Cardiac surgeons from the Upper Silesian Children’s Memorial Health Institute in Katowice (GCZD) implanted a pacemaker, weighing only about 1,5 kg, in Maks – a premature baby who had a life-threatening defect before birth.
This is the smallest premature baby in Poland who has had a pacemaker implanted, Dr. Michał Buczyński, a cardiac surgeon operating Maks, told PAP on Sunday. Now the baby is fine and will soon be released home.
Maks was born a month and a half ahead of schedule. Already during the prenatal tests it turned out that his heart beats too slowly. Even before birth, doctors diagnosed him with congenital heart block. Without the intervention of cardiac surgeons, the child might not have survived.
Dr. Buczyński explained that congenital total heart block is a defect, which means that the conduction of impulses between the atria and the ventricles in the heart is interrupted. I beat it about half the slower than it should, and it doesn’t respond to attempts to increase the heart rate at times when the body needs more blood – as it happens during exercise or during a fever. As a result, the heart, and thus the child, develops worse and gets tired faster. He eats less, because eating is a considerable effort for a newborn.
As noted by cardiac surgeons with GCZD, bradycardia caused by the defect, i.e. slow heart rate, is particularly dangerous for premature babies with extremely low birth weight. Such children have the smallest reserves and in them the coexistence of the block is a critical threat to life.
This was the case with Maks. After being born in a hospital in Ruda Śląska, the child was transported to the Intensive Therapy and Pathology Department of the GCZD Newborn in Katowice, where, despite pharmacological treatment and respiratory support, his condition worsened. Maks, who weighed just over 1,5 kg after birth, was losing weight.
“The only salvation for the toddler was the implantation of a pacemaker. This device consists of electrodes sewn onto the heart and a control module with a battery. The decision was not easy, because although it is a routine procedure in the case of adults, in such a small patient it carries a high risk ”- said Dr. Jacek Pająk, who is the head of the Department of Pediatric Cardiac Surgery at GCZD.
The operation was performed three weeks after Maks was born, on March 23. The main problem for doctors was the size of the pacemaker. Although the smallest available stimulator was used, weighing only 13 grams and smaller than a matchbox, it turned out to be monstrous with Max’s small body.
“The procedure required opening the chest, sewing two silicone electrodes on the heart the size of a nut, and then leading them under the skin under the abdominal wall, where the pacemaker itself is placed” – explained Dr. Michał Buczyński.
After the surgery, which was uneventful, the little one returned to the incubator. Soon the child started to gain weight quickly, was disconnected from the ventilator and is now in the room with the mother awaiting discharge from home. It already weighs 3,1 kg. According to Dr. Buczyński, she should return home next or next week.
Maks will have to use the pacemaker for the rest of his life. The device will have to be replaced from time to time.