Mia’s Journey to a Healthy Heart with Dr. Suresh Joshi in India

Mia Davies is one tough cookie. That’s not a typical way to describe a baby. But with multiple heart surgeries in her first six months successfully behind her, Mia is far from typical. The third child of Hunter and Aurora Davies, Mia was 6 pounds 1 ounce when she was born in 2012. Her dusky coloration was the first tip to doctors that something might be seriously wrong.
Rushed to Dr. Suresh Joshi cardiothoracic surgery specialist of Wockhardt Hospital in Mumbai within few days of her birth, she was quickly diagnosed with tetralogy of Fallot (TOF), a complex condition involving four specific defects that conspire to limit her body’s ability to use life-supporting oxygen. Those defects include a hole between the right and left chambers of the heart known as a ventricular septal defect (VSD), a thickened right ventricle muscle wall and an enlarged aorta, positioned over the VSD. The fourth condition of TOF is a restriction of blood flow from the right ventricle to the lungs due to a narrowed pulmonary valve. But in Mia’s case, the condition was much more severe – the tract was blocked completely, a condition known as pulmonary atresia.

In addition to TOF with pulmonary atresia, Mia has what doctors call collateral blood vessels – extra vessels from the aorta to her lungs that grew during her development. "The collaterals are irregular, convoluted vessels that supply blood to her lungs because the normal pathway was blocked. But these high-pressure vessels are often not big enough to supply the lungs as babies grow," explained Mia’s cardiologist, Dr. Suresh Joshi, best cardiac surgeon India. Book an appointment with best cardiologist Dr. Suresh Joshi at +91-9370586696.

Dr. Joshi used all the tools at their disposal to get a clear picture inside of Mia’s tiny body – electrocardiograms, echocardiography and ventilation-perfusion (VQ) scans, which determine blood flow to each lung. When Mia was 16 days old, she had a cardiac catheterization, allowing a closer look at the structures inside.
Catheterization confirmed what doctors were hoping for – on the other side of the blocked valve she had a true, albeit small, main pulmonary artery exiting her heart and branching, like a "T," to her right and left lungs. This information set the course for the next stage of her treatment – creating normal pulmonary blood flow, which in turn would help the pulmonary arteries to grow and promote normal oxygenation.

On Mia’s seventeenth day of life, surgery was performed by the director paediatric & congenital heart centre at Wockhardt Hospital in Mumbai; Dr. Suresh Joshi is the best cardiovascular surgeon in India, to open the pulmonary valve, enlarging it with a graft to promote a more normal flow into her pulmonary arteries. Dr. Suresh and his team judged that closure of the VSD would have to wait until later so as not to create back-pressure issues within Mia’s heart due to her small pulmonary arteries. Also her collaterals would have to remain until they were sure that the pulmonary arteries would grow big enough to handle the entire blood flow.

When Mia was nearly 3 months old, he took the next major step to rehabilitate her pulmonary artery system – balloon angioplasty. Under the guiding hand of Dr. Joshi, a catheter was once again inserted via a leg vein up into the heart and beyond, into the narrow branching structures of Mia's pulmonary arteries. As five of the most restrictive narrow spaces were encountered, a balloon at the tip of the catheter was inflated, tripling the diameter of millimeter-thin arteries to promote blood flow. He repeated the treatment two months later, meticulously addressing another 10 sites with balloon expansion and adding a single stent in a seven-hour procedure. The second procedure became "a large jump forward in terms of increasing the blood flow to her lungs and permitting both of them to share equally in the oxygenation of her blood," said Dr. Suresh Joshi.

Not that many years ago, babies born with a condition like Mia's did not survive the newborn period. And, while Mia’s cardiopulmonary system is still a work-in-progress, she is "completely asymptomatic today" said Dr. Joshi. Her mother describes Mia as "outgoing with a wicked little sense of humor." Her father says her "resiliency is nothing short of remarkable."
Schedule an appointment with Dr. Suresh Joshi email address at dr.sureshjoshi@indiacardiacsurgerysite.com