Doctors perform less-invasive heart valve implant on elderly

Doctors at a city hospital performed a non-surgical procedure for heart, transcathether aortic valve replacement (TAVR), on a 76-year-old woman in less than 45 minutes along with angioplasty with stenting of the main artery in the same sitting.
Aortic stenosis is the narrowing of the aortic valve of the heart which restricts the blood flow to the whole body. It is one of the most common and most serious valve disease, doctors said.
Patients usually complained breathlessness, chest pain, fainting etc. It mainly affects older people due to scarring and calcium built up and usually starts after the age of 60 years but does not shows symptoms until age of 70 or 80, informed Dr P Lal, Chairman, Metro Group of hospitals.

"About one in eight people over the age of 75 years may have moderate or severe aortic stenosis," he said.
In clinical practice, atleast 30 per cent of the patients with severe symptomatic aortic stenosis do not undergo surgery for replacement aortic valve, owing to advanced age or presence of multiple co-existing conditions.
The patient had a past history of hypertension since 15 years, hypothyroidism since 10 years, COPD (bad lung), severe osteoarthritis of both knees. She has been complaining of difficulty in breathing and chest pain and has been hospitalised many times.

"Her coronary angiography revealed critical block of its main artery. Neither the patient was fit for surgery nor was the family ready for open heart surgery at any cost.

"Thus, the procedure was done under local anaesthesia from the groin area like any other angiography procedure. Initially angioplasty with stenting of the main artery was performed followed by 26 mm size pre-crimped self expandable valve," said Lal.
"Now the patient has come for three weeks follow-up and is doing well. This particular procedure of combination of innovative pre-crimped self expandable, ready to use valve Replacement along with angioplasty with stenting of the main artery makes this the first procedure of its kind in the world," he added.
The surgery took place on November 9 at Metro hospitals and Heart Institute.

"It was difficult and scary time for me as my health was deteriorating each passing day and there was no option but to live with it. I was not fit to have the open heart surgery due to my age and other health problems. But my hopes were rekindled when I learned about the possibility of having the procedure without the surgery and minimal complications involved," said the patient after the surgery.