Pakistan’s first artificial heart success

40-day-old survived on artificial heart-lung machine for 3 days at Aga Khan University Hospital.

KARACHI:

Time must have stood still when doctors took 40-day-old Mohammad Ahmed Baloch’s heart off a make-shift, customized system – one that was set up because the actual machine that would have saved the infant’s life is not available anywhere in Pakistan.

But his heart began to beat.

“All the team members, doctors and nurses will never forget the amazing moment when the artificial support was taken off and the baby’s heart started beating on its own,” recalls his paediatric cardiac surgeon, Dr Muneer Amanullah.

To save Ahmed’s life, the paediatric cardiac and critical care team of the Aga Khan University Hospital (AKUH), Karachi, assisted by Dr Asif Hasan from the UK, set-up a customised heart-lung bypass system that acted like an ECMO (Extra-Corporeal Membrane Oxygenation) machine, which is not available anywhere in Pakistan.

Hence, 40-day-old Ahmed from Dera Allah Yar, Balochistan, became the first patient in Pakistan to survive on an artificial heart-lung machine for three days.

Mohammad Ahmed Baloch was born with a severe heart defect, wherein the two major vessels in his body that carry blood away from the heart, were misconnected. The arteries supplying blood to the lungs and the rest of the body were switched, which meant that he was a ‘blue’ baby, and, with less oxygen in the blood, always short of breath. Without surgery, he stood no chance of surviving.

Ahmed’s family was no stranger to adversity. Internally-displaced, they had moved to Quetta following threats of flooding in their hometown Dera Allah Yar.

They took Ahmed to a children’s hospital in Quetta after he began showing signs of difficulty in breathing. The doctors, however, told the family that they would not be able to treat him, and advised them to take him to the AKUH. “He is the first baby of my only son, I came immediately,” Ahmed’s grandfather, Sher Ahmed Baloch, a primary school teacher in Dera Allah Yar, said.

Ahmed was just 10 days old when he was brought to the hospital’s emergency room, where the doctors performed an initial life-prolonging procedure. “We had to create a hole in his heart, between the right and left chambers, so that the blood could mix better,” said Dr Mehnaz Atiq, the paediatric cardiologist in AKUH.

After turning a month old, Ahmed was ready for the next step – an operation that would ‘switch’ his heart’s blood vessels back to their normal position. While the ‘switch’ operation itself was a success, after the surgery Ahmed’s blood pressure started to drop and it became evident he needed further support for survival.

His paediatric cardiac surgeon, Dr Amanullah, and paediatric cardiologist, Dr Babar Hasan, agreed that an artificial heart support would provide the time needed for the newborn’s heart to rest, recover and function properly.

In Pakistan, however, there is no cure for this particular side effect of the primary surgery and normally the patient would die.

To save Ahmed’s life, the paediatric cardiac and critical care team, assisted by Dr Asif Hasan from the UK, set-up the customised heart-lung bypass system that acted like an ECMO.

Ahmed spent 72 hours on the system – the first such procedure in the country.

Prof Anita Zaidi, the chair of the Department of Paediatrics and Child Health, said that “AKUH were successful in showing how advanced and sophisticated our paediatric cardiac services and critical care team have become in a short span of time.”

This procedure is performed across the world and is more advisable in child cases, and costs around Rs1 million.

The Hospital’s Patient Welfare Programme and the Patients’ Behbud Society for AKUH supported Ahmed’s family. “We couldn’t have afforded this surgery without the hospital’s assistance and very grateful for it,” says Sher Ahmed’s grandfather.

Ahmed’s mother arrived in Karachi on Thursday and is feeding the baby, which is a good sign, said Dr Amanullah, adding that the baby will be discharged on today (Saturday).

With the success of the operation, Sher Ahmed Baloch now hopes his grandson will study at the AKUH and grow up to become a life-saving surgeon.

Published in The Express Tribune, October 13^th, 2012.