Doctors at Vishwaraj Hospital Successfully Treat Rare Congenital Condition in a Child with Abernethy Malformation

Pune: A team of doctors at Vishwaraj Hospital, Loni, successfully treated a rare congenital vascular condition in a one-and-a-half-year-old female child through a minimally invasive cardiac procedure under the leadership of Dr. Ashish Banpurkar, Paediatric Cardiologist.

Explaining the case, Dr. Ashish Banpurkar, Paediatric Cardiologist at Vishwaraj Hospital, Loni, said that the child had been under observation and required admission due to mildly elevated blood ammonia levels, which were managed conservatively. During ongoing evaluation, doctors diagnosed the child with a rare congenital condition known as Abernethy Malformation, also called a Congenital Portosystemic Shunt.

In a normal child, blood from the stomach and intestines flows to the liver through portal veins where it gets filtered before entering the heart. However, in this case, the portal veins were abnormally connected directly to the heart via Vena cava, bypassing the liver. Because of this hepatic circulation was not well developed and there was  a possibility of developing pulmonary hypertension and abnormal circulation ( Pulmonary AV malformation) she was planned for elective closure of abnormal connection.

“This is a rare condition, seen in approximately one out of fifty thousand live births,” said Dr. Ashish Banpurkar. “If left untreated, such abnormal circulation can lead to complications affecting the liver, lungs and overall metabolism.”

After careful evaluation and monitoring of the child’s clinical condition, blood parameters and liver function, the medical team decided to perform a Transcatheter Device Closure of Abernathy Malformation, a minimally invasive procedure.

During the procedure, doctors inserted a catheter through a blood vessel and performed detailed angiography to measure portal venous pressure and blood flow dynamics. Once the team confirmed that the abnormal connection could be safely closed, a specially designed occlusion device was deployed to block the shunt. Post-procedure imaging and sonography confirmed that the device was correctly positioned and that blood flow to the liver had been restored.

The child responded well to the procedure and was discharged from the hospital within three days. We expect normal circulation to continue, and the closure is considered a permanent solution with minimal chances of recurrence, added Dr Banpurkar.

Prior to the procedure, the child had shown mild liver involvement with elevated serum ammonia levels and occasional increased nasal bleeding. With the abnormal connection now closed, these issues will  resolve gradually.

Dr. Banpurkar emphasized the importance of early diagnosis and regular follow-up in congenital conditions. “Because this child was monitored from the fetal stage, we were able to plan the treatment at the right time and perform the intervention safely.”

The team of doctors included Dr Vitthal Shendage (cardiac Anaesthesia), Dr Satyajit Funde (Radiologist), Dr Chandrakant sahare(Consultant Intecivist & Pediatrician)from Maeers Vishwaraj Hospital.

Date of admission 9/3/26
Date of surgery 11/3/26
Date of discharge 13/3/26