With this achievement PGIMER becomes first hospital in the region to perform this minimally invasive heart valve procedure
CHANDIGARH, 1 JULY: In a first-ever minimally invasive heart valve procedure, performed by cardiac team, led by Interventional cardiologist and Structural Heart Specialist Prof Dr Parminder Singh Otaal, PGIMER, Chandigarh becomes the first hospital of north India to perform this complex procedure. With this landmark transfemoral transseptal mitral valve replacement (TMVR) procedure, PGIMER enters into a league of pioneer institutes in structural heart interventions at national and international level.
TMVR is a minimally invasive but technically challenging procedure to replace a mitral valve without the need for conventional open-heart surgery. TMVR is indicated to treat selected cases of narrowed mitral valve (mitral valve stenosis ), leaky mitral valve ( mitral valve regurgitation ), or a mix of the two, especially in high surgical risk patients with failure of a previously implanted bioprosthetic heart valve.
The principal operator Dr Parminder Singh Otaal who recently returned from England after completing Fellowship in transcatheter heart valve operations from Liverpool Heart and Chest Hospital, UK, told us that the treated patient is a 78 year old male, who underwent bypass surgery along with mitral valve replacement in 2005. He also suffers from hypertension, kidney problems and low platelet counts (thrombocytopenia). Recently, he started having breathlessness for last few months and was admitted with heart failure . He was diagnosed with structural degeneration of the previously implanted bioprosthetic surgical valve, leading to leakage as well as blockage, for which reintervention was mandatory. Being at very high risk for conventional redo valve surgery, TMVR offered a minimally invasive alternative for valve replacement at a very low risk.
He further added that the transfemoral transseptal access procedure was performed through the femoral vein of the leg which is the least invasive of all the implantation methods. After achieving femoral vein access non-surgically, the remainder of the procedure was performed under fluoroscopic (X-ray) and echocardiographic (ultrasound) guidance via transeptal route and US FDA approved Edwards Sapiens valve was implanted inside the failed surgical mitral valve. No open surgical access through the chest was required for the procedure and a patient’s completely recovered within few hours after the procedure.
This innovative technology shows promise for our patients with advanced mitral valve disease , especially those at high surgical risk , reiterated Prof Dr Parminder Singh Otaal, Professor of Cardiology, who primarily performed the procedure along with the team including supporting cardiologist, a cardiac anaesthetists cum perioperative imaging specialist, technical and nursing professionals. Surgical backup being provided by the cardiac surgical team, led by Dr Anand Misra.
Dr Rajarajan, associate professor of cardiac anaesthesia, who additionally performed intraoperative transoesophageal imaging added that the efforts of the various members of the structural heart team allow us to offer therapies such as this valve-in-valve procedure to patients who otherwise have no other options.