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NDO – Suffering from life-threatening, infectious complications caused by congenital heart diseases, two child patients, only a few months old, have been saved by medical staff at the Children’s Cardiology Centre, under Hanoi-based Central Children’s Hospital.
According to Doctor Cao Viet Tung, head of Anesthesia Department, the Children’s Cardiology Centre has successfully performed two surgeries for the two child patients with complex congenital heart diseases.
Additional success in trachea shaping based on congenital heart disease
Child patient N.D.L (three months old) was hospitalised due to respiratory failure. Doctors diagnosed the patient with a right ventricular malformation, accompanied by abnormalities originating from left pulmonary artery, causing a severe narrowing of the airway. D.L’s trachea was very narrow as the child’s entire airway was surrounded by congenital cartilage.
The patient was given mechanical ventilation, but the child’s lungs were unable to operate normally due to the narrowed airway. D.L’s condition deteriorated rapidly with a rapid increase in the levels of CO2 in the blood.
“This case is extremely difficult because D.L only weighs less than 5kg, with many complicated lesions, especially narrowed tracheal injuries in young children. At the same time, it is also difficult to assure ventilation in the resuscitation process. Without surgery, the patient would have certainly died within a few hours,” said Tung.
However, this is a complex case, as doctors have to repair the right ventricular outflow, patch the ventricular septal defect and replenish the left lung artery. In addition, the formation of the trachea in a child that is so small adds to complexity of the surgery.
Following the surgery, D.L condition remained critical; the child was actively and continuously resuscitated for 15 days. After a 34 day stay at the hospital, D.L was discharged in a stable state as a normal and healthy baby.
Tracheostomy is a big challenge for doctors because of the postoperative narrowed trachea recurrence and high mortality from infections due to prolonged mechanical ventilation. Doctor Tung said that the operation was successful thanks to the combination of surgical experience and resuscitation care for the baby post-surgery.
Previously, the failure rate when performing tracheostomy in children was very high. Since 2016, the centre has successfully performed eight tracheostomies. With the surgery for N.D.L, the centre has added an additional milestone in technological development for domestic congenital heart surgery.
Rescue an ethnic minority boy with multiple organ failure
Doctor Cao Viet Tung visits N.M.N after the surgery.
Ethnic minority N.M.N. was hospitalised in a very critical condition. He was diagnosed with tetralogy of Fallot.
Doctors at the centre carried out a surgery to completely repair his heart injuries. Although the lesions have been repaired successfully, postoperative progression deteriorated rapidly. His organs’ functions began to deteriorate severely and doctors performed ultrasonography and discovered a severe ventricular septal defect that threatened his life.
After a consultation, doctors decided to intervene in order to seal the ventricular septal defect, regarded as the only possible treatment when the child was in a state of organ failure. The intervention was a success, but rescuers still struggled to treat the organ failure as the child fought for its life.
Fortunately, after 12 days of recovery, M.N was able to remove the ventilator and after 28 days of treatment, he was ready to be discharged.
According to Doctor Tung, for patients with narrowed airways, the Central Children’s Hospital is capable of conducting regular surgeries to treat the disease. For those suffering from tetralogy of Fallot, patients can be treated with a high success rate due to the close coordination among surgeries, intervention and anaesthesia resuscitation.