The patient was reluctant to undergo the surgery and continued medical management. Since last year the condition worsened, and she started getting increasingly breathless so much so that she couldn’t do her daily chores.
A 65-year-old patient Ms. Rekha (Name changed) was diagnosed with severe aortic stenosis 5 years ago. The patient was reluctant to undergo the surgery and continued medical management. Since last year the condition worsened, and she started getting increasingly breathless so much so that she couldn’t do her daily chores.
She got admitted in a hospital in an ICU in Ranchi with severe breathlessness requiring non-invasive ventilation. Patient’s 2D echocardiogram showed severe aortic stenosis with heart pumping of 10 – 15%. She also was diagnosed to have severe kidney and liver injury. This was accompanied by severe urinary tract infections. Considering the patients critical condition, she was airlifted to Wockhardt Hospital, Mumbai Central to undergo Trans catheter Aortic Valve Implantation (TAVI).
Trans catheter Aortic Valve Replacement (TAVR) is a minimally invasive heart procedure to replace a thick aortic valve which can’t be opened completely. This aortic valve is located between the lower heart chamber called left ventricle and the body’s main artery. In case if the valve doesn’t open correctly, the blood flow from the heart to the body is reduced. TAVR helps to restore the blood flow by reducing the signs and symptoms of aortic valve stenosis- chest pain, shortness of breath, fainting and fatigue.
Speaking on the case, Dr Ankur Phatarpekar, Consultant Cardiologist at Wockhardt Hospital, Mumbai Central says, “The patient was advised to opt for open heart surgery around 5 years back for severe aortic stenosis however she declined any surgical procedure. When she landed at Wockhardt Hospital the heart pumping was very low just 10 to15% which is low. She also had other complications like low platelet count, renal & liver failure which made her a very high risk for TAVI. The pumping of heart was so low that the heart was not tolerating any balloon dilatation during TAVI and required Cardiopulmonary resuscitation multiple times during the procedure. On the 3rd day post-surgery, the heart pumping improved to 40%. Later she recovered and her kidney function and liver parameters improved due to TAVI procedure.
The doctor recommends TAVR surgery if one has severe aortic stenosis which causes issues in the functioning of biological tissue aortic valve. Another health condition such as kidney or lung disease which makes open-heart valve replacement surgery risky and complicated.
Dr Ankur Phatarpekar,
Wockhardt Hospital, Mumbai Central