HYDERABAD: A pioneering cardiac procedure, percutaneous transcatheter aortic valve implantation (TAVI), has been performed on an 80-year-old man with critical calcific aortic stenosis by a team of doctors led by Dr PC Rath at Apollo Hospitals in Jubilee Hills here.
The procedure was performed for the first time in this part of the country including Telangana and Andhra Pradesh.
“TAVI was performed on the elderly patient in the cath lab from the groin region as in angioplasty. After the patient was administered short general anaesthesia, the valve was put to the heart through the femoral artery and was implanted accurately under the guidance of fluoroscopy and trans-esophageal echo. The valve implanted was the latest second-generation valve from Medtronic USA called Evolute-R. The procedure lasted about one and a half hours.
Immediately after the procedure, the patient was extubated, he became conscious and was shifted to ICU. He was monitored in the ICU for two days, for three more days in the ward and was then discharged,” Dr PC Rath explained.
Dr Rath was assisted by Dr Manoj Agarwal, Dr B.Dikshit and Dr Sundar.
Dr Rath said TAVI is being routinely performed in Europe and of late in the USA for patients who are at high risk for an open heart surgery.
“The procedure got FDA approval in 2015 and since then has been being routinely performed in the USA.
In India the procedure is not yet approved by DCGI and needs permission on case-to-case basis and then the device is imported. Very few cases have been performed in India and the ones performed were mostly in Delhi and Bangalore,” he said.
Though the device is expensive, the procedure is a boon for such patients to be able to save their lives and continue to live through a relatively safe non-surgical procedure. “Now we can offer this
life-saving procedure to many of our sick patients with calcified aortic stenosis,” Dr Rath added.
Aortic Stenosis
Narrowing of the aortic valve of the heart is called aortic stenosis. Such blockage in the valve leads to gradual petering of blood flow and consequently an increased effort from the heart is required to pump blood. This condition can lead to heart failure. In normal circumstances, an open heart surgery is performed on such patients to replace the valve. However, in the case of this patient, due to his advanced age and renal failure, an open heart surgery was considered to be a high risk and, therefore, the minimally-invasive TAVI was preferred.