Aided by VR, Chennai docs perform critical surgery on Egyptian lad

The VR model developed by a student of the Indian Institute of Technology Madras (IITM) was to check whether the LVAD could be implanted in the boy and whether his chest could be closed post the implant.

The boy, small in size for his age, was suffering from a life threatening condition called restrictive cardiomyopathy and severe pulmonary hypertension (very high pressure in the lungs) with recurrent heart failure admissions for the last one year, MGM Healthcare said.

The boy with a history of cardiac arrest was airlifted urgently in an air ambulance from Cairo.

After being turned down by hospitals in the US and western Europe, the boy was referred to K.R. Balakrishnan, Chairman, cardiac sciences, and Director, Institute of Heart and Lung Transplant & Mechanical Circulatory Support, by the pediatric cardiologist in Cairo who was treating the child.

According to MGM Healthcare, the boy was turned down by foreign hospitals as his high lung pressure meant that a heart transplant was ruled out and there were no commercially available LVADs for a child of his size.

Soon after his arrival here, the boy's heart failure worsened. The only option available was to consider whether somehow an LVAD, a battery-operated mechanical pump, could be implanted to help the left chamber of the heart pump blood to the rest of the body, MGM Healthcare said.

The doctors faced major impediments, as the existing pumps were built for adults. What if the chest could not be closed after the operation?

Also, the size of the heart chamber, the left ventricle, was a major concern, as it was heavily muscle bound, full of excess, useless muscle with very small cavity size. There was no way of knowing if the pump could be fitted inside the heart.

It was then that Balakrishnan got in touch with R. Krishna Kumar, a professor in the Department of Engineering Design, IITM, and requested him if a virtual reality model could be built from the CT scan of the child, so that a virtual implant could be carried out to ensure that the implant was possible.

So, a virtual model was built to make sure that the procedure was possible.

Armed with the confidence of this knowledge, the implant was carried out and it was a success. The boy has recovered rapidly and gained weight.

The family is now waiting to return to Cairo, once air travel restrictions are lifted.

"We thoroughly evaluated the child before planning for the LVAD. We had limited options. We decided to go ahead with the heart pump implant only after the virtual model built at the IIT showed that it was feasible," Balakrishnan said.

Commenting on the virtual reality model, IITM's Kumar said, "There were many challenges technically as the image clarity of the commercial software built into the imaging machine did not meet the requirements. After intense discussions on the algorithms to be used, Sathish Kumar, my student, built the virtual reality model in one night, as time was crucial."

"After being turned down by many hospitals, we had almost given up hope. Our child had been ailing for a few years and we could not bear to see him suffer like this. We are grateful that we were referred to this facility where the doctors ensured a fresh lease of life for our son," the boy's mother, a pediatrician herself, said.