘃𝗲𝗻𝘁𝗿𝗶𝗰𝘂𝗹𝗮𝗿 𝗱𝘆𝘀𝗳𝘂𝗻𝗰𝘁𝗶𝗼𝗻
𝗡𝗼𝗿𝗺𝗮𝗹 𝗹𝗲𝗳𝘁 𝘃𝗲𝗻𝘁𝗿𝗶𝗰𝘂𝗹𝗮𝗿 𝗳𝘂𝗻𝗰𝘁𝗶𝗼𝗻
𝗚𝗼𝗼𝗱 𝗳𝗹𝗼𝘄 𝘁𝗵𝗿𝗼𝘂𝗴𝗵 𝘁𝗵𝗲 𝗚𝗹𝗲𝗻𝗻 𝘀𝗵𝘂𝗻𝘁

Inhaled nitric oxide was gradually weaned over the next 48 hours.
Hemodynamics improved, allowing withdrawal of inotropic support.
Extubated on postoperative day 3 but required re-intubation because of lung collapse.
Successfully extubated on postoperative day 4 to non-invasive ventilation and gradually weaned from all respiratory support.
𝗗𝗶𝘀𝗰𝗵𝗮𝗿𝗴𝗲𝗱 𝗼𝗻 𝗽𝗼𝘀𝘁𝗼𝗽𝗲𝗿𝗮𝘁𝗶𝘃𝗲 𝗱𝗮𝘆 𝟭𝟭.

Follow-up cardiac MRI at two months demonstrated improvement in right ventricular ejection fraction from 13% to 27%, with no tricuspid stenosis and only mild tricuspid regurgitation.

𝗧𝗵𝗮𝗻𝗸 𝘆𝗼𝘂 𝘁𝗲𝗮𝗺!!

[sairam palaparthi @drpsairam]

Paediatric Cardiac Surgery Complex Patient stories #17

#StarHospitals
#HrudayagivesNewLife
#FreeHeartSurgery

Summary:
A 12-day-old baby was fighting for life. Born with a rare heart defect, he could not survive without surgery. As if that wasn't enough, he developed severe bloodstream and lung infections caused by highly drug-resistant bacteria. By the time he reached us, he was on a ventilator and required medicines just to maintain his blood pressure.

After carefully stabilizing him, our team performed complex open-heart surgery to correct the defect. Within hours, his tiny heart was working normally. The breathing machine was removed the same day.

Over the next week, he gradually began feeding, breathing on his own, and recovering like any healthy newborn. Seven days after surgery, he went home.

Every child deserves this chance—not just those who can afford it. At Star Hospitals, our charity pediatric cardiac surgery program provides completely free heart surgery for children from economically disadvantaged families. One successful operation doesn't just save a child. It gives a family their future back.

𝐂𝐚𝐬𝐞 𝐨𝐟 𝐭𝐡𝐞 𝐖𝐞𝐞𝐤 (𝟐𝟕/𝟎𝟒/𝟐𝟔 - 𝟎𝟑/𝟎𝟓/𝟐𝟔)

B/0 Ru Pe
12 days, Mch, 3.6 Kg
D Transposition of GA
Large Sub-pulmonary VSD
Usual coronary pattern with Intramural LMCA

Baby was intubated at birth at outside hospital
Shifted on Ventilator to Star Hospitals on Day 9 of life in view of worsening sepsis and hemodynamic instability requiring high inotropic support
Blood cultures positive for MDR Klebsiella, ET culture positive for XDR Acinetobacter pneumonia
Taken after brief optimization for surgical correction

Procedure:
Arterial switch with VSD closure
Complex coronary transfer
Primary chest closure

Uneventful procedure
Recovery to normal biventricular function and sinus rhythm, Trivial Neo-AR, No residual VSD
Good coronary flow and good branch PA flow in LeCompte

Extubated at 11 hours after surgery to NIPPV
Gradually weaned to CPAP and then to Nasal prongs oxygen
Transitioned to oral feeds and room air

Discharged on POD 7

Thank you team!!

