Times of India
27 September 2010
By Sumitra Deb Roy
Mumbai, India

Three–year–old Yash Narvekar was a regular kid, except that he detested eating. His mother, Rupali, recalls that he never asked for food and was never hungry even after not being fed for hours.

The parents realised all was not well with their child when he turned 10 months old. Subsequent visits to doctors and a battery of tests, including X–ray and ultrasonography, revealed that Yash had a huge hole in his heart, one of the most common congenital cardiac disorders in the country.

Doctors who diagnosed his condition told his parents that the hole was as large as a fiverupee coin. While several suggested surgery, Yash’s parents were not very confident about having their child go under the knife at such a tender age. But, two weeks ago, their problem was finally solved after Yash underwent a successful cardiac surgery to close the hole in a city hospital. Most importantly, according to the parents, their toddler does not have a scar on his chest that could have been a visually disturbing reminder of a major surgery all their lives.

Yash’s surgery was special on several counts. Doctors at the SevenHills Hospital, where he underwent the procedure, managed to approach the hole in his heart through his back without cutting open his chest. The technique, called posterior thoractomy, is gradually achieving acceptance given its cosmetically superior appeal. His treating doctor and paediatric surgeon, Dr K Shiva Prakash said that the technique, currently used in about 18 centres worldwide, has many advantages.

"Most importantly, the child’s breast bone remains untouched and that cuts down the healing time as well as chances of contracting a post–operative infection,’’ he said. In Yash’s case, the doctors made an incision of about 2–3 inches between his ribs. "Thereafter, we pulled up the upper chamber of his heart and put a patch to close the hole,’’ Prakash added.

Prakash also said that globally it was observed in many studies that a scar–free chest helps many children grow up without related problems.

The cost of treatment remains the same as conventional open heart surgery via the chest. But the duration of hospital stay is reduced. A cardiac surgeon from JJ Hospital, however, said that the technique has its limitations. "It can only be used for patients when the hole is located on the upper chamber of the heart,’’ the doctor said.