Heart surgery, placing ECMO to save the newborn

After the 8-hour surgery, the newborn girl’s heart gradually deteriorated, the doctors of Children’s Hospital 1 continued to spend 4 hours setting up the ECMO system to support the baby’s heart and lungs.

A girl from Tra Vinh was born with purple lips, her family thought it was a genetic trait, so she didn’t take her to the doctor. Recently, the baby went to the hospital for a checkup because of pneumonia, the doctor discovered that his heart had an abnormal condition in the structure of the heart chamber septum along with the position of the arteries changed. This leads to oxygen-deficient blood mixing with oxygen-rich blood, causing cyanosis in the lips, fingertips, and toes. This anomaly, called transposition of the great arteries, is difficult to detect prenatally with ultrasound.

Doctors at Children’s Hospital 1 (Ho Chi Minh City) determined that the golden time to operate this heart defect was before one month of age, now the baby is four months old, so it is possible that the heart chambers have failed. The imaging results showed that the baby’s heart was about to fail, which was still curable, so the doctor quickly arranged an operation schedule.

Doctor Nham Ba Duy (Department of Surgical Resuscitation), said that after an 8-hour surgery, the baby’s breathing tube burst into pink foam when gradually reducing the cardiopulmonary support machine, showing that the left heart is failing. The cardiopulmonary support machine used exclusively in the operating room has a limited run time, if you want to continue to support the baby, you need to switch to a cardiopulmonary support machine with a longer running time (ECMO machine).

The resuscitation and surgery teams discussed and decided to attach ECMO to the baby. The time from decision making to successful completion is approximately 4 hours. “The doctors and nurses were tired when they had to work continuously for 12 hours, but for the future of the baby, they tried to focus highly, diligently, meticulously, and try their best,” said Dr. shall.

After surgery, the baby was transferred to the Department of Surgical Resuscitation. During the next 6 days, doctors were always on hand to fine-tune blood clotting, electrolytes, and acid-base to keep the optimal state for the heart muscle to recover. The nurses take very good care of them, trying to be as careful as possible to avoid accidents. The head doctor always updates the baby’s situation every day to family members by phone, helping the mother to somewhat relieve her anxiety when she can’t be near her child.

After weaning off ECMO, the baby’s heart recovered, and the lungs were well ventilated. Baby drinks milk through nasogastric tube, restores digestive nutrition. Four days later, the baby was weaned off the ventilator, slept well, his whole body was warm and rosy, and was transferred to the department to be close to his mother’s arms.

Doctors set up ECMO for pediatric patients after heart surgery. Photo: Children’s Hospital 1

According to Dr. Duy, in the past, cases of congenital heart disease were delayed and severe, patients often did not survive. Now, this pathology can be improved by means of ECMO together with a coordinated cardiac surgery team, making timely and effective treatment decisions.

Doctors recommend parents to regularly take their baby to the doctor for screening when there are abnormal signs such as purple lips, purple extremities, tired breathing, poor feeding, slow weight gain, in order not to miss congenital heart defects as well as heart defects. avoid being late.

Children’s Hospital 1 has performed heart surgery for children since 2006, bringing the mortality rate down to less than 5% per year. The hospital is about to inaugurate a Center for Cardiovascular Surgery and Intervention, helping more babies with congenital heart defects receive more effective treatment.

Le Phuong