[sairam palaparthi @drpsairam]

Paediatric Cardiac Surgery Complex Patient stories #16

#StarHospitals
#HrudayagivesNewLife
#FreeHeartSurgery

Case of the Week (20/04/26 - 26/04/26)

Baby Ak
1 month 23 days, Mch, 3.2 Kg
Heterotaxy, Mesocardia, Right isomerism - Asplenia
Complete AV canal defect, Anatomically corrected Malposition of GA (ACMGA): {S, D, L}
Hypoplastic LV, Large VSD, Large ASD, Obstructed TAPVC
Severe PAH

Procedure:
TAPVC repair, PDA Ligation and PA banding

Uneventful procedure
Recovery to normal ventricular function, Qp:Qs of 2 intraop
Primary chest closure

Brief cardiac arrest on POD 1: Chest reopened: ROSC with cardiac massage: Down time of 10 mins: Qp:Qs was noted to be high
Band tightened to Qp:Qs of 1.4
Delayed chest closure on POD 4
extubated on POD 5 to NIPPV
Gradually weaned to Nasal prongs oxygen
Transitioned to oral feeds and room air

Discharged on POD 12 at room air with 80% saturation

Thank you team!!

[sairam palaparthi @drpsairam]

Paediatric Cardiac Surgery Complex Patient stories #15

#StarHospitals
#HrudayagivesNewLife
#FreeHeartSurgery

Case of the Week (13/04/26 - 19/04/26)

Baby Md G
29 days, Mch, 3.0 Kg
Tricuspid Atresia, restrictive ASD, Large VSD, NRGA
Severe PS: Amounting to near atresia, Closed off PDA

Presented with severe dehydration and hypoxemia with saturation below 10%
Emergently intubated and resuscitated: No improvement in desaturation
Persistent circulatory shock with lactates greater than 20 mmol/L and sats below 10% to unrecordable
Remained on very high multiple inotropic support
Taken for emergency BTT shunt placement in the mid-night

Procedure:
Right modified BTT shunt placement: 3.5 mm PECA graft
Under Emergent sternotomy and crash cardiopulmonary bypass
Primary chest closure

Uneventful procedure
Recovery to normal biventricular function and remained in Sinus rhythm
Saturation improved to 85% with Qp:Qs of 1.5

Extubated on POD 1 to CPAP
Gradually weaned to Nasal prongs oxygen
Transitioned to oral feeds

Discharged on POD 7

Thank you team!!

[sairam palaparthi @drpsairam]

Paediatric Cardiac Surgery Complex Patient stories #14

#StarHospitals
#HrudayagivesNewLife
#FreeHeartSurgery

Case of the Week (06/04/26 - 12/04/26)

B/o Ma
4 days, Fch, 2.9 Kg
TGA with intact ventricular septum
Large ASD, PDA
Bilateral SVC

Procedure:
Arterial switch + ASD closure
Primary chest closure

Uneventful procedure
Recovery to normal biventricular function and Sinus rhythm
Trivial neo-AR, Laminar BPA flow

Extubated on POD 1
Reintubated on POD 2 for RD and pulmonary bleed
Extubated again on POD 3 to CPAP
Episodes of SVT: Improved with antiarrhythmics
Gradually weaned to Nasal prongs oxygen
Transitioned to oral feeds

Discharged on POD 12

Thank you team!!

[sairam palaparthi @drpsairam]

Paediatric Cardiac Surgery Complex Patient stories #13

#StarHospitals
#HrudayagivesNewLife
#FreeHeartSurgery

Case of the Week (30/03/26 - 05/04/26)

B An As
18 months, Fch, 8 Kg
TOF with pulmonary atresia
Large malaligned VSD
PDA supplying confluent PAs: S/P PDA stent
severe LPA ostial stenosis: Jailed LPA

Procedure:
VSD routing to aorta
RV PA conduit, Hand sewn PTFE with PTFE leaflets
PDA stent removal, LPA reimplantation onto bifurcation

Uneventful procedure
Recovery to normal biventricular function and Sinus rhythm
No residual VSD
Near laminar RVOT and branch PA flows
No AVVR

Extubated on Table:
Uneventful postoperative course
Discharged on POD 4

Thank you team!!

