Success Story of Two heart valve replacements without open heart surgery: 1st case in India

JAIPUR: A 55-year-old Indian-Canadian patient, originally from Chandigarh, underwent successful two heart valve replacements without open heart surgery after a team of doctors at Eternal Hospital here successfully performed TAVI and TMVR.

Led by interventional cardiologist and structural heart disease specialist Ravinder Singh Rao, the procedure resulted in “no complication” and “both the valves started functioning immediately”.

TAVI, short for Transcatheter Aortic Valve Implantation, is a minimally invasive heart procedure conducted to replace a narrowed aortic valve that fails to open correctly and can be an option for people who are in immediate or high risk of complications from the traditional surgery.

TMVR is a minimally invasive technique to treat a common form of mitral valve leakage.

This transcatheter native double valve replacement in the same sitting is rarely performed worldwide.

“This was the first successful TMVR in MAC (Mitral Annular Calcification) in the country and the first case of native transcatheter double valve replacement,” Rao said in a statement on Friday.

The patient was suffering from several heart problems — severe aortic stenosis, severe mitral stenosis and severe mitral annular calcification.

Aortic stenosis refers to narrowing of the aortic valve. Aortic valve is the outflow valve which controls the oxygenated blood flow from heart to the body.

Mitral valve controls the flow of blood from lungs to the heart. Narrowing of both the valves creates a life threatening situation called aortic stenosis and mitral stenosis, causing heart failure.

The patient was admitted to the hospital with the condition of heart failure, a history of shortness-of-breath, difficulty in walking and carrying out the daily activities.

Traditionally such patients are treated with open heart surgery. However, due to his calcification in aorta and chest wall, he was deemed high risk for open heart surgery by more than three surgeons from all across the country.

Rao who specializes in TAVI and TMVR from Mount Sinai, New York and Washington University School of Medicines, St Louis, US decided to perform TAVI and TMVR in MAC (Mitral Annular Calcification) in the same sitting.

“The aortic valve was replaced using TAVI, and a new valve was placed inside the old valve. The new valve started functioning immediately and had no complications. Substituting the mitral valve in calcified stenosis was one of the biggest challenges. The new valve was placed by going from the femoral vein (found in the leg) under fluoroscopic and echo visualisation,” Rao said.

“The valve was then deployed under rapid pacing following which both the valves began to function. Both the valves started functioning immediately and had no complication,” he added.

The son of the patient said that “it felt unreal to be able to speak to my father immediately after the procedure, and he was with us in the room the very next day.”

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