Nepal Achieves Medical Milestone: Successful Nikaidoh Surgery

For the first time in Nepal, a rare heart surgery called 'Nikaidoh' has been performed.

The 'Nikaidoh' surgery was done on a 7-year-old girl from Syangja at the Shahid Gangalal National Heart Centre. The surgery was successfully conducted by a team led by Dr. Ravindra Bhakta Timala. According to Dr. Timala, the 9-hour surgery was performed on October 26 and the girl was kept in the ICU for 23 days post-surgery. Now shifted to the ward, the girl's health condition is normal. Doctors say the surgery was required as the girl had a congenital heart disease.

Medically, the girl had Transposition of Great Arteries, Ventricular Septal Defect (VSD) and Pulmonary Stenosis. Due to these conditions, the oxygen level in the body becomes extremely low. In her case, the main artery that should originate from the left ventricle was arising from the right ventricle. And the pulmonary artery that should arise from the right ventricle was coming from the left ventricle in a twisted fashion. There was also a large hole between the lower two chambers of the heart.

"In the surgery, we detached the main artery from the right side and reimplanted it to the left side. We also detached the pulmonary artery arising from the left side and reimplanted it to the right side. The ventricular septal defect and hole between the two lower chambers was also repaired," Dr. Timalsina told Onlinekhabar.

The heart had to be stopped for almost 4 hours during the procedure and the entire surgery took 9 hours. He said such conditions are congenital defects present from birth. The surgery team led by Dr. Timala included Dr. Marisha Aryal, Dr. Sujan Bohora, and anesthesiologist Dr. Smriti Mahaju.

The girl had been undergoing health examinations at Gangalal Hospital for 3 years and her condition was diagnosed. But at that time, the family was hesitant about the surgery and doctors also did not dare to operate.

Dr. Timala said, "There are many such cases in Nepal. Many may have died due to a lack of timely diagnosis. Families don't agree to complex surgeries until the patient's condition deteriorates."

He explained that in the girl's condition, the left ventricle artery tries to supply blood to the lungs while the right ventricle arteries try to supply the whole body, the opposite of the normal process. This happens because the arteries are connected opposite. The pathway for blood to reach the lungs also becomes narrow, causing insufficient oxygen, heart failure, and breathing difficulties.

Earlier, Dr. Timala's team had successfully performed various complex heart surgeries at the center for the first time in Nepal including Arterial Switch, Konno-Rastan Aortoventriculoplasty, Pulmonary Thromboendarterectomy (PTE) and Total Arch Replacement.