In a high-risk and time-sensitive procedure, Fortis Escorts Hospital in Okhla, New Delhi, performed emergency open-heart surgery on a 24-hour-old pre-term newborn diagnosed with a rare congenital heart defect known as infradiaphragmatic total anomalous pulmonary venous connection (TAPVC).
The condition, which affects roughly one in 10,000 live births, prevents oxygen-rich blood from returning normally from the lungs to the heart. Instead, the blood is misdirected to the liver through an abnormal connection, leading to severe lung congestion, respiratory distress, and critically low oxygen levels soon after birth. Without immediate surgical correction, survival is unlikely.
The baby, born to a 33-year-old first-time mother, had been diagnosed during the sixth month of pregnancy through a routine antenatal ultrasound and later confirmed via fetal echocardiography. Anticipating the complexity of the case, the parents—both doctors from Patna—opted for a carefully planned delivery at a facility close to Fortis Escorts to ensure swift postnatal intervention.
Soon after birth, the newborn developed severe breathing difficulties and required respiratory support before being transferred to the hospital’s intensive care unit. Following stabilisation and reconfirmation of the diagnosis, a multidisciplinary team determined that urgent surgery was the only viable option.
The nearly four-hour procedure involved rerouting the abnormal blood flow back to the left side of the heart, restoring normal circulation. It was led by Dr KS Iyer, Chairman and Head of Paediatric and Congenital Heart Surgery, along with Dr Ashutosh Marwah, Director of Paediatric Cardiology.
“This was a critical cardiac emergency where every minute mattered,” said Dr Iyer. “The advantage in this case was early prenatal diagnosis and meticulous planning, which allowed us to intervene at the right time. Without prompt treatment, such conditions can be rapidly fatal.”
Post-surgery, the newborn remained unstable for several days but gradually improved under intensive care. According to Dr Parvathi Iyer, paediatric cardiac intensivist, the child was successfully weaned off ventilator support on the fourth postoperative day and discharged in stable condition after 11 days.
Highlighting the importance of early detection, Dr Marwah said fetal echocardiography plays a crucial role in identifying complex congenital heart defects before birth. “Timely diagnosis allows for better planning of delivery and immediate access to specialised care, which significantly improves outcomes,” he noted.
For the family, the experience was both harrowing and transformative. “Those weeks were filled with fear and uncertainty,” the child’s mother said. “Seeing our baby survive such a critical procedure just hours after birth feels nothing short of a miracle.”
Hospital authorities said the case underscores the importance of advanced prenatal diagnostics, coordinated clinical care, and specialised paediatric cardiac expertise in managing rare and life-threatening conditions in newborns.
While such complex congenital heart surgeries remain challenging, this case demonstrates how early intervention and multidisciplinary care can significantly improve survival rates—even in the most fragile patients.
