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The Origami of the heart
Pediatric Cardiac Interventions
The Folds of Nature
Nature is a master architect, but even the finest blueprints can have a flaw. Sometimes, the complex origami of the human heart folds incorrectly.
The statistics are sobering: one in every two hundred mothers will deliver a baby with congenital heart disease. For these families, the primal joy of birth is instantly eclipsed by a long, dark shadow. Some of these defects—holes in the chambers, stenosed valves, or abnormal connections between the great arteries—are serious enough to turn a newborn blue. For decades, the only answer was the scalpel. The prospect of open-heart surgery on a baby weighing only a few kilograms is enough to make any parent’s blood run cold.
But medical science has a way of evolving toward kindness. Today, we have a piece of good news that feels like a miracle: many of these defects can be repaired without ever opening the chest.
The Magician from the UK
To perform this kind of magic in a village like Sevagram, you need three things: a well-equipped Cath Lab, a support team with nerves of steel, and a truly skilled operator. We found our operator in Dr. Abhay Bhoyar.
Abhay is a pediatric interventional cardiologist who brought back to India the wisdom he had painstakingly acquired during his training in the United Kingdom. Last month, our Cath Lab was abuzz with a new kind of energy as we asked him to take charge of these fragile lives.
Over a two-month period, a dozen babies arrived, their little hearts struggling to keep pace with the world. Under Abhay’s hands, it was a symphony of precision. We watched as he closed Ventricular Septal Defects (VSD) and Atrial Septal Defects (ASD)—the “holes in the heart.” We saw him balloon open tightened valves and repair narrow aortas. The babies would arrive, have their defects fixed via a tiny puncture in the leg, spend a day or two in the ICU, and go home. Their chests were no longer heaving with the effort of breathing; they were rising and falling with unbridled joy.
The Economics of Tears
The medicine was advanced, but the demographics remained the same. None of these babies belonged to parents who could afford a private corporate hospital. Most came from the poorest corners of our district.
These parents would arrive at MGIMS with a fragile hope and eyes filled with tears. When they left, the tears were still there—but they had changed. They were now tears of relief, the kind that come when the crushing weight of potential debt and the fear of a child’s death are suddenly lifted. In Sevagram, we don’t just measure outcomes in heart rates; we measure them in the quiet return of a father’s dignity and a mother’s peace.
The Baby Who Turned Pink
One story, in particular, captures the essence of why we do this. Last week, a four-month-old baby girl was brought to us. Her life was already a tragedy of abandonment before it became a medical crisis. Soon after her birth, her father—a man lost to alcohol—had deserted the family, leaving the mother and the grandfather to fend for themselves.
To make matters worse, the baby was diagnosed with a Patent Ductus Arteriosus (PDA)—a persistent opening between the two major blood vessels of the heart. The mother and grandfather began a desperate pilgrimage. They took the breathless child to village clinics, district hospitals, and finally a for-profit center. Everywhere, the verdict was the same: “She needs urgent surgery, and it will be expensive.”
They had no money. They had only despair. As serendipity would have it, the grandfather chanced upon Dr. Bhoyar. Abhay looked at the baby, looked at the weeping grandfather, and said simply, “Admit her.”
The Resuscitation and the Fairy Tale
The procedure itself was a reminder of how thin the line is between life and death. In the middle of the Cath Lab, the baby’s fragile heart gave way. She suffered a cardiac arrest. The room froze. It is a moment every physician dreads—the silence of a monitor that should be beeping.
But the team didn’t give up. They resuscitated her, stabilized her, and with hands that did not shake, Abhay proceeded to place the device that would plug the hole. She survived. After two days in the Pediatric ICU, the change was startling. The baby who had arrived blue and gasping for air went home a healthy, vibrant pink.
In a world that can be so harsh to the poor, some stories do have a fairy-tale ending. Sometimes, the origami just needs a gentle, expert hand to fold it back into place.