3-Month-Old Mumbai Baby With Rare Chest Defect Undergoes Life-Saving Heart Protection Surgery

Mumbai: A three-month-old baby girl with a rare congenital chest-wall defect that left her heart partially unprotected has successfully undergone complex reconstructive surgery at Narayana Health SRCC Children’s Hospital in Mumbai.

Baby Janki, aged three months and 20 days, was diagnosed with a partial congenital sternal cleft, an extremely rare condition in which the breastbone fails to fuse during foetal development. In her case, the upper part of the sternum was separated by nearly five centimetres, leaving her heart visibly pulsating beneath the skin.

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Rare Defect Left Heart Without Normal Chest Protection

The condition had not been detected during pregnancy. Despite the serious defect, Janki was active and feeding normally. She had intermittent noisy breathing and breathlessness and had experienced one episode of respiratory infection after birth. Doctors said the absence of the normal protective breastbone left her heart and major blood vessels vulnerable to injury.

A detailed investigation confirmed the absence of the fused sternum. It showed mild enlargement of the right side of the heart, along with small areas of lung collapse and patchy consolidation. However, the major blood vessels and airways were normal.

Complex Surgery Performed With Multidisciplinary Team

Considering the infant’s age and the proximity of the defect to the heart, doctors planned the surgery with extensive precautions. A cardiopulmonary bypass machine was kept on standby throughout the procedure.

During the operation, surgeons mobilised the pectoralis major muscles to provide protective tissue coverage. They also performed carefully planned chondrotomies of the clavicles and upper ribs, allowing the chest wall to be brought together without excessive tension. The sternum was reconstructed using steel wires.

The procedure was performed by a team comprising paediatric surgeons, paediatric cardiothoracic and congenital heart surgeons, cardiac anaesthesiologists, radiologists and paediatric cardiac intensive-care specialists. Temporary fluctuations in blood pressure occurred while the chest structures were being mobilised but were managed successfully by the medical team.

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Janki was monitored in the Paediatric Cardiac Intensive Care Unit for four days before being shifted to the ward. She resumed full oral feeds, remained haemodynamically stable and developed no postoperative complications. She was discharged eight days after surgery, with follow-up showing satisfactory healing of the reconstructed chest wall.

Baby Recovers After Successful Reconstruction

Dr Rasiklal Shah, Senior Consultant, Paediatric Surgery, and Dr Pradeep Kumar Kaushik, Senior Consultant, Paediatric Cardiothoracic and Congenital Heart Surgery, said partial sternal cleft is among the rarest congenital chest-wall anomalies and requires early recognition, meticulous planning and coordinated multidisciplinary care.

The doctors said successful reconstruction restores protection to the heart and major blood vessels, potentially allowing children with the rare defect to lead normal, active lives.

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