Rebecca Ejifoma
Interventional Cardiologist and Professor of Medicine, Professor Kamar Adeleke and his team of medical experts have successfully carried out a life-saving procedure on a 13-year-old baby (name withheld) at the Tristate Hospital in the Lekki area of Lagos.
The baby, according to the expert, was born with a rare congenital abnormality called transposition of the great arteries and hence needed an arterial switch operation. It is known as a complex type of pediatric cardiothoracic surgery that took place from 10:15 am to 5 am.
The MD/CEO of Tristate Healthcare system Adeleke explained to newsmen at a conference that the medical condition is a transposition of the great arteries where the two major arteries leaving the baby’s heart were transposed (wrongly connected) to the lower chambers of the heart (ventricles).
The US-trained medical expert with over 34 years of experience continued that the arterial switch operation is an open-heart procedure that is done within two weeks of life or it will be too late. “As a result of the abnormality, blood containing oxygen from the baby’s lungs was being pumped back into the lungs, while blood that lacked oxygen was pumped throughout the body.
“Normally, the heart has two sides; the right side takes in blood from the organs of the body. This blood is devoid of nutrients, and from here the blood is pumped into the lungs where it is oxygenated and purified and then transported into the left side of the heart where it is pumped to all parts of the body.”
While noting that the left side of the heart pumps out four to six litres of blood every minute, the intervention cardiologist, explained that “This baby was born with a badly structured heart.
“What happened to this baby was that the left and right structures were switched, so the baby was not getting any purification of the blood. The mortality of this condition is 100 per cent.”
According to Adeleke, he and his medical team had to restructure the heart in addition to a bypass. All the blood vessels coming from the wrong sides were correctly repositioned. He said, admitting that it was a complex surgery of 19 hours.
In cases of congenital heart defects, the Tristate CEO insisted that these cases are usually hopeless except flown abroad for surgery and they may still die eventually. “It is a huge achievement we have done here, if we can achieve this in Nigeria, there is nothing that we cannot do medically.
While describing it as a significant feat for the hospital and the country, the president said th defect occurs in about 0.01 per cent of the nation’s population.
Advice to women on pregnancy
“Fortunately, this type of abnormality is very rare in pregnancy,” says Adeleke. “The human heart is very complex and is completely formed at six weeks of gestation even before the woman may realise she is pregnant.”
He cautioned women, “We advise women that when you know you’re likely to get pregnant, you don’t do certain things.”
The cardiac psychologist dissuaded them from things like smoking cigarettes, and taking drugs carelessly, adding that they should try to stay away from stress, and eat well.
“However, the abnormality may not even be because the mother did something wrong. It could just be an unfortunate occurrence,” he clarified.
Notwithstanding, he called for an urgent need to establish paediatric cardiac centres in Nigeria, and said the best time to prevent any type of congenital anomaly is before conception.
“It is important that we investigate every pregnant woman at multiple levels. There is what is known as the level three ultrasound that detects all these abnormalities. Some congenital heart defects can be detected and corrected before the baby is born, but if it cannot be done before birth, the mother must, at least know, and be prepared for it.
“What we need to do is reduce infant mortality by paying attention to the care of the mother so that before and during pregnancy, abnormalities can be detected and addressed early. If we invest in the mothers, we are going to be saving a lot of money in the future.”
Adding the Tristate CEO said things as simple as lacking the right vitamins and developing a nutrient deficiency could cause neurological problems after delivery. “But if these nutrients are given during pregnancy it will avoid potential anomalies.”
Evaluating every newborn
Every newborn, he insisted, must also be properly evaluated. “Take your stethoscope, examine the baby and if you detect a heart murmur, then you can quickly do the ultrasound. It takes just 30- 45 minutes to do this you can then follow up on the baby.
“All we need is proper evaluation of the baby. Let’s take care of the mother during pregnancy. The routine should be that any woman that is pregnant should be automatically covered by insurance. By doing that, we are investing in the baby even before it is born.”
Through Tristate Healthcare System, a conglomeration of best-in-class super-speciality healthcare providers, Adeleke is changing the narrative in the nation’s healthcare system.
Besides being the President/CEO, of Tristate Cardiovascular Institute, Prof Adeleke is the Chief, Division of Cardiac Catheterisation and Interventional Laboratory, University College Hospital, Ibadan, the Oyo State capital.
He also pioneered the Tristate Cardiovascular Institute in Wilmington, Delaware. Afterwards, he founded the First State Diagnostic Centre, Peninsula Medical Associates, and Wilmington Cardiovascular Associates. Adeleke is also a visiting consultant at the Reddington Hospital.
