TIL Desk Lucknow :ЁЯСЙDoctors at Medanta Lucknow successfully performed a PDA stenting procedure on a 3-day-old newborn suffering from a severe congenital heart defect. The 4-kg baby had a blood vessel called the PDA, which supplies blood to the lungs, beginning to close on the third day after birth, causing his oxygen saturation to drop to 50%. Keeping this blood vessel open was essential to save the newborn’s life. Doctors inserted a stent into the PDA without open-heart surgery, maintaining blood flow to the lungs. Immediately after the stent was placed, the baby’s oxygen saturation increased to 85%.
The challenging procedure was performed by Dr. Mahim Saran, Director, Interventional Cardiology, Medanta Lucknow, and Dr. Roli Srivastava, Senior Consultant, Pediatric Cardiology. The baby had a complex congenital heart defect. He had a large hole in the heart, medically known as a ventricular septal defect (VSD). In addition, the main artery carrying blood to the lungs was not fully developed, a condition known as pulmonary atresia. In such cases, blood reaches the lungs through a natural blood vessel called the patent ductus arteriosus (PDA).
In newborns, this blood vessel normally closes on its own within a few days after birth. However, in this baby’s case, it was necessary for the vessel to remain open to ensure blood flow to the lungs. On the third day, as the vessel began to close, the baby started turning blue and the oxygen level in his blood dropped rapidly. When he arrived at the hospital, his oxygen saturation was only 50%.
Considering the baby’s condition, the doctors decided to perform PDA stenting. In this procedure, a small stent is placed inside the PDA to keep the blood vessel open and help maintain blood flow to the lungs.
Before the procedure, investigations showed that the baby’s PDA was quite long, vertical and tortuous. To avoid keeping the baby for too long in the cold catheterisation laboratory environment, femoral access was obtained in the NICU itself with the help of ultrasound. During the procedure, access was also obtained through another route, which was used to advance the stent to the PDA and confirm its correct placement.
Immediately after the stent was placed, the baby’s oxygen saturation increased from 50% to 85%. This indicated that blood flow to the lungs had improved through the stent.
Dr. Mahim Saran said that keeping the PDA open is extremely important in such children because it is the pathway through which blood reaches the lungs. If this pathway closes prematurely, the baby’s condition can deteriorate rapidly. In such cases, timely PDA stenting can be an important treatment option for the child.
Dr. Roli Srivastava said that PDA stenting can help some children avoid major surgeries such as open-heart surgery and a BT shunt. However, challenges such as the formation of blood clots in the stent and the need for another procedure in the future may arise. Despite these challenges, hospital stay in such cases may be shorter compared to open surgery.
