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6
THE STRAITS TIMES
OCTOBER 25 2012
Orthotics Cushions &
Supports Your Every Step
From blue to pink
W
hat most people take
for granted, Mr Pang
Poi Wong has had to
fight for his whole life
to get: a clean bill of
health.
Born 19 years ago with four heart
defects that conspired to deprive his
body of oxygen, he faced death on
countless occasions, turning blue in
the face, lips and nails whenever he
was exhausted.
Madam Lim Lye Kiaw thought the
birth of her youngest child had gone
normally until the doctors came to her
and told her something was wrong
with the baby. He had a bluish cast to
his skin. She recalled in Mandarin:
“My mind went blank and I could only
ask myself repeatedly why my child
had to be ill.”
The 49-year-old sales promoter,
whose husband died 13 years ago,
has two other sons aged 25 and 22
who were born healthy.
Doctors put the tiny baby through
an echocardiogram, or ultrasound
examination of the heart, and
determined he had pulmonary atresia.
This means that his pulmonary artery,
Polytechnic student went through
five operations in 19 years to fix
his heart. JOAN CHEW reports
Mr Pang, who has
a congenital heart
condition, chats
with his mother
while doing
stretching
exercises at
home.
ST PHOTO: NURIA LING
Mending a heart
THE NORMAL HEART
■ Oxygen-poor blood flows from other parts of the body back
into the right side of the heart. It flows into the pulmonary
artery and then to the lungs where it picks up oxygen.
■ The oxygen-rich blood flows back into the left side of the
heart. It is then pumped through the aortic valve and into the
aorta to the rest of the body.
Oxygen-rich blood flows
to other parts the body
Oxygen-poor
blood from other
parts of the body
To
right
lung
Aorta
Main pulmonary
artery
To left
lung
From
left lung
From
right
lung
Right atrium
Left atrium
Pulmonary
valve
Mitral valve
Tricuspid
valve
Ventricular
septum
Right
ventricle
Aortic
valve
Oxygen-poor blood from
other parts of the body
Left ventricle
Oxygen-rich blood flows
to other parts the body
Four structural defects caused abnormal blood flow in Mr Pang’s
heart and made it hard for his blood to get sufficient oxygen. These
were corrected in a major operation when he was 13 years old
THE DEFECTS
1. Pulmonary atresia
The pulmonary artery connecting the heart
and lungs was not developed, making it
impossible for his heart to pump blood
into his lungs to pick up oxygen.
What was done: A
homograft (a tissue
graft, in Mr Pang’s
case from a
cadaver) replaced
the underdeveloped
pulmonary artery
and allowed blood
to pass through
this conduit into
the lungs. This
homograft had to
be replaced five
years after the
first surgery.
2. Wrong aorta
connection
The aorta, which
supplies oxygen-rich
blood to the body, was
connected to the right
ventricle containing
deoxygenated blood. It
should be connected to
the left ventricle instead.
What was done: The
aorta was reconnected
to the left ventricle
surgically.
3. Disconnected branches
of the pulmonary artery
The left and right branches of the
pulmonary artery were not joined
to each other, so deoxygenated
blood could not flow
through them.
What was done: The
two branches of the
pulmonary artery were
connected with a graft,
which was also linked
to the reconstructed
main pulmonary
artery.
Left
atrium
Right
atrium
Source: Dr Terence Lim, consultant at the division
of paediatric cardiology at National University Hospital
Right
ventricle
Left
ventricle
4. Ventricular
septal defect
There was a large hole
in the wall separating
the lower chambers of
the heart, or ventricles.
As a result, oxygenated
and deoxygenated
blood were mixed
within the heart.
What was done: The
hole was closed with
a mesh fabric patch.
Heart tissue
eventually grew over
the patch, so that it
became part of the
heart muscle.
Note: Drawing has been simplified for ease of representation.
GRAPHICS: MIKE M DIZON
TEXT: JOAN CHEW
an important blood vessel which
carries oxygen-poor blood to the
lungs to receive oxygen, was not
properly developed.
To make things worse, the three
branches of the artery were not
joined, as they should be. He also
had a hole in the wall (septum)
separating the right and left
ventricles of the heart, so blood that
had been depleted of oxygen kept
mixing with blood that had been
enriched with oxygen.
