A rare, non-surgical heart procedure gets ailing 71-year-old woman back on feet at Aster RV Hospital.

by Dr. S Venkatesh

Aster RV Hospital recently conducted a rare and minimally invasive heart procedure on a 71-year-old patient, Shobha (name changed) suffering from rheumatic heart disease, giving her a new lease on life.

Earlier this procedure was conducted only once in Karnataka, making this the second of its kind in the state. Having already undergone two open-heart surgeries to treat her condition, a third open-heart surgery would be high risk and lead to a longer recovery time for the patient. "Shobha was suffering from repeated spells of breathlessness, especially upon exertion which is a common sign of valve degeneration. She had a bioprosthetic tricuspid valve implanted during her second open-heart surgery 12 years back which had now degenerated," explained Dr. S. Venkatesh, Lead Consultant - Interventional Cardiology at Aster RV Hospital. "In such a patient, particularly because of her age and comorbidities, conducting another open-heart surgery to fix a new valve can be extremely risky. We advised her to undergo a Minimally Invasive Percutaneous Valve-in-valve Procedure."

A physical examination, Echocardiogram, and CT Aortogram were performed to evaluate the size of the heart and determine whether there was any extra fluid in the heart or lungs, as well as other procedures to check the heart and assess any potential damage. The patient successfully underwent Tricuspid valve-in-valve implantation on 11 October 2021. "Through a vein puncture in the groin, we accessed her heart and implanted a MYVAL 27.5 mm tricuspid valve within the previous bioprosthetic valve. This procedure typically takes about an hour to complete. She was extubated the same day and had an uneventful recovery," said Dr. Venkatesh. "I was anxious about going through another open-heart surgery as I have crossed 70 years of age and do not have the strength that I earlier used to have. This non-surgical option was great news to me, and I am glad I was in the hands of skilled doctors who made it a very seamless experience. My recovery has been very smooth, and I was able to go back to my normal tasks within a week of surgery. I am enjoying my time with my grandkids!" said Shobha.

According to reports, about 70% of patients suffering from valve disease are due to rheumatic heart disease in India. This is a condition where the valves in the heart are permanently damaged because of childhood streptococcal infection and its sequela. The incidence of heart valve disease increases significantly with age affecting the longevity as well as the quality of life for elderly patients. This procedure requires expertise and is done only at specialised centres.

Aster RV is a tertiary care hospital that pioneers in percutaneous valve implantations and incidentally performed the First valve-in-valve transcatheter Aortic replacement, the third valve-in-valve Transcatheter Mitral replacement, and now the second valve-in-valve Tricuspid replacement in the state of Karnataka.