A 68-year-old farmer from Andhra Pradesh recently underwent a cardiac procedure using a bioprosthetic stent at a city hospital here.
The farmer underwent aortic valve replacement surgery in 2017 due to a severely calcified aortic valve that prevented blood from flowing from the heart to the aorta and the rest of the body.
However, over the years the stent developed calcification and degenerated. He was admitted to the Fortis Hospital in Vadapalani and put under the care of Govina Balasubramani, head of CTVS, a heart and lung transplant program, in November.
Investigations revealed that blood drawn from the heart’s left ventricle was leaking backwards and, if left untreated, could lead to heart failure and death.
dr. Govini said the patient was evaluated for minimally invasive transcatheter aortic valve replacement (TAVI) without removal of the previous stent. However, the patient’s valve was only 20 mm, whereas normally aortic valves measure 21 mm. Because another operation involving suturing could weaken or damage the aortic valve, the specialist decided to replace the aortic valve again without suturing.
“Sutureless valve replacement is recommended for older patients or patients with co-morbidities as it does not require sewing a new valve into place,” he said.
The procedure was less complicated and inserting the valve would take less than three minutes. As a result, the risk of postoperative complications such as blood transfusion, kidney failure, atrial fibrillation and long-term ventilation was reduced.
“The patient was in the intensive care unit for one day, and the next day he was taken to rehabilitation. Two days later he was ready to be discharged. He continued with his normal activities. It would take four weeks for the patient to resume normal activities,” said Dr. Govini.
Bioprosthetic valves are cheaper at ₹3.5lakh, while those used for TAVI are more expensive. For TAVI, a patient may have to spend ₹25 lakh, but for a stitch-free procedure, it costs only ₹6.5 lakh, he said, adding that there are many advantages in the new procedure.