His aorta, which was supposed to
carry oxygen-rich blood from the left
ventricle, also received oxygen-poor
blood from the right ventricle
because of the hole in the heart.
Most babies now pull through
complex heart conditions like his, but
Mr Pang’s journey was especially
difficult.
Associate Professor Quek Swee
Chye, head of the division of
paediatric cardiology at the National
University Hospital (NUH), said
congenital heart disease occurs in
eight out of every 1,000 live births.
Of these, about 3 per cent will,
like Mr Pang, have pulmonary atresia
with a ventricular septal defect. More
boys than girls have the defect.
At two days old, Mr Pang had an
operation to create a pathway for
blood to reach the lungs. As he grew,
alternative pathways had to be
created to meet his oxygen needs.
Due to his heart condition, he
never had a single physical education
lesson in school. When his brothers
played basketball with other kids, he
stayed on the sidelines.
For his mother, no sacrifice was too
great. Every time he fell sick, she
would rush him to a clinic before the
infection could exacerbate his
condition and make breathing difficult.
Finally, his doctors scheduled the
major operation to repair his heart
defects after his Primary School
Leaving Examinations.
But catastrophe struck just after
his first paper. He came down with
dengue fever and had to take the
rest of his exam in hospital. The
operation was delayed by half a year.
His mother said she was so
worried during the repair operation
that she could neither sit nor stand.
She said: “I rallied all my family
members to come to the hospital to
support me round the clock.”
He was in hospital for close to a
month. When he returned to school,
his teacher asked other students to
take turns to carry his schoolbag.
But Mr Pang was elated. He could
Desserts for a good cause
feel his body was on the mend. He
had more energy and no longer
needed his eldest brother to carry
him piggyback when they went out.
He also started playing basketball
regularly with his friends in school,
going for 20 minutes at a stretch.
Still, his problems were not over.
Five years later, the conduit, which
was put in his heart when he was 13
to take over the job of his
underdeveloped pulmonary artery,
had to be replaced.
Dr Terence Lim, a consultant at
the division of paediatric cardiology in
NUH said such grafts have to be
replaced periodically because of the
calcium deposits on the walls.
But again, the operation,
scheduled for the beginning of 2010,
faced a hitch when Mr Pang was
infected with H1N1 – an influenza
virus – followed by acute transverse
myelitis, a neurological disorder.
The operation was finally
performed a year later. Doctors also
replaced a faulty valve with an
artificial one.
Prof Quek said that each
subsequent surgery Mr Pang goes
through carries an incremental risk as
the operating time gets progressively
longer.
Madam Lim said her son was a
“very brave child” because he never
cried and would take the initiative to
learn about his condition and surgical
procedures from the Internet.
Mr Pang’s final operation resulted
in complications that led to a
hospital stay of 53 days.
After a year-long hiatus, the
first-year Ngee Ann Polytechnic
student is back in school now, where
he studies logistics and supply chain
management.
He said: “I’m really lucky and
grateful to the doctors. Despite my
condition, I was never bullied or
teased in school.”
Prof Quek said Mr Pang’s repaired
heart will never “be as pristine as a
normal heart”, although he can now
do many things just like his peers.
Dr Lim said Mr Pang has a higher
risk of arrhythmia (abnormal heart
rhythm) and infective endocarditis
(where the heart valves become
infected by bacteria) as compared to
a healthy person.
Mr Pang’s last two operations cost
about $45,000, of which $7,000 was
covered by the NUH Kids’ Heart Fund,
that provides financial support to
children with congenital heart
disease.
[email protected]
Chui Huay Lim Teochew Cuisine
will donate 30 per cent of each
Twenty-nine restaurants are
bowl of sweet yam paste with
participating in the Sweet Charity
gingko nut sold. The rest will
fund-raising campaign for the NUH donate $5 from the sale of each
Kids’ Heart Fund, which subsidises designated dessert to the fund.
Sweet Charity aims to raise
costs of heart surgery for needy
$100,000. For more information,
children.
go to Facebook.com/
This month, Jumbo Seafood and sweetcharitymonth.
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