Viagra saves child's life.

CHENNAI: Small doses of Viagra, a critically ill newborn girl and unflagging human hope scripted an inspiring medical tale at a city hospital.

The team of doctors at Malar Hospitals, an associate of Fortis Healthcare, fought all odds to save the life of one-year-old Ashmita, who came in with total anomalous drainage of pulmonary veins to the right side of the heart.

Her condition was made even rarer when she developed narrowing of pulmonary veins a few weeks after she was operated upon for her primary disorder. The child came with acute breathlessness caused by very high pressure in the lung and severe heart failure.

“The challenge was two-fold as we needed to attempt a quite complex second surgery to redress the constriction of the pulmonary vein and then manage post-operative ventilation of the patient whose pulmonary pressure was six times higher than the normal rate,” recalled K.R. Balakrishnan, Director, Cardiac sciences, Escorts Heart Institute at the hospital. Surgeons created an intermediate chamber to re-channel blood flow to the left ventricle. The team innovated during the post-op phase by avoiding endotracheal tubes and, instead, designing a non-interventional and suture-less technique of ventilating through a nasal mask.

The baby was put on the ventilator for 51 days, which Dr. Balakrishnan said, was unprecedented.

“However, we were still worried about the menacingly high pulmonary pressure,” said Suresh Rao, chief of cardiac anaesthesia.

It was at this juncture that surgeons turned to Sildenafil (Viagra), encouraged by the promising results during laboratory work with the drug, which is associated with the treatment of erectile dysfunction. Administering Viagra in minute doses helped bring down the menacingly high pulmonary blood pressure levels. According to the growing body of medical literature on the spin-off benefits of the wonder drug, Sildenafil when deployed interferes with the activity of the phosphodiesterase enzyme. This immediately sets off two things – lowering arterial blood pressure by dilating the smooth muscle around the lungs and increasing blood traffic to the central site of the human body.

According to Ravi Kumar, cardiologist, a cardiac evaluation had affirmatively ruled out any residual narrowing of the pulmonary vein and the lung pressures were back to normal for the first time since the child was born.

Dr. Balakrishnan said a relapse was an extremely rare possibility, confined perhaps to 1-2 per cent of child patients.

Ashmita, who celebrated her first birthday at hospital, is now ready to return to a much-relieved family fold.