Times of India
24 July 2010
By Durgesh Nandan Jha
New Delhi, India

For heart patients, who require valve replacement but are unfit for an open heart surgery, there’s hope on the horizon.

Usually, a patient with a defective valve has to undergo an open heart surgery in which the thoracic cavity is cut open to implant a new valve. But patients above 65 years of age and those with poor health condition are considered unfit for the complex surgery. However, they can now bank on a new method widely practised in Europe – Percutaneous Aortic Valve Replacement (PAVR) technique – to get their diseased valves replaced without having to go under the knife. Using this method, doctors transport a synthetic valve to the heart through a small hole made in the groin area. And now for the first time in India, cardiologists at the Medanta Medicity Hospital in Gurgaon will perform this procedure on patients next week.

“Six patients have been screened already. We have sent letters to more patients, who had to be turned away earlier as they were unfit for open heart surgery. The procedure will be conducted next week by a team of doctors from the hospital and experts from Europe,” said Dr Praveen Chandra, chairman of the division of interventional cardiology at Medanta Heart Institute, adding that Medanta is the first hospital in the country to perform this procedure.

In this technique, Chandra said, a small puncture is done in the groin vessels with or without anaesthesia depending on the condition of the patient. “The prosthetic valve is passed through lower limb blood vessels to the heart and is positioned correctly over diseased valve under X–ray guidance. The entire process takes up to one hour unlike the open heart surgery which requires at least 4–5 hours. Unlike surgery, it doesn’t require cutting open of chest wall and heart which requires three months for complete recovery,” Chandra said, adding that patient whose valve has been replaced through PAVI is ready to go home in 4 days. At Medanta, the cardiologists said, they will use tissue heart valve which is made from animal tissues.

“The new procedure will be a boon for old patients suffering from aortic valve stenosis, high–risk patients like those suffering from chronic obstructive pulmonary disease (COPD) and previous bypass surgery patients among others. The only concern is that valve implantation through this process is going to to be costlier. It will cost a patient about Rs 12 lakh. But, once the technique is popular, I am sure the rates would come down,” said Dr Naresh Trehan, chairman and managing director of Medanta Medicity.

He said the technique has proved to be a success in several European countries, including Italy, the United Kingdom, Belgium and France.

Doctors say that valve needs to be replaced if it gets narrowed due to calcium deposition or degeneration, which may lead to restricted blood supply from the heart to other parts of the body. In some patients, the valve degenerates due to congenital defects.