Baby A is a three-month-old male child from Sri Lanka. Soon after
birth, the child was evaluated in Sri Lanka for breathing difficulties,
poor feeding, excessive sweating, poor weight gain, and bluish
discoloration.The child was diagnosed with one of the major birth-
related heart problems. The child was seen at various hospitals in Sri
Lanka, and all the hospitals deferred surgery in view of the lack of
expertise and high risk associated with surgery. Parents were asked to go
to other centres around the world. Parents have decided to visit India.
Parents were consulted by various doctors across the major hospitals in
India (Delhi, Chennai, and Bangalore). All of them have denied surgery
in view of the high risk.

Finally, the child & parents had approached us at the GKNM hospital in
Coimbatore, Tamil Nadu. We have decided to take the child up for
surgery after explaining the risk. Following admission, we performed a
3D reconstruction of the heart using a CT scan to better understand its
complexity.After getting adequate information, we have taken the child
up for a very complex double switch operation and VSD closure. The
surgery lasted for about 12 hours. The child's chest was left open for 48
hours and had delayed chest closure. The child recovered quickly after
that and was discharged on the 14th day.

The double switch operation is done for corrected transposition of the
great arteries (both lower chambers of the heart were deranged). A
double switch operation involves switching the upper chambers of the
heart (atrial switch) and switching the great arteries (arterial switch). It is
a very major open-heart surgery in children, and this surgery is done
only in a few centres across India. Most surgeons in developing
countries will prefer to postpone the surgery for at least a year or two.