KOCHI: A 67-year-old woman underwent a rare medical procedure to repair the damaged aortic valve of her heart without opening the chest at Amrita Institute of Medical Sciences (AIMS). This is the first time that this procedure, called Transcatheter Aortic Valve Replacement (TAVR), was done in Kerala. The non-surgical procedure was performed by a team led by Dr C V Rajiv, professor of cardiology, AIMS.
The patient, Amaloor Pavam from Kanyakumari, had undergone a replacement of the aortic valve 11 years ago, but the problem resurfaced. “This procedure is done on patients on whom an open heart surgery is unviable. Pavam had already undergone a surgery and another surgery would have been risky. That is when we decided to carry out the procedure,” said Dr Rajiv. He added another motivating factor behind conducting the procedure in the hospital was to take up a technical challenge and be ahead of the curve in medical upgradation.
TAVR uses a catheter to replace the heart valve instead of opening up the chest. In this case, a heart valve made of nitinol (a metal alloy of nickel and titanium ) and bovine pericardial tissue was squeezed into the catheter and placed between the already replaced heart valve of the patient.
TAVR has many advantages compared to open heart surgery as it is minimally invasive, on table extubation is possible and has no need for blood transfusion. Moreover, a patient can be discharged within six days of the procedure. But, the procedure is not without risks. Dr Rajiv says the success rate of the procedure is 90 per cent and is a risky procedure. Dr Rajiv and Dr Vijayakumar of the hospital had gone to Switzerland to acquaint better with the procedure.
The cost of the valve was Rs 15 lakh and the surgery cost another Rs 1.5 lakh. The hospital bore the entire cost of the treatment as the patient could not raise the amount.