Fortis Escorts Heart Institute, Okhla, New Delhi has successfully performed a TAVR (Transcatheter Aortic Valve Replacement) procedure on a 74-year-old man with a rare condition of Dextrocardia (heart on the right side). The patient, Mr. Inderpal Singh (74 years) had been suffering from breathlessness on exertion since past 1.5 years and chest pain since last few weeks. His other health conditions include diabetes, hypertension, high body mass index, and obstructive sleep apnea.
Prior to his admission at Fortis, Mr Singh had visited many hospitals and cardiac centers, without any relief. At Fortis Escorts Heart Institute, Okhla the Cardiology team led by Dr Atul Mathur, Executive Director, Interventional Cardiology successfully carried out the complex procedure of TAVR wherein his abnormal heart valve was replaced using cardiac catheter through skin puncture, thus avoiding a risky open surgery. The investigations at the time of admission revealed that patient was suffering from aortic stenosis (narrowed malfunctioning heart valve), in his right-sided positioned heart. The procedure was all the more difficult in view of the heart being right sided, thus making the approach challenging. This is the first reported case of TAVR in right sided heart in India and only the fourth worldwide. Though the patient’s anomalous heart condition and comorbidities posed a challenge, the doctors performed the TAVR procedure successfully, giving him a new life on his 74th birthday on May 26, 2022. After a short hospital stay of three days post procedure, the patient was discharged in a stable condition.
Mr. Inderpal Singh shared that some years ago, his father had also been treated at Fortis Escorts Heart Institute, Okhla- this added more faith on part of the patient in Dr. Mathur and Fortis.
Dr Atul Mathur, Executive Director, Interventional Cardiology, Fortis Escorts Heart Institute said, “This was a very rare case, where the heart was anatomically not located in its normal position since birth. The patient was having morbid obesity, obstructive sleep apnea component (most common sleep-related breathing disorder and is characterized by recurrent episodes of complete or partial obstruction of the upper airway leading to reduced or absent breathing during sleep). All of these made the TAVR procedure a challenging task to perform). The procedure lasted for 5 hours. The chances of mortality, in this case, was extremely high (above 25% in first year and 50% in two years). After the successful procedure, survival is safe which is mostly 100%. If the patient was not treated and diagnosed on time, his condition could have deteriorated and he could have suffered heart attack, leading to loss of life.”
Bidesh Chandra Paul, Zonal Director, Fortis Escorts Heart Institute, Okhla, New Delhi said, “This is the first case in India, where TAVR procedure was performed on a patient with a condition of Dextrocardia. It was a very risky and medically challenging case, and it gives me immense pride to say that Fortis Escorts Heart Institute has the expertise and high-end technologies to perform and manage high-risk cardiac cases of very old, frail patients. Under the expert leadership and guidance of Dr Atul Mathur, Executive Director, Interventional Cardiology, the procedure was successful. A thorough evaluation, adequate monitoring, and medical care provided by the medical team ensured that the patient’s conditions did not worsen, and he recovered. I applaud the team of doctors for performing this high-risk procedure quite meticulously.”
Fortis Escorts Heart Institute is the leading centre in the country in performing TAVR procedures. In recent years, TAVR has become a preferred treatment modality for patients who are at risk or unwilling to undergo open-heart valve replacement surgery. It is a minimally invasive procedure that repairs the aortic heart valve without removing the old, damaged valve, by placing a replacement valve through a catheter or tube inserted through the femoral artery (the large artery in the groin). The procedure is also beneficial for treating patients with previously failed bioprosthetic valve, thus, avoiding any major surgery. This is used for the very elderly or those with severe co-morbidities which makes surgeries complex or risky.