A 61-year-old woman recently underwent a double heart valve replacement in one sitting at a city hospital here.
The woman had undergone the first open surgery in 1979 to open the fused left-sided mitral valve and in 2004 it had to be replaced with a valve prosthesis. In 2006, a clot blocked the metal prosthetic valve and it was replaced with a tissue valve prosthesis. In 2021, she developed heart failure as the prosthesis was damaged and the left-sided aortic valve developed a block. Her heart had weakened that increased pressure in lung circulation, resulting in irregular heartbeat and anaemia.
She was admitted in Madras Medical Mission with heart failure, pneumonia and sepsis. Medications and antibiotics did not help arrest deterioration and she spent nearly a month in the intensive care unit.
Doctors at MMM decided to replace the aortic and mitral valve without undertaking an open surgery. So far, only four such procedures have been done in the country, they said.
“She was in a very critical condition by that point. Our team of heart specialists evaluated her for surgical valve replacement. However, in view of her fourth cardiac surgery, the need to replace two valves and the patient’s deteriorating condition, she was considered a non-surgical candidate and advised evaluation for percutaneous valve replacement,” said Ajit Mullasari, director of cardiology, MMM.
A team, including cardiologists, cardiac surgeon and cardiac anaesthetist, treated her.
A catheter-based valve replacement was done with transesophageal echocardiography guidance. She was administered general anaesthesia and the aortic valve was replaced by going through the left groin.
In a two-hour procedure, the mitral valve was replaced by going through the right groin and crossing to the left side of the heart by making a small hole in the partition between the right and left chambers of the heart.
An India-made balloon expandable high quality valve prosthesis was used thus reducing the procedure’s cost. For the first time such a procedure was done using India manufactured valve and prostheses as usually they are imported, said Vijayakumar Subban, head of intravascular imaging department.
The patient was taken off ventilator support the next morning and discharged after a week. She underwent the procedure two moths ago and is doing well, the doctors said.
