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Dr. Apoorva Kanhare

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Doctors handle 140 cm tall jester's heart with kidgloves

AHMEDABAD: Viren Panchal, 38, works as a jester with famous magician K Lal and is only 140 cm tall. He recently came to the city for a complex surgery to replace his heart valve. Cases like Panchal's are few and far between in medical history because he suffers from genetic dwarfism.

Panchal was doing a show in Mumbai when he became breathless. He was taken to a hospital in Mumbai where he was diagnosed to be suffering from a leaky heart valve, which was causing heart failure. It was a serious medical situation for Panchal who has battled genetic Achondroplastic Dwarfism with a smile. Achondroplastic Dwarfism is a disorder in which the bones of the arms and legs do not grow to normal size and the vertebrae of the spine do not grow normally.

As for the surgery, the catch was that while Panchal had the physiology of an adult and his vital organs were mature, his weight was that of an average 10-12-year-old, at 36 kg. It was a surgical challenge to fit in an adult valve in his body as there was not enough room. Also, there was apprehension about whether valves used for children would work in his case.

"There were other surgical challenges," said a city-based cardiovascular surgeon, Dr Apurva Kanhere, who performed the surgery. "The administration of anesthesia required acumen as his spine was damaged due to genetic skeletal deformities." Dr Kanhere said that most adults needed a valve which measures 20 mm and above, depending on the height and weight. The surgeons zeroed in on a heart valve measuring 16 mm, the size generally used in children.

"In Texas, surgeons had enlarged the surrounding heart structure to fit in an adult heart valve, but we decided to use the 16 mm valve," said Dr Kanhere. "It worked well, we had to adjust dosages according to his weight but he has responded well to the surgery. His condition is stable."

The little master is currently recuperating and has extended an invitation to his doctors to attend his show to be held next month.


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