Smallest baby, 1.5kg, ticks on with 11g pacemaker

Mumbai: Ayush Arora is hailed as a champion on the eighth-floor ICU of an Andheri hospital. Born two months prematurely and weighing barely 1.5 kg, Ayush, then only two days old, had a pacemaker fitted to his heart that was functioning at a third of its capacity. Today, at 47 days, he is inching towards the 2-kg mark that should serve as the green signal to move him out of the neonatal ICU. 

    "He is certainly the smallest premature child in the city to have got a pacemaker. He is likely to be the smallest in the country too," said paediatric cardiac surgeons Suresh Rao and Smrutiranjan Mohanty of Kokilaben Ambani Hospital. 
    "His heart was literally the size of a strawberry. It was a task deciding how to fix the lead wires and where to fit the generator," said Mohanty. An X-ray taken after the surgery shows the 11-gram device covering up a sizeable portion of Ayush's tiny abdomen. 
    In February 2012, a baby born to an Indian couple in the 31st week of pregnancy and weighing 1.58 kg got a pacemaker implanted right after birth at Lucile Packard Children's Hospital in Stanford University, San Francisco. 
    Mumbai, too, has had previous cases in which a 3-kg baby, born after 38 weeks of pregnancy, was fitted with a pacemaker within 15 hours of birth. "Ayush is so premature that he is still not a 38-week full-term baby," pointed out Mohanty. 
    Cardiologist Yash Lokhandwala from Holy Family Hospital, Bandra, concurs that Ayush is among the smallest to get a pacemaker: "In our country, it is still difficult for premature babies to survive with a complete heart block." 'PRECIOUS BABY' 'Landmark in paediatric cardiac care' 
Pacemaker To Be Changed After Kid Is 5 
Mumbai: Tiny Ayush Arora's problem — a complete heart block — came to light during his mother's 26th week of pregnancy. Ayush is a 'precious baby', considering that he was born after IVF treatment over 20 years after his parents' marriage. His 43-year-old father, Jodhpur-based chartered accountant Chandravijay Arora, said: "We faced some 
of the most critical moments of our lives in the last few months." Just when the couple was savouring the twin pregnancy, Arora's wife Sheetal was diagnosed with an auto-immune disease in April. Medical textbooks say that in such cases, the mother's immune system mistakenly attacks the nerve fibres that control the foetus's heart beats. 
    The problem with the twins was thus discovered, and two weeks later, one of them died. 
    "My wife was taken to Kokilaben Ambani Hospital on June 20 from the Malad hospital where she had been admitted. Ayush 
was delivered through Caesarean section the same day," added Arora. The infant's cries and heartbeats — barely 40 per minute as against the normal 120 per minute — were so faint that he was put on ventilator. 
    When he was two days old, the team of cardiac surgeons Suresh Rao and Smrutiranjan Mohanty fitted a temporary pacemaker. On the tenth day of his life, Ayush got his permanent pacemaker whose battery may last till he is five years old. The operation along with the pacemaker cost Rs 2 lakh. 
    Rao said: "Ayush's operation is an important landmark when one considers that in India people still wrongly believe that children shouldn't get a pacemaker till they are 10 kg in weight. This operation proves that paediatric cardiac care in India is getting better." 
    Treatment of heart block in India has hitherto been conservative. Cardiologist Bharat Dalvi, who is attached to SevenHills Hospital in Andheri, said: "The usual practice is not to operate on a child till he or she is six or seven years old and has no visible symptoms of a heart block." He added that there are concerns with pacemakers in infants because of early battery depletion, and protrusion of the device from its perch. 
    Ayush's parents are waiting to take him home to Jodhpur. "We got timely help at every level in Mumbai, but we want to get home with him soon," said new dad Chandravijay.

LITTLE CHAMPION: Ayush Arora, who was fitted with the pacemaker when only two days old, has now completed 47 days and is approaching the 2kg mark, a signal that he may soon be out of ICU