[sairam palaparthi @drpsairam]

Paediatric Cardiac Surgery Complex Patient stories #12

#StarHospitals
#HrudayagivesNewLife
#FreeHeartSurgery

Case of the Week (23/03/26 - 29/03/26)

B/o Sa Sa
4 month 26 days Fch, 4.2 Kg
DORV with Taussig Bing anomaly, Side by side GA
Large subpulmonic VSD, Severe PAH
Severe size mismatch between GA
Usual coronary pattern
ASD, 3 mm PDA

Procedure:
Arterial switch operation with VSD routing to native PA
Neo-aortic root reduction plasty
Shift of bifurcation to right with LeCompte
Primary chest closure

Uneventful procedure
Recovery to normal biventricular function and Sinus rhythm
No residual VSD
Mild flow acceleration in LVOT: PPG of 20 mm of Hg, No RVOTO, Mild Neo AI
Flow acceleration in RPA with PPG of 15 mm of Hg
No AVVR

Extubated on POD 1:
Uneventful postoperative course
Discharged on POD 6

Thank you team!!

[sairam palaparthi @drpsairam]

Paediatric Cardiac Surgery Complex Patient stories #11

#StarHospitals
#HrudayagivesNewLife
#FreeHeartSurgery

Case of the Week (16/03/26 - 22/03/26)

B/o Ka Gr
1 month 29 days Fch, 2.7 Kg
D Transposition of Great arteries
Large PM VSD, Severe PAH
Usual coronary pattern
PFO, PDA, Moderate TR

Procedure:
Arterial switch operation with VSD closure
Neo-aortic root reduction plasty
Primary chest closure

Uneventful procedure
Recovery to normal biventricular function and Sinus rhythm
No residual VSD
Mild flow acceleration in LVOT: PPG of 10 mm of Hg, No RVOTO, Mild Neo AI
No AVVR

Extubated on POD 0: 4 hours after shifting to ICU
Uneventful postoperative course
Discharged on POD 5

Thank you team!!

[sairam palaparthi @drpsairam]

Paediatric Cardiac Surgery Complex Patient stories #10

#StarHospitals
#HrudayagivesNewLife
#FreeHeartSurgery

Case of the Week (09/03/26 - 15/03/26)

B/o Po Sh
2 days Mch, 2.5 Kg
D Transposition of Great arteries
Usual coronary pattern
PFO, PDA, Moderate TR
Down's Syndrome, Hypothyroidism

Procedure:
Arterial switch operation
Primary chest closure

Uneventful procedure
Recovery to normal biventricular function and Sinus rhythm
No LVOTO or RVOTO, Mild Neo AI
No AVVR

Extubated on POD 0: 2 hours after shifting to ICU
Uneventful postoperative course
Discharged on POD 5

Thank you team!!

[sairam palaparthi @drpsairam]

Paediatric Cardiac Surgery Complex Patient stories #9

#StarHospitals
#HrudayagivesNewLife
#FreeHeartSurgery

Case of the Week (02/03/26 - 08/03/26)

Baby Ve
6 months Fch, 4.7 Kg
AV canal defect
Severe PAH
Mild left and right AVVR

Procedure:
Two patch repair of AVCD

Uneventful procedure
Recovery to Normal biventricular function
No LVOTO or RVOTO
Tiny residual VSD
Mild left AVVR with no right AVVR

Extubated on POD 0
Uneventful postoperative course
Discharged on POD 4!

Thank you team!!

