Times of India
30 June 2011
Chennai, India

They stopped the baby's heart, laid ice cubes around her head to bring down the body temperature and pulled out a walnutsized tumour that blocked blood supply to the heart.

On Wednesday, nearly 10 days after the four–hour surgery, doctors at Fortis Malar told reporters that the surgery was not just life–saving but rare as the tumour they removed was leiomyoma, generally found in the womb.

Three–day–old Asiffa was rushed to the hospital when she became unconscious. Doctors found she had turned blue as the tumour on the right side of the heart blocked blood supply to the heart. The oxygen levels dropped drastically.

The test showed a walnutsized tumour blocking the flow of blood between the right atrium and right ventricle (2 of the 4 chambers in the heart connected by valves). "At that time, we didn’t know if it was malignant and decided to remove it as early as possible," said cardio–thoracic surgeon and director of cardiac care Dr KR Balakrishnan.

On June 18, Asiffa was wheeled in for surgery. After anaesthesia was administered, she was connected to the heart–lung machine and the heart was stopped. "We wanted the heart to be still. The machine took over the heart's role," said Dr Suresh Rao, head of the department of cardiac anaesthesia and cardiac critical care. But there was another challenge.

The blood was flowing rapidly and it was difficult to operate. That’s when the doctors decided to bring down the body temperature to 15 degrees Celsius from the normal 37 degrees. At low temperatures, the body’s metabolic rate reduces and blood circulation slows down. "We placed ice cubes near the baby’s head. This reduced the body temperature," said Rao. In 30 minutes, the tumour was removed and the baby’s body temperature was raised to normal.

Asiffa, now 20 days old, now has a near–normal heart, said doctors. The tumour was revealed through laboratory tests as leiomyoma but doctors still don’t know why the child developed the tumour. Medical literature says only three persons, all above 40, had so far had this tumour in the heart.

"Children usually get tumours in the eye and stomach. There may be different reasons for the tumour to have formed in the child’s heart. As of now we don't rule out genetic reasons," said Rao.

What Went Wrong
The Problem
Three day old baby Asiffa had a tumour on the right side of her heart. This blocked blood supply to the heart as a result of which oxygen levels dropped drastically

The Surgery
After administering anaesthesia, doctors connected the baby to heart–lung machine to stop the heart. Then, to slow down her blood ciruclation, doctors placed ice–cubes around her head. It helped bring down the body’s metabolic rate, which slowed down blood flow. Then the tumour was removed

Rarest OF Rare
Tumour leiomyoma, generally found in the womb of women above 40, was detected in the heart of Asiffa, which is a very rare occurance