One of them a five month old Syrian infant, the other a young patient aged 21 living in Northern Iraq. They shared the same fate. The two patients suffered a rare combination of two distinct diseases stemming from congenital septal defects and the non-development of pulmonary veins. They were treated for the same condition at the same hospital. Five month old Ammar and 21 year old Niwar both went through extremely high-risk heart surgeries in the so-called “return to life operation” at the Çam ve Sakura City Hospital. The patients were successfully treated and discharged.
Ammar Alfaraj Almohamad from Syria was saved, despite being close to death upon his arrival at the emergency room, while Niwar Mohammed Saeed Fatah from Northern Iraq was confined to bed in his twenties due to his untreated conditions. The young patient had already been rejected for surgery when the previous countries he applied to said it was too risky, but the two managed to hold onto life at Çam ve Sakura City Hospital with a complicated operation that is possible at only a few centers around the world. Prof. Dr. Alican Hatemi and Assoc. Dr. Erkut Öztürk from Pediatric Cardiovascular Surgery closed the holes in Ammar and Niwar’s hearts, rebuilt their pulmonary veins that were unformed at birth and connected them to their hearts. United by their fate, the two had their remaining treatment carried out in separate rooms on the same corridor and were subsequently discharged.
ALMOST DYING ON ARRIVAL AT ER
Five month old Ammar Alfaraj Almohamad and 21 year old Niwar Mohammed Saeed Fatah were admitted to Çam ve Sakura City Hospital as two different patients with the same fatal heart condition. Both of them were born with ventricular septal defect (VSD) and pulmonary artery atresia defined as the non-development of pulmonary veins.
Ammar is a rare case of the two diseases presenting simultaneously and three weeks ago when he arrived at the emergency room with cyanosis, Ammar was already close to death. Meanwhile, due to the same conditions Niwar had become confined to bed at the early age of 21. Even though he applied to many centers in Türkiye and elsewhere in the world, he was rejected due to the very high risk of the operation. Having reached out to Çam ve Sakura City Hospital and finding out the operation could be done there, his family immediately made their way to Istanbul. The two patients were operated on by a team led by Prof. Dr. Alican Hatemi ve Assoc. Dr. Erkut Öztürk of Çam ve Sakura City Hospital Pediatric Cardiovascular Surgery Department. Given his condition, Assoc. Dr. Erkut Öztürk qualifies Niwar’s survival to this day as a “miracle,” as he should have normally been treated during infancy.
“A MIRACULOUS SUCCESS STORY”
Assoc. Dr. Erkut Öztürk said that the operations the pair had undergone were a “renaissance” in Çam ve Sakura City Hospital, stating that “Their discharge represents a miraculous success story”. Noting that the coexistence of two distinct heart anomalies in the two patients is a rare condition, Assoc. Dr. Öztürk gave the following information: “VSD and pulmonary artery atresia are in fact conditions that require prompt surgery. There are only a small number of centers around the world capable of such surgery. A few of them are in Türkiye , including ours. VSD is one of the most frequently encountered types of heart disease. But coupled with developmental defects in the pulmonary artery, things take on a whole new level of complexity, and the situation becomes grave. The surgery suddenly becomes much riskier than in regular VSD surgery. Unfortunately, some patients even miss out on the chance of surgery in the short term.
PULMONARY VEINS REBUILT
Assoc. Dr. Öztürk explained that Ammar is the child of a refugee family from Syria, brought to the emergency service three weeks ago, only moments before death. He said, “The child presented with cyanosis. The tests revealed a very low level of oxygen in blood, and it was seen from cardiac ultrasonography that pulmonary veins were not developed. We urgently took him in for an emergency angiogram. It could be seen that the pulmonary vessels were very thin and there were different vessels feeding the lung from the aorta. He was urgently operation on, in spite of the very high risk, and his pulmonary veins were rebuilt during surgery. Now his oxygen levels are entirely back to normal and he is healthy. He held on to life, despite being moments from death. Talking about the specific case of Ammar, we can say it is rare that such an operation is performed on an infant of his age.”
TURNED DOWN FROM MANY CENTERS DUE TO THE HIGH RISK
Stating that 21 year old Niwar from Northern Iraq had the same complications as Ammar, Assoc. Dr. Öztürk concluded his remarks, saying: “Similarly, this patient also had ventricular septal defect (VSD) and the so-called pulmonary artery atresia. Niwar made it to 21 thanks to the veins that somehow developed in addition to the pulmonary veins. But in terms of daily activity and the ability to perform, he was almost entirely confined to bed. When he exerted himself, he quickly became exhausted and unable to do anything. They had apparently both applied to various centers in Türkiye and around the world through miscellaneous channels. However, no center was prepared to risk surgery. Then they came to us for an opinion. We responded by saying we could realize the operation, which we evaluated as very high risk. They came to Türkiye, an operation was carried out in a similar way and his oxygen levels too went up to normal. He has the chance to live a full and healthy life for the remainder of his days.”