[sairam palaparthi @drpsairam]

Paediatric Cardiac Surgery Complex Patient stories #8

#StarHospitals
#HrudayagivesNewLife
#FreeHeartSurgery

Case of the Week (23/02/26 - 01/03/26)

Baby Ra
1 Year 2 months Mch, 6.0 Kg
Anomalous origin of LCA from PA (ALCAPA) from Non-facing sinus
Mild MR
Dilated LV with severe LV Dysfunction with LVEF of 5%

Procedure:
Left coronary translocation

Uneventful procedure
Recovery to Severe LV dysfunction with EF of 5%
No LVOTO or RVOTO
Mild MR

Extubated on POD 2
Had persistent Left lung collapse due to cardiomegaly and bronchial compression: Gradually improved
Required Left ICD insertion for pneumothorax
Uneventful further postoperative course
Discharged on POD 8
Follow up Echo after two months shows improved LVEF to 15%

Thank you team!!

[sairam palaparthi @drpsairam]

Paediatric Cardiac Surgery Complex Patient stories #7

#StarHospitals
#HrudayagivesNewLife
#FreeHeartSurgery

Case of the Week (16/02/26 - 22/02/26)

B/o N
5 days Mch, 3.0 Kg
D Transposition of Great arteries
Usual coronary pattern
PFO, PDA

Procedure:
Arterial switch operation
Primary chest closure

Uneventful procedure
Recovery to normal biventricular function and Sinus rhythm
No LVOTO or RVOTO, Mild Neo AI
No AVVR

Extubated on POD 0: 4 hours after shifting to ICU
Uneventful postoperative course
Discharged on POD 5

Thank you team!!

[sairam palaparthi @drpsairam]

Paediatric Cardiac Surgery Complex Patient stories #6

#StarHospitals
#HrudayagivesNewLife
#FreeHeartSurgery

Case of the Week (09/02/26 - 15/02/26)

Baby An Ma
3 months Fch, 3.5 Kg
Type A Interruption, PDA continuing as DTA with severe PDA stenosis
Bicuspid aortic valve with mild AS
Large doubly committed PM VSD
Severe TR with Severe PAH with systemic RVSP
ADPKD with single right kidney with multiple cysts with atrophic left kidney

Procedure:
Interruption repair with VSD closure
Innominate and DTA cannulation for renal protection
under CPB with single dose del Nido formula cardioplegia
Primary chest closure

Uneventful procedure
Recovery to normal biventricular function and Sinus rhythm
No radial - femoral gradients
Mild AS with PPG of 10 mm of Hg with no AI
No AVVR

Extubated on POD 1
Post Op: Severe PAH: treated with Sildenafil, Bosentan and Selexipag
Had non oliguric AKI: Recovered in 48 hours:
Post Op sepsis: Recovered with antibiotics
Uneventful further postoperative course
Discharged on POD 10

Thank you team!!

[sairam palaparthi @drpsairam]

Paediatric Cardiac Surgery Complex Patient stories #5

#StarHospitals
#HrudayagivesNewLife
#FreeHeartSurgery

Case of the Week (02/2/26 - 08/2/26)

Ms. G. Bh
2 Year old Fch, 9.0 Kg
Heterotaxy, Atrial ambiguous, Visceral inversus
SVC to left sided atrium with IVC interruption and Hemiazygos continuation
Hepatic veins to left sided atrium
D Looping with DMGA
Complete AV canal defect with Mild LV hypoplasia
Moderate left and right AVV regurgitation
DORV with Aorta from RV
Large VSD and Large OP ASD
Severe Pulmonary stenosis with near atresia with PA bifurcation stenosis

Procedure:
Biventricular repair
Mustard baffling of SVC and Hepatic veins to right side
Two patch Complete AV canal repair with routing of LV to aorta
Mitral and tricuspid valve repairs
PA bifurcation plasty
RV PA conduit with 14 mm ePTFE with 0.1 mm ePTFE tricusp valve

Uneventful procedure
Recovery to normal biventricular function and Sinus rhythm
Unobstructed LVOT and RVOT
No right AVVR, trivial left AVVR
Good flow in RPA and LPA
Unobstructed mustard Baffle

Extubated on POD 1
Uneventful postoperative course
Discharged on POD 8
Child had rim of pericardial effusion which was conservatively managed

Thank you team!!