In a first-of-its-kind emergency transcatheter aortic valve replacement (TAVR) procedure conducted at Sir HN Reliance Foundation Hospital, doctors have saved the life of a 62-year-old farmer from Navi Mumbai, who was brought with heart failure.
The special type of TAVR, which is valve-in-valve procedure, was performed within four hours of the patient’s relatives and doctors agreed for the procedure, which is also a record in itself, hospital authorities said.
TAVR is a planned/elective procedure and it takes a few days to organise this, which involves a battery of diagnostic tests, CT scans, planning by a team of doctors, and deciding on right size of the valve.
The patient, identified as Vitthal Kadam, was brought in on June 20 evening while gasping for breath. “Initial assessment showed he had very low blood pressure, no urine output, and swelling all over the body, suggestive of severe heart failure. He was immediately put on multiple medicines to support his dropping blood pressure levels and dialysis,” a person familiar with the case said.
“The medical team was sure that he needed an urgent valve replacement surgery as there was a severe leakage and narrowing of the artificial tissue valve which was put in his heart six years ago through an open heart surgery,” he said.
However, the patient was considered to be extremely high risk for an re-do valve replacement surgery because of his critical condition and previous open heart surgery. Medical team then suggested the TAVR procedure as a better option.
TAVR is a complex but minimally invasive cardiac procedure to treat severe narrowing (stenosis) of aortic valve (valve between heart and the main blood vessel). Once the patient’s relatives gave a go-ahead, within four hours, he was taken up for the procedure.
The planning of TAVR was a difficult task as the patient was critical and was not fit for a CT scan that was needed to find the exact size of the valve. With his deteriorating health, it was a race against time to arrange logistics for ordering the right size of the valve in a short time, authorities said.
“In this patient’s case, luckily he had undergone angiography a week before, which further helped them in judging the exact type and size of the previously implanted valve and place the request for the appropriate valve for him. The valve was delivered by the manufacturers within two hours,” hospital officials said.
In the hour-long procedure, cardiologists implanted a new valve inside the previously implanted valve which had failed, through arteries of the groin and without opening the chest. The patient’s heart failure improved and all his parameters stabilised soon after the procedure. Mr. Kadam was discharged from the hospital on July 4.
Dr. Sanjay Kadam, the nephew of the patient, in a statement said it was a rebirth for his uncle. “My uncle is leading an absolutely normal life. Today, if he is alive with us, it is because of doctors at Sir HN Reliance Foundation Hospital.”
The team of doctors included Dr. Maulik Parekh, Dr. Anvay Mulay, Dr. Manoj Mashru, Dr. Ajit Menon, Dr. Pravin Kulkarni, Dr. Talha Meeran, Dr. Bhavesh Vora, Dr. Himanshu Chaudhary, and Dr. Niranjan Vaze.
