Amrita Institute of Medical Sciences - a center of excellence in open-heart surgery for newborns and infants
Posted on: 20/Jan/2018 9:42:00 AM
India’s top pediatric heart surgeons from Kochi’s Amrita Institute of Medical Sciences – a center of excellence in open-heart surgery for newborns and infants – have urged an India-wide campaign to save the lives of more than 220,000 children born with heart defects each year through better diagnosis and treatment. The number of centers with the capability of infant and newborn open-heart surgery needs to be increased ten-fold, and public-private partnerships encouraged to address immediate requirements, they said at a workshop on pediatric heart concerns.
Said Dr. R Krishna Kumar, Head, Deptt. of Pediatric Cardiology, Amrita Institute of Medical Sciences: “One in every 120 children is born with a heart defect. About 220,000 children are born every year with heart defects in India, 10,000 of them in Tamil Nadu alone. This is the largest burden of congenital heart defects in the world. Over 90% of these children do not receive timely attention, resulting in premature death or lifelong disability. Early diagnosis and treatment are essential because the maximum number of deaths from congenital heart defects happen in the first year after birth and a substantial proportion of them die in first month of life.”
The most common congenital heart defects in children include holes in the heart or the great vessels, the narrowing of heart valves or vessels, and conditions resulting in the child becoming a “blue baby.” The symptoms in infants include difficulty in breathing or feeding, excessive sweating, blueness of lips, fingers and toes, poor growth and frequent episodes of chest infection.
Talking about the severity of heart defects in children and treatment options, Dr. R Krishna Kumar added: “About 30% of all congenital heart defects (CHDs) are life threatening and can prove fatal if not treated. Less severe forms of CHD can contribute to a child’s illness and reduce chances of survival. With timely treatment, most babies with CHD can expect to survive and lead productive lives. Most heart defects need open-heart surgery, even in newborns. Cardiac catheterization technology now allows treatment of many heart defects without operation with just a needle prick in the groin. This avoids the trauma of surgery for an infant and allows rapid recovery. Technological advancements like 3D printing of hearts, devices to close heart defects, and miniaturization of cardiopulmonary bypass circuits have made complex heart surgery easier and more precise.”
Said Dr. Brijesh PK, Clinical Associate Professor, Amrita Institute of Medical Sciences, an expert in performing heart surgeries on youngest infants: “Creating infrastructure for care of children with heart disease involves substantial investments, and few hospitals can afford it. Less than 50 centers exist in India with the capability of infant and newborn open-heart surgery when the requirement is for 500 such centers. Very few of these are truly comprehensive and suffer from shortfall of human and material resources. The most serious deficiencies are in nursing, intensive care physicians and dedicated pediatric heart surgeons. There is also a serious lack of ability to provide timely diagnosis and referral among the primary healthcare professionals, resulting in late presentation or untimely death of babies. Less than 10 centers exist in the government sector with the capability of infant and newbwborn open-heart surgery. Economic barriers come in the way of most child heart patients receiving timely care. Most medical insurance providers have specifically listed congenital heart defects as an exception to the list of conditions covered.”
Added Dr. Brijesh PK: “Selected states like Maharashtra, Andhra Pradesh, Chhattisgarh and Gujarat have introduced schemes for screening and treatment of children with heart disease, but these largely cater to school children, leaving out the most vulnerable group of newborns and infants. The RBSK scheme of Indian Government seeks to screen and treat over 270 million children for defects at birth. Heart diseases in children also figures prominently in the list of conditions included for universal health coverage. However, it is unrealistic to expect every child with heart defect to be covered by government-aided schemes. Charitable foundations can play a valuable role in filling this gap. Corporate CSR funds can be effectively directed through these foundations to fund heart surgery of child patients. But this will require a sustained campaign to educate and convince the growing number of affluent Indians to donate to the cause.”
Said Dr. R Krishna Kumar: “To save lives of children with heart defects, we need setting up of comprehensive pediatric heart programs in hospitals, public-private partnership, training manpower in pediatric heartcare, establishing a framework for funding heart surgeries under public insurance schemes, screening initiatives for CHD, strengthening of diagnostic facilities at district hospitals and medical colleges, and improving transportation of newborns with CHD. Only 10% of newborns and infants in India receive comprehensive care in a timely fashion. While widespread screening will allow for increased detection of CHD, it is also necessary to sensitize healthcare personnel at all levels, starting with primary care pediatricians. Most pediatricians have undergone their PG training in institutions without any facility for infant and newborn heart surgery. This contributes to limited skills in clinical identification of CHD. It is imperative to conduct training workshops for pediatricians to sensitize them about screening, diagnosis, treatment and prognosis of CHD.”
The pediatric cardiac program was initiated at Amrita Institute of Medical Sciences in 1998. It is now recognized as India’s leading pediatric heart programs and is a preferred destination for patients from all over India and other countries in South Asia, Middle East and Africa. A team of four dedicated full-time pediatric cardiac surgeons headed by Dr. GS Sunil perform heart operations with results matching global standards. On an average, 3-4 operations are performed for children with congenital heart disease every day.
