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Heart failure is a major medical concern across the world and affects more than 26 million people worldwide. In Asia, its prevalence ranges between 1.3% and 6.7%, higher than the western countries. The patient condition can be improved by heart transplant but the organ donation scenario continues to be dismal. In India, out of the 80,000 potential donors, organs from only about 100 are retrieved. In Delhi-NCR, only one heart donation was reported in 2012, none in 2013 and just two in 2014, making a total of mere 3 heart donations in 3 years.



7-year old Aayana (name changed) from Tashkant, Uzbekistan, was battling with Viral Myocarditis lead to end stage heart failure since 2-years of age. As a result, there was severe water retention and her liver was enlarged with severe disbalance of functions. She was being managed conservatively in her country but when the conditions were overboard, her family consulted Dr. Kewal Krishan at Max Super Speciality Hospital, Saket. Aayana (name changed) had swelling all over her body owning to water retention and an extremely enlarged heart. She was breathless even at resting body position and was also diagnosed with gross heart failure. As a result, she was stabilised with inotropes and was advised a Left Ventricular Assist Device (LVAD). Now, Aayana (name changed)is the youngest recipient of LVAD in the Asia-Pacific region.



Commenting on the successful procedure, Dr. Kewal Krishan, Director – Heart Transplant & Ventricular Assist Devices Principal Consultant – CTVS, Max Super Speciality Hospital, Saket, said, “Aayana(name changed)was brought in to Max Hospital Saket under extremely critical condition. Suffering from Viral Myocarditis for 5 years now, her small body already had a compromised heart along with enlarged liver with impaired functions. In order to increase her chances of survival, we operated for an LVAD and, to everyone’s delight, she is recovering well. Her liver functions have improved drastically and the swelling has been cured. The team paid special attention to the post-operative blood thinner management and explaining LVAD related aspects to the caregivers as the patient is very young. LVAD has been a bridge to transplant but this is one of the rare occasions where it could serve as a bridge to recovery as Aayana (name changed)is quite young and the scope of improvement with continuous monitoring is possible in the long run, thereby eliminating the need for a transplant.”



Unlike adults, the causes of heart failure in many children are due to congenital disorders that usually results in cardiac failure. On a global scale, congenital heart disease (CHD) occurs in around 8 out of 1000 live births. Around 20% cases suffer from heart failure associated with CHD. Although, with introduction of advanced surgical interventions, the occurrence of cardiac failure has been brought down significantly said Dr Viveka Kumar, Senior director cath lab. Max hospital, Saket, NewDelhi



The LVAD, a battery-operated mechanical pump, serves as a viable option for patients who suffer from end-stage heart failure. The ventricular assist device is surgically implanted in patient’s chest where it helps the left ventricle in pumping blood to the rest of the body. In such an extreme situation, where the heart is so weak that it can neither wait for a donor nor an artificial heart, LVAD comes as a positive ray of hope to pull the patient from the jaws of death.

 


 
 
 

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