3-Month-Old Baby Undergoes Rare Chest Surgery at SRCC Children's Hospital in Mumbai
A three-month-old baby girl born with a rare congenital chest-wall defect 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 her breastbone failed to fuse during foetal development.
The upper portion of Janki's sternum was separated by nearly five centimetres, leaving her heart visibly pulsating beneath her skin. The defect had not been detected during pregnancy. Despite the vulnerability, she was active and feeding normally, though she experienced intermittent noisy breathing, breathlessness, and one episode of respiratory infection after birth.
Medical investigations confirmed the absence of a fused sternum and showed mild enlargement of the right side of her heart, along with small areas of lung collapse and patchy consolidation. Doctors noted that the absence of a normal protective breastbone left her heart and major blood vessels exposed to injury, making surgical intervention necessary.
A multidisciplinary medical team prepared the operation with extensive precautions, keeping a cardiopulmonary bypass machine on standby. During the surgery, doctors mobilised the pectoralis major muscles to provide protective tissue coverage and performed carefully planned chondrotomies of the clavicles and upper ribs to bring the chest wall together without excessive tension. The sternum was then 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. Although temporary fluctuations in blood pressure occurred while the chest structures were being mobilised, they were successfully managed by the team.
Janki was monitored in the Paediatric Cardiac Intensive Care Unit for four days before being transferred to the ward. She resumed full oral feeds, remained haemodynamically stable, and developed no postoperative complications.
She was discharged eight days after the surgery, with follow-up appointments showing satisfactory healing of her reconstructed chest wall. Dr. Rasiklal Shah, Senior Consultant in Paediatric Surgery, and Dr. Pradeep Kumar Kaushik, Senior Consultant in Paediatric Cardiothoracic and Congenital Heart Surgery, stated that early recognition and multidisciplinary care restore protection to the heart, allowing children with the defect to live normal, active lives.
