Pune, May 21 : Cardiologists at Manipal Hospital Baner successfully treated a 72-year-old male patient suffering from severe heart valve dysfunction using a minimally invasive transcatheter mitral valve-in-valve replacement procedure. The patient had undergone mitral valve replacement in 2014 using a bioprosthetic valve, which had deteriorated over time, leading to serious heart-related complications.
The patient presented with progressively worsening breathlessness over the last six months, which initially occurred during exertion and later progressed to breathlessness even at rest. He also experienced episodes of sudden breathlessness at night and had multiple hospital admissions for heart failure.
On evaluation, doctors found that the previously implanted valve had degenerated, causing severe leakage and narrowing of the valve. The patient also had significantly elevated pressure in the lungs, indicating increased strain on the heart.
Considering the patient’s age and previous heart surgery, another open-heart valve replacement surgery was considered high risk due to scar tissue and fibrosis from the earlier procedure, with an estimated mortality risk of 10–15 percent. After detailed evaluation and counselling, the medical team decided to proceed with a minimally invasive transcatheter mitral valve-in-valve replacement (TMVR).
Dr Abhijit Joshi, HOD and Consultant, Manipal Hospital Baner, said,
“The procedure was performed through a vein in the right leg using a catheter-based approach. Using continuous imaging guidance, we accessed the heart and placed a new valve inside the old damaged valve through a valve-in-valve technique.”
Further he added, “Bioprosthetic valves can deteriorate over time and traditionally require repeat open-heart surgery, which carries higher risks, especially in elderly patients. In this case, the transcatheter valve-in-valve procedure allowed us to replace the failing valve through a minimally invasive approach. This significantly reduced the procedural risk and helped in faster recovery for the patient.”
Following the procedure,doctors found that the previously replaced heart valve had weakened over time, leading to severe leakage and restricted blood flow. This also increased pressure on the heart and lungs, putting additional strain on the patient’s condition. Considering the patient’s age and previous heart surgery, another open-heart surgery was considered highly risky. After detailed evaluation and counselling, the medical team decided to proceed with a minimally invasive transcatheter mitral valve-in-valve replacement (TMVR).
The procedure was performed by a multidisciplinary team comprising interventional cardiologists, cardiac anaesthetists, Cath lab staff and supporting clinical teams.