*GUCH with BUCH*
A 12-year-old boy with *cyanosis* was brought to me by his mother for an opinion.
After thorough exam and eval, he was diagnosed with Tetralogy of Fallot (TOF).
Despite consulting family physicians, consultants, and cardiologists, his condition remained untreated.
His mother, a single parent, a housemaid, had limited education and no savings. She was deeply concerned about the grave prognosis of the surgery, as narrated by all the doctors and was hesitant to take the risk and lacked the financial means.
I explained to her that avoiding surgery would certainly lead to death, whereas undergoing the surgery offered a chance for full recovery. Understanding the risks, she agreed to proceed with the surgery. She began collecting donations, and we managed to get the surgery done at KEM Hospital with manageable expenses.
35 years later, this boy, now a 47 year  man, visited me on 2024 World Heart Day and is thriving, after his surgery for TOF.
This case exemplifies Grown-Up Congenital Heart Disease (GUCH), also known as Adult Congenital Heart Disease (ACHD), where congenital heart defects persist into adulthood. Thanks to advancements in pediatric heart surgery, many individuals born with congenital heart defects now survive into adulthood and lead active lives.

Seeing this patient, now a successful electrician in Vadodara, with his family on World Heart Day was incredibly heartwarming.
*His mother, now a proud grandmother, is overjoyed*.
This story highlights *the importance of accurate diagnosis, proper risk stratification, and clear communication of the risks and benefits of surgery.* Understanding these factors can lead to life-changing decisions and make life truly worth living. *Focus on patient OUTCOME and NOT your INCOME !*