J J Doctors Fix Pacemaker In A Right-sided Heart
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23 June 2010
By Malathy Iyer
For over two decades, Vile Parle resident Mansi Joshi, 45, had known that there was something different about her heart. "During a pregnancy scan, a doctor told me that my heart was on the right side instead of the usual left side,’’ she said.
But it only last week, during a health emergency, that the state government employee realised the extent to which her heart was different. Doctors at the state–run J J Hospital in Byculla not only found out her anomaly, but also found an innovative way to fix her heart problem, which is medically described as a complete heart block (the flow of blood from the heart is greatly reduced due to irregular heart pulse).
"Joshi not only had her heart on the right side, she also had abnormal arterial connections. In fact, she has a rare congenital condition called the corrected transposition of the great arteries,’’ said Dr N O Bansal, who heads the cardiology department of J J Hospital.
Of all the heart defects at birth, the transposition of the great arteries (in which the aorta and pulmonary arteries don’t originate from the heart chambers that they are meant to) is common. The defect prevents the flow of pure blood to the body and needs to be fixed within a month of birth to prevent fatality.
"Joshi, too, had transposed arteries, but in her case the condition was corrected by another structural anomaly,’’ said associate professor (cardiology) Dr Bhanu Kapoor. Joshi’s ventricles – the right which is ridged and the left that has smooth interiors – too were switched.
Persons born with corrected transposition don’t need any corrective surgeries, but the abnormality does take a toll on the heart over the years. "In Joshi’s case, the heart’s electrical circuit (that controls heart beats) suffered, leading to lowered blood supply,’’ said Bansal.
Three months ago, she started getting spells of dizziness and breathlessness. "By the time, she came to us she had a complete heart block in which blood flow is poor due to improper impulses,’’ added Kapoor.
The J J team decided to fix a dual pacemaker to set right her heart’s electrical system. But given her right–apexed heart, they had to use a different method. "In Joshi’s case, everything was like a mirror reflection,’’ said the doctors. There was another worry: Placement of the pacemaker. "Usually the pacemaker and its circuit is placed in the right ventricle, which has trabeculated interiors. But in Joshi’s case, we had to place it in the left ventricle (which is smoother) with the use a special screw–in system to ensure the wires do not get dislogded,’’ said Bansal.
Senior cardiologist Dr A B Mehta from Jaslok Hospital said, "One in every 25,000 live births has the hearts on the right side. But a corrected transposition along with right–sided heart is definitely rare.’’
Joshi, a mother of a 21–year–old, is happy to breathe easily. "I never realised that I had such a different heart. I am glad it has been fixed,’’ she said.