The first case in the province! A rare baby with "mirror-shaped dextrocardia" is born

A heart surgery was performed on a 9-month-old baby in front of a "mirror" without visible incision. This surgery is the first of its kind in Jiangsu. Recently, the Cardiovascular Center of the Second Affiliated Hospital of Nanjing Medical University successfully performed a rare congenital heart disease surgery. The little patient not only had "mirror dextrocardia" but also ventricular septal defect. In addition, the surgery was extremely difficult due to his young age.

9-month-old baby suffers from rare congenital heart disease

It is reported that since the launch of the "Heart Care Project", the Cardiovascular Center of the Second Affiliated Hospital of Nanjing Medical University has performed surgeries on children with various types of congenital heart disease and is quite familiar with the treatment and surgical plans for children with different types of congenital heart disease. However, recently a 9-month-old patient, Xiao Mao (pseudonym), made the expert team of the Cardiovascular Center nervous.

Nine months ago, Mr. Mao (pseudonym) from Changzhou welcomed a new baby, Xiao Mao, into his family. But this happiness was soon shattered by the news that the child had congenital heart disease.

Shortly after Xiao Mao was born, he was diagnosed with ventricular septal defect by the local hospital. Because the Cardiovascular Center of the Second Affiliated Hospital of Nanjing Medical University enjoys a high reputation in the treatment of congenital heart disease, they rushed from Changzhou to Nanjing and found Dean Li Qingguo for outpatient consultation.

The cardiovascular center team of the Second Affiliated Hospital of Nanjing Medical University found that Xiao Mao suffered from "mirror dextrocardia" and ventricular septal defect. Unlike ordinary people, Xiao Mao's heart grew on the right side of his body. What's even more rare is that his heart was mirror-imaged! This rare "mirror dextrocardia" condition has an incidence rate of only 0.01%. Together with ventricular septal defect, the combined incidence rate of the two diseases reached a rare 0.05‰.

Surgery faces many challenges

During the months of follow-up observation, doctors found that Xiaomao often sweated a lot, caught cold easily, and his weight gain was obviously slow. What's worse, his ventricular septal defect tended to grow gradually. If he didn't have surgery as soon as possible, it might cause pulmonary hypertension, which would be life-threatening in severe cases. Arranging surgery as soon as possible was the best option.

Such an operation is a huge challenge for the expert team. Li Qingguo and the team of Zhang Chong, deputy chief physician of the Cardiovascular Center, had an in-depth discussion before the operation and formulated a perfect surgical plan. The traditional surgical method requires a large incision in the middle of the sternum, which is not only traumatic and aesthetically pleasing, but may also have adverse effects on the growth and development of children. The new axillary small incision minimally invasive repair has many advantages such as less trauma, hidden wounds, high postoperative aesthetics and fast recovery. However, there is no precedent for infant mirror dextrocardia surgery with axillary small incision in the province.

For patients with normal heart position, the routine operation is to perform surgery through a small incision in the right armpit. However, for patients with "mirror dextrocardia" like Xiaomao, the surgery needs to be performed through an incision in the left armpit. This not only requires the surgical team to change their long-term operating habits, but also requires the surgeon to have superb skills and extraordinary surgical suturing skills. At the same time, due to the special position of Xiaomao's heart, the arrangement of various tubes for extracorporeal circulation is also opposite to normal, which is another huge challenge.

The operation was successful and he has been discharged from the hospital

On May 29, Li Qingguo's team performed "ventricular septal defect repair + tricuspid valvuloplasty" on Xiao Mao. The operation went very smoothly. Considering the need to help Xiao Mao quickly recover spontaneous breathing after the operation, the advanced "extubation under deep anesthesia" technique was also used after the operation. This technique not only reduces the strong stimulation during the traditional extubation process, but also reduces the dependence on the ventilator, thereby reducing the risk of infection.

Six hours after the operation, Xiao Mao resumed eating and drinking milk. The next day, he was transferred from the intensive care unit (ICU) to the general ward to reunite with his family. In less than a week, Xiao Mao had fully recovered and was successfully discharged from the hospital.

Mr. and Mrs. Mao were extremely grateful for their child's rapid recovery and the success of the surgery. Before their child was discharged from the hospital, they said excitedly: "We are deeply moved by the doctors' hard work, meticulousness, great medical ethics, superb medical skills and sincere dedication. We came here with anxiety and tension, but finally returned home happy and satisfied. We will remember this touching and love, and teach my child to be a caring, responsible and helpful person!"