A patient story from Dr. Apurba Kumar Sarma’s practice – Tulip Mediworld Superspeciality Hospital, Guwahati
Quick Takeaways
- A large Ventricular Septal Defect (VSD) – a hole between the two main pumping chambers of the heart – requires surgery when it does not close on its own and is causing symptoms or affecting the child’s growth and development
- Children with unrepaired VSDs may seem healthy but often tire faster than their peers, feed poorly as infants, or show slow weight gain – these are early warning signs worth investigating
- Congenital heart surgery for children, including VSD repair, is performed at Tulip Mediworld, Guwahati – families from Nagaland, Manipur, Meghalaya, and Arunachal Pradesh no longer need to travel to Delhi or Chennai
- Complete VSD repair in childhood typically means a normal heart for life – most children are fully active and unrestricted within weeks
Bendang Ao teaches secondary school science in Dimapur. His wife, Anisenla, is a homemaker. They have two children – a son, Temjen, who is eight, and their daughter Priya, who is now six.
Priya is, by her father’s account, “the louder one.”
She runs before she walks anywhere. She sings at the top of her voice. She demands to be in the middle of whatever is happening. She is, in every way that matters, entirely fine.
It was not always clear that this would be the case.
“She was always a little behind,” Anisenla says. “Not sick. Not obviously unwell. Just – a little behind.”
When Priya was an infant, she fed slowly and tired easily. She never quite caught up with the growth charts the way her brother had. She caught chest infections that seemed to take longer to clear than they should. Her paediatrician in Dimapur monitored her carefully and reassured them that some children are simply smaller, simply slower to settle.
Then, during a routine check-up when Priya was two years old, the paediatrician heard something with her stethoscope. A sound that had not been there clearly before. She listened again. She said nothing alarming – but she wrote a referral.
“She said – I want her heart to be looked at by a cardiologist. There’s a murmur. It’s probably nothing. But let’s be sure.”
It was not nothing.
The cardiologist in Nagaland ordered an echocardiogram – an ultrasound of the heart. Priya was two years and four months old, and the scan required her to lie very still. She did not cooperate entirely. They got what they needed.
The result was a large Ventricular Septal Defect.
A VSD is a hole in the wall (septum) that separates the left and right ventricles – the heart’s two main pumping chambers. In a normal heart, the left ventricle pumps oxygenated blood at high pressure out to the body, and the right ventricle pumps at lower pressure to the lungs. When there is a hole between them, blood leaks from the high-pressure left side to the lower-pressure right side – overloading the lungs and making the heart work much harder than it should.
Small VSDs often close on their own in the first years of life. Priya’s was not small. It was large enough that it had been causing her symptoms since birth – the slow feeding, the poor weight gain, the chest infections, the tiredness – all of it explained, in a single scan.
The cardiologist told Bendang and Anisenla what they were facing.
“She said – this is a significant hole. It is not going to close on its own. Your daughter will need surgery. And you will need to take her to Delhi or Chennai.”
Priya was two years old. Delhi is 2,500 kilometres from Dimapur.
Bendang sat with this information for several days before he told anyone outside the immediate family.
He teaches science. He is not a man who panics. He made a list of what “go to Delhi” would require. The estimated cost of surgery at a major Delhi cardiac centre, including travel, accommodation, and post-operative stay: between ₹4 and 5 lakh, before complications. The time away from Dimapur: a minimum of three weeks, probably more. Temjen, their son, was four. He would need to be looked after by grandparents while they were away. Anisenla does not speak Hindi.
“I kept thinking – my daughter needs open heart surgery. She is two years old. And we are supposed to fly to a city we don’t know, find a hospital we don’t know, and put her in the hands of a surgeon we don’t know. I kept thinking – is there no other way?”
He asked a colleague at school – a science teacher who had been through his own cardiac scare the previous year. The colleague mentioned a name. A surgeon based in Guwahati who had been operating on hearts for more than 25 years. A man who had trained at one of India’s top cardiac institutes and had come back to the Northeast to build a hospital of his own.
“He said – before you book a flight to Delhi, go see Dr. Sarma at Tulip Mediworld. Just go for a consultation. See what he says.”
Guwahati is four hours from Dimapur by road.
