On the morning of January 23th, outside the maternity ward of the Obstetrics and Gynaecology Hospital, the neonatal transport team of Children’s Hospital of Fudan University affiliated with Fudan University was anxiously waiting for the arrival of a new life. Accompanying the birth of a baby delivered by Caesarean section at 37 weeks, were extremely disturbing signs: her lips were visibly blue and purple, her oxygen saturation was only 60% (normal children are above 95%), and her breathing was very laboured. The situation is critical! The transport team didn't dare to delay for a moment, and every second counted to transfer her to the paediatric hospital for treatment.
As early as the 26th week of her mother's pregnancy, the baby was found to have complete transposition of the great arteries with an intact ventricular septum during her antenatal check-up. This is a serious and complex congenital heart disease, and if left untreated, the child will die in the neonatal period. Zhang Huifeng, deputy director of cardiothoracic surgery at Children’s Hospital of Fudan University, said that complete transposition of the great arteries is a serious and curable congenital heart disease, and despite the risks associated with the surgery, the prognosis is mostly ideal, and the child can grow up like a normal child.
The cardiothoracic surgery team of the hospital, together with the team from the Department of Prenatal Diagnosis and Fetal Medicine of the Obstetrics and Gynecology Hospital affiliated with Fudan University, worked closely before and after the birth, and after the prenatal checkups and several online discussion meetings, they formulated a delivery and transfer plan to ensure that every step was flawless and to meet the little one's safe birth.
Upon arrival at the paediatric hospital, after a multidisciplinary assessment and preparation including neonatal, anaesthesia, cardiac monitoring, cardiac surgery and cardiac ultrasound, it was found that Lili's atrial septal defect was only 1.8mm, which was a complete transposition of the great arteries in a critical condition. It could not wait any longer! Born only 4 hours ago, the baby was immediately admitted to the operating theatre. The newborn's heart is smaller than an egg, and the coronary arteries are as thin as hair, so the difficulty of completing the anastomosis and transplantation in such a heart is comparable to dancing on a tightrope. In the end, the surgical team led by Deputy Director Zhang Huifeng successfully reversed the baby's misaligned aorta and pulmonary artery with skilful suturing techniques. A powerful heart began to beat again!
Under the careful care of the Cardiac Intensive Care Unit team, the baby's vital signs are stable, her heart function is gradually recovering, and all indicators are becoming normal. At present, she has been transferred to the general ward and is recovering well.
What is complete transposition of the great arteries?
The two important blood vessels of the foetal heart have been reversed from left to right and misplaced from front to back. Normal aorta and pulmonary artery should be connected to the left ventricle and right ventricle respectively, but this patient has formed an abnormal connection of aorta-right ventricle and pulmonary artery-left ventricle, resulting in the body-pulmonary circulation to do its own thing, losing the function of exchange, and the blood with high oxygen content will always circulate in the lungs, and the blood that goes to the various organs of the body will always be the venous blood with low oxygen content, so that the life of the patient is only sustained by the ventricular septal defect (or the patent foramen ovale) after birth. The child's life is sustained only by the atrial septal defect (or patent foramen ovale) that occurs after birth.