PGI performs minimally invasive heart valve procedure

Chandigarh, July 1 The PGI Hospital here became the first hospital in the region to perform the minimally invasive heart valve procedure.

Led by interventional cardiologist and structural heart specialist Parminder Singh Otaal, the Postgraduate Institute of Medical Education and Research (PGIMER) performed the transfemoral transseptal mitral valve replacement (TMVR) procedure.

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, an official statement said.

The principal operator, Parminder Singh Otaal, who recently returned from England after completing Fellowship in transcatheter heart valve operations from Liverpool Heart and Chest Hospital, told the media the treated patient was a 78-year-old male, who underwent bypass surgery along with mitral valve replacement in 2005.

He is also suffering from hypertension, kidney problems and low platelet counts (thrombocytopenia). Recently, he started having breathlessness 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 re-intervention 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 the transfemoral transseptal access procedure was performed through the femoral vein of the leg which is the least invasive of all 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 the 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 the patient completely recovered within a few hours after the procedure.

"This innovative technology shows promise for our patients with advanced mitral valve disease, especially those at high surgical risk," said Dr Otaal, Professor of Cardiology, who primarily performed the procedure along with the team. Surgical backup was provided by the cardiac surgical team, led by Dr Anand Misra.