An 82-year-old man, who had multiple heart valve diseases and went through valve replacement surgery a decade ago, underwent double heart valve replacement and pacemaker implantation through transcatheter in a private hospital recently.
Doctors of Kauvery Hospital, Chennai performed two transcatheter “valve-in-valve” replacements in a hybrid cath lab operating room. The patient suffered from multiple heart valve diseases — severe regurgitation (leak) of both aortic and mitral valves and moderately leaking tricuspid valve with severe pulmonary hypertension.
R. Anantharaman, senior consultant Interventional Cardiologist, Kauvery Hospital, Chennai, said that in 2012 the patient underwent valve replacement surgery in which the aortic valve was replaced with a 21 mm bioprosthetic valve, the mitral valve was replaced with a 31 mm bioprosthetic valve and the tricuspid valve was repaired. A bypass graft to the front of the left anterior descending artery was also performed.
This year, he started to face difficulty in breathing and it worsened. Echocardiography showed a re-narrowing in the aortic and mitral bioprosthetic valves. “His heart function was about 20% prior to performing the procedure,” he said.
Considering his age, reduced heart function, and previous surgery, doctors said they could not afford a repeat surgery due to the high risks involved. “Transcatheter was the alternative. We had to replace two valves and implant a pacemaker. Our heart team had a detailed discussion and decided this was the best for the patient,” he added.
In a four-hour procedure, transcatheter “valve-in-valve” replacement for both aortic and mitral valves was done, and a conduction block in the heart was resolved by a pacemaker, using a transcatheter pacemaker, he added. The patient was discharged on the third day post-procedure.
Iyappan Ponnuswamy, medical director of the hospital, was present at the press meet.
