Doctors at Apollo Hospitals, Chennai successfully implanted the first and the world’s largest Pulmonary Valve (32mm) without surgery on a 61-year-old patient on 15th September 2020. The patient had undergone a total surgical correction in 1981 for a condition called Tetralogy of Fallot. This is a condition caused by a combination of four heart defects that are present at birth (congenital). These defects, which affect the structure of the heart, cause oxygen-poor blood to flow out of the heart and to the rest of the body. The patient was doing fine, until the Pulmonary valve (the valve to the lung) developed a leak gradually.
The patient was admitted to Apollo Hospitals, Greams Road, Chennai on May 2019 with a history of breathlessness and tiredness. After a thorough diagnosis, the reports revealed that she was suffering from severe valve leak and the leakage had progressed to her right pumping chamber of the heart which later began to dilate.
The Pulmonary artery, the blood vessel that carries blood to the lungs had enlarged significantly. If left untreated, this could lead to progressive deterioration of the heart function. The team of doctors headed by Dr. CS Muthukumaran, Consultant Structural Interventional Cardiologist, Apollo Hospitals, Chennai decided to perform a very high risk surgery, a percutaneous valve implantation in June 2019. The largest available balloon expandable artificial valve at that time was 29mm which was not a suitable valve for immediate implantation.
Importing a suitable valve [self-expanding] was considered as an option, but due to the COVID Pandemic which struck early this year it became difficult. Due to the long wait, the patient’s condition deteriorated and she suffered severe breathlessness.
In the meantime, the world’s first 32mm valve introduced by Meril Life Sciences, India was considered as a best option for the patient’s condition. The 32 mm artificial valve was utilized for the procedure.
Dr. CS Muthukumaran said, “Tetralogy of Fallot is a congenital heart defect and requires an open heart surgery at 6 months of age. But these patients have a faulty pulmonary valve and will require at least two further surgeries to replace the valve in their life. Redo open heart surgery is high risk and these patients present to us late due to fear of surgery. This latest technology will help all these individuals to get their valve replaced without surgery, in a single day admission. This 32mm new valve has widened our scope to design better treatments for the patient with such heart defects and other anomalies.”
A team of doctors comprising Dr. Sengottuvelu, Senior Consultant Interventional Cardiologist, Dr. Neville Solomon, Senior Consultant, Cardiac Surgeon, Dr. Vasantharoopan, Anesthetists, Dr. Vinodh cardiologist, Intensivists and Radiologists joined together and planned the procedure. The doctors’ team implanted the valve through the right femoral vein, that takes blood to the heart from the groin] of the patient, and the whole procedure was successfully completed in 2 hours. The patient quickly recovered after the procedure and was discharged the very next day.
