A baby born in Van, eastern Türkiye, almost seven months ago with an underdeveloped right side of the heart, has regained health following advanced treatment administered in Istanbul after being transported by air ambulance.
Muhammed Akın Dağgezen was urgently transferred to Istanbul at just one day old after developing cyanosis. The newborn was flown by a Ministry of Health air ambulance to Koşuyolu High Specialization Training and Research Hospital, where doctors initiated immediate intervention.
Initial echocardiography examinations revealed that the right side of the baby’s heart had not developed. Doctors also determined that blood flow to the lungs was being maintained through a connection between the aorta and the pulmonary artery. Medical treatment was started to keep this connection open and sustain pulmonary circulation.
On the baby’s fourth day of life, doctors performed an angiography. A balloon procedure was carried out via the groin to address the underdeveloped pulmonary vessel, but when this intervention did not yield results, doctors placed stents both inside the heart and in the vessel that needed to remain open. Following the procedure, blood flow to the lungs increased, oxygen saturation levels rose and the baby’s cyanosis decreased significantly.
After 13 months of follow-up, medical examinations showed that the pulmonary vessels and the previously small right heart chamber had developed. Based on an evaluation conducted with the surgical team, the baby was taken into surgery. Following a successful operation, the baby’s heart achieved a near-normal structure and the infant was discharged in good condition.
Professor Ayşe Inci Yıldırım of the Pediatric Cardiology Clinic at Koşuyolu High Specialization Training and Research Hospital explained that the baby had been referred to their clinic for urgent intervention due to multiple symptoms.
"We admitted and evaluated the baby immediately upon arrival. Our assessment showed that half of the heart had not developed,” Yıldırım said. "After discussing the case in our council, we decided to perform a balloon procedure on the narrowed vessel to increase pulmonary blood flow and to place a stent in the vessel kept open with medication if the balloon procedure proved ineffective.”
Yıldırım explained that medication was initially used to keep the connection between the two vessels open, but this approach did not produce sufficient results. "We determined treatment strategies to both increase blood flow to the lungs and support the development of the underdeveloped part of the heart. The right side of the heart was almost absent, and the pulmonary vessels were severely underdeveloped,” she said.
She noted that the baby weighed just 2 kilograms when admitted and underwent treatment in several stages. "When the baby arrived, oxygen saturation levels ranged between 50% and 70%. By the time we sent him back to Van, at 15 to 20 days old, oxygen saturation had risen above 85%,” she said.
At the six-month follow-up, doctors observed significant development of the right ventricle. "Initially, we had considered a single-ventricle surgery, but this improvement made a near-normal, biventricular repair possible,” Yıldırım said, adding that further improvement was seen during later evaluations.
Associate professor Metin Songur said the procedures were challenging due to the baby’s young age and low weight, but were completed successfully. He noted that follow-up examinations showed no cyanosis and strong cardiac development by the age of 1.