In a surgery that lasted nine hours, doctors at a hospital here used deep hypothermic circulatory arrest (DHCA), a surgical technique in which the body temperature was reduced to 15 degrees C, to successfully remove a 200 gm cancerous tumour that had grown inside and outside a two-year-old boy’s heart.
Aadhi Thoppil Fabeer was rendered clinically dead as a team of 30 doctors operated upon him for removal of intracardiac yolk sac germ cell tumour in the heart, an extremely rare condition. Aadhi’s heartbeat and brain activity was stopped for 40 minutes during the surgery. The normal human body temperature is 37 degrees C and humans quickly die if the core body temperature drops below 22 degrees C.
“The surgery was the fifth such successful surgery performed in the world,” said Dr M K Mossa Kunhi, head of department, cardiac surgery and heart transplantation, VPS Lakeshore, who led the team that operated on the boy.
“In all the four other cases, the tumour was reported inside the heart but in this case the tumour was inside and outside the surface of the heart,” he added.
The yolk sac tissue develops on the third day of pregnancy and is usually dissolved within a month. But in this case, the tissue developed into a cancerous tumour.
“It is a very rare condition and I have not seen one such case in my career. It is an extremely difficult surgery to perform as the tumour infiltrates the heart muscle and comes out. Chemotherapy will help burn residual tumour, if any,” said Lisie Hospital’s cardiac surgeon Dr Jose Chacko Periappuram, who has performed 17 successful heart transplants so far.
Aadhi’s condition was detected when he developed fever recently. His parents, working in Dubai since last 10 years, initially took him to a hospital there. “The patient was brought in a critical condition here with 95% blood circulation blocked by tumour. The child was breathless and we suspect that he developed the tumour during intrauterine life. We operated him on Eid day and now he is doing fine. He needs chemotherapy course once in three weeks about 3 to 4 times. He was given this first chemo course on Saturday,” Dr Kunhi said.
“This tumour is commonly seen in reproductive organs but it is extremely rare in the heart”, said Amrita Institute of Medical Sciences (AIMS) paediatric surgeon Dr Naveen Vishwanathan.
The boy’s mother, Merin Fabeer, an IT professional, revealed that though the Dubai doctors had denied permission to travel, she and her husband had flown Aadhi to Kochi. “Our efforts have paid off and now he is recovering,” she said.
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