Q: My 52 days old daughter has been diagnosed with congenital heart disease on a 2D echo test. She is having problems like a single ventricle, transposition of the great arteries (TGA), severe pulmonary arterial hypertension, hypoplastic arch of aorta with juxtaductal coarctation of aorta, unobstructed bulbo ventricular foramen, anterior deviation of conal septum with no evidence of subaortic obstruction and small sized PDA with left to right shunt. What can be the possible treatment for the same?

A:This is classified as a complex congenital heart disease, which in essence means that we will not be able to achieve a 2-pump repair by surgery (because there is a single ventricle, which will act as the sole pumping chamber). These types of heart diseases require multiple surgeries with the aim of separating the good and bad blood. The first surgery has to done now. It is called PA banding. The subsequent surgeries will be at 1 year and sometime between 3-5 years. The surgery will definitely prolong life and improve quality of life in a condition, which has otherwise a hopeless prognosis. There will however be restrictions in terms of physical activity. The child will be on lifelong medications (especially blood thinners), will require lifelong follow up and may be prone to complications during follow up. Overall the life expectancy at 20 years will be between 70-75%. It has to be emphasised that timing of first surgery is very crucial to achieve a good result later in life. The optimal timing for this is now as emphasised above.