Bendang and Anisenla brought everything: the echocardiogram report, the cardiologist’s referral, Priya’s growth charts, her medical history from birth. Priya was two and a half by then.
“She was not in a good mood,” Bendang says. “She was two. She did not want to sit still.”
Dr. Sarma reviewed the echo carefully. He examined Priya. He asked about her feeding history, her weight gain curve, how far she could run before she sat down, whether she had ever gone blue during crying or feeding. He asked questions that felt, Anisenla says, like he was building a picture rather than ticking boxes.
“He told us – yes, this hole is too large to wait for. We need to repair it. But I want one more echo before we plan the surgery – her anatomy is clear but I want the latest measurements.”
He told them what the surgery would involve. The VSD would be repaired by sewing a patch across the hole – either a synthetic patch or one made from the child’s own pericardium (the sac around the heart). This would require open heart surgery with cardiopulmonary bypass – the heart-lung machine that takes over the function of the heart and lungs during the operation.
He explained recovery. He answered questions about whether she would be able to run after. Whether she would always have a scar. Whether she would need more surgery in the future. He answered each one directly.
“By the end of the appointment, I understood what was going to happen,” Anisenla says. “I was still scared. But I was no longer terrified of the unknown. That is a different thing.”
Surgery was scheduled for the following month.
Priya Ao’s VSD repair was performed by Dr. Sarma at Tulip Mediworld Superspeciality Hospital when she was two years and eight months old.
In VSD repair, the surgery is performed through a median sternotomy – the breastbone is divided and the heart is gently stopped while the heart-lung machine maintains circulation. The hole in the septum is precisely repaired, typically with a patch sutured securely across the defect, allowing it to be covered by the heart’s own tissue over time. The heart is then restarted. The sternum is closed with wire.
The operation took three and a half hours.
Priya spent the first 48 hours in Tulip Mediworld’s cardiac ICU. The nursing staff explained every monitor, every number, every change in her condition to her parents. Anisenla slept in the chair beside the bed.
On day three, she was moved to the paediatric ward. On day four, she asked for biscuits.
“That was when I cried,” Anisenla says. “Not from worry. Just – she asked for biscuits. She was back.”
Priya was discharged on day eight. She made the four-hour journey back to Dimapur in her father’s car, asleep for most of it.
The post-operative instructions were clear: no strenuous activity for six weeks while the sternum healed. No lifting. No rough play with her brother. Small, frequent meals. Follow-up echo in six weeks, then in six months.
“The hardest part was telling Temjen he could not rough-house with her,” Bendang says. “She recovered faster than he accepted the restriction.”
At six weeks, an echocardiogram showed the patch was secure and the heart had returned to normal size. The right ventricle, which had been overloaded for two and a half years, had normalised. There was no residual leak across the patch.
Dr. Sarma’s assessment at that visit was direct: “The heart is repaired. There are no restrictions. She can live completely normally.”
Priya Ao is six years old. She starts school in August.
She runs. She sings at the top of her voice. She demands to be in the middle of whatever is happening. She has a thin vertical scar on her chest that she refers to, when asked, as “my heart line.”
She has had no cardiac symptoms since surgery. Her last echocardiogram, done at age five, was entirely normal.
Anisenla thinks often about the parents who are where they were four years ago – sitting in a doctor’s office with a child who looks fine, being told the heart is not.
“I want them to know – this can be fixed. Completely. And you do not have to take your two-year-old to Delhi to fix it. You can come to Guwahati. Dr. Sarma will look after them like they are his own.”
Bendang adds one thing: “We drove four hours. That was the journey. Everything else was straightforward.”
Priya Ao underwent open heart VSD repair performed by Dr. Apurba Kumar Sarma at Tulip Mediworld Superspeciality Hospital, Guwahati. Her story is shared with her parents’ consent. Their daughter’s name has been changed at her parents’ request.
If your child has been diagnosed with a hole in the heart – a VSD, ASD, or any congenital cardiac defect – a consultation with Dr. Sarma at Tulip Mediworld may mean you do not need to leave Northeast India. Call 1800 890 4655 or visit drapurbasarma.in.
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Please consult a qualified cardiac surgeon for evaluation and treatment specific to your condition.
