Doctors perform revolutionary heart procedure to save 6-year-old from a rare life-threatening defect

Six-year-old Ayansh, from a remote village in Haryana, never knew what it meant to run freely without gasping for breath. Born with a rare and life-threatening congenital heart defect—single ventricle physiology—Ayansh’s heart had only one functional chamber instead of the usual four.

This condition affects less than 1 per cent of children with congenital heart disease and often proves to be fatal without early and complex surgical intervention.

Unlike most children his age, Ayansh would tire easily, and his lips and fingers regularly turned blue due to chronically low oxygen levels—a phenomenon called cyanosis. His right heart, which is responsible for pumping deoxygenated blood to the lungs, was missing. This meant pure and impure blood mixed in his body, depriving his organs of critical oxygen.

Now, thanks to a revolutionary procedure performed at BLK-Max Super Speciality Hospital in New Delhi, Ayansh has a new lease on life. A team led by Dr Gaurav Garg, Associate Director of Paediatric Cardiology, performed a Transcatheter Fontan procedure, a minimally invasive alternative to conventional open-heart surgery. This marked the first time such a procedure was successfully performed in India using a transcatheter approach.

“Traditionally, the Fontan procedure is done through open-heart surgery, involving reoperation of the chest, significant risk of bleeding, infection, and long recovery,” said Dr Garg. “Given Ayansh’s age and fragile condition, we opted for a transcatheter route through a small incision in the groin.”

Instead of cutting open the chest, doctors threaded thin tubes—catheters—through the veins to reach the heart and placed a covered stent to create a new pathway for blood flow. The result was immediate. Ayansh’s oxygen levels rose from a dangerous 70% to near-normal levels, and within days, the bluish tint on his skin began to fade.

Ayansh had previously undergone the first stage of treatment, the Glenn procedure, at just six months old. That surgery redirected blood from the upper body to the lungs, bypassing the missing right side of the heart. The Fontan, which completes the bypass, is typically done at around 3–6 years of age and is crucial for long-term survival.

Congenital heart disease (CHD) is the most common birth defect globally, affecting 1 in every 100 live births, according to the World Health Organization (WHO). Among these, single ventricle defects represent one of the most severe forms, often requiring surgical intervention in infancy and early childhood.

A 2022 study published in Circulation noted that outcomes for Fontan procedures have improved significantly over the past two decades, but morbidity remains high. The emergence of minimally invasive transcatheter techniques is a promising frontier. A 2021 review in JACC: Advances found that catheter-based Fontan completions may reduce complications, lower healthcare costs, and improve recovery time—especially in resource-limited settings.

India has made strides in paediatric cardiology, yet access remains deeply unequal. In rural areas, many children with complex CHDs go undiagnosed or are misdiagnosed. Dr Garg points out that Ayansh’s survival hinged on early diagnosis and continuous follow-up.

CHDs such as a hole in the heart or narrowing of one of the main vessels need immediate surgical intervention, within hours to days of birth. If delayed, it can affect a child's lungs and hearts irreversibly,” says Dr S Ramakrishnan, professor of cardiology, All India Institute of Medical Sciences, Delhi. “If such conditions are treated at the right time, children are cured for life.”

“We need stronger referral systems, early screening, and awareness,” said Dr. Garg. “Ayansh was lucky. Many others are not.”

Thanks to this pioneering procedure, Ayansh is now looking forward to starting school, playing cricket with his cousins, and dreaming of a future once unimaginable. 

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