Mumbai team of doctors perform the state’s first valve in valve transcatheter aortic valve replacement procedure on a 59-year-old businessman.
The Solapur resident had a few episodes of fainting after which he underwent an ECHO test, which revealed the previously implanted tissue valve had degenerated and he had severe stenosis (choking) of the valve.
“Kishore Rathi underwent a valve replacement procedure seven years ago at our hospital. However in the last few days, he had fainted and an ECHO done in a local hospital showed degeneration of previously implanted tissue valve and severe choking. He was then referred to us,” said Dr CK Ponde, Cardiologist, PD Hinduja Hospital.
Once in Mumbai, Rathi underwent a coronary angiography, too, but luckily he didn’t have any blockages in the artery. He was then recommended a repeat open heart surgery for valve replacement. But, the biggest worry for doctors was his age and mortality risk attached with a repeat open heart surgery for valve replacement in the world is 6%.
“Apart from mortality risk, when you cut open the heart in such cases, chances of bleeding, need for ventilator and pacemaker is high. This is an experience worldwide. We, therefore, gave the family an option of Transcatheter Aortic Valve Replacement (TAVR) – a minimally invasive surgical procedure repairs the valve without removing the old and damaged valve,” said Dr Ponde.
He explained that each heart valve has two important functions – to open correctly so that blood can empty from the chamber and to close properly so that blood cannot flow the wrong way.
While the TAVR technology is new in India, it has been used in the western countries for a long time.
“Nearly 1 lakh TAVR procedures have already been done abroad and the patients have been followed-up for seven years. All are doing well. Initially, it was used for high risk patients above age 80 as the durability of implant was not known then. Now, it is being done on an intermediate risk patient like Rathi,” said Ponde.
Rathi underwent a one-and-half-hour-long procedure this week and was discharged from hospital on April 7.
“This is the country’s 14th Valve in Valve Transcatheter Aortic Valve Replacement procedure and state’s first,” said Dr Ponde.
The team of doctors who conducted the procedure along with Dr Ponde included Dr Kaushal Pandey, Consultant Cardiovascular Surgeon and Dr Uday Gandhe, Consultant Cardiac Anaesthesiologist.