Coimbatore: A 65-year-old Kenyan national came to a city hospital for treatment after her tissue valve or bioprosthetic valve failed and her heart got completely blocked.
The usual procedure would be to attach the patient to a heart lung machine, stop her heart, open the organ, remove the degenerated valve and replace it with a new valve.
Doctors in the city-based Kovai Medical Centre and Hospital instead introduced a new valve through a catheter inserted through her groin vein which correctly implanted itself within the old valve.
It took 45 minutes to complete the surgery and the patient was out of the intensive care unit in 24 hours. The procedure called valve-in-valve replacement was performed in the tricuspid valve in a Chennai hospital last year. But then, doctors had introduced the valve through a vein in the neck. This time cardio thoracic surgeons introduced it from a vein in the groin.
Lucy Karanja, who is a retired nurse from Nairobi, had developed a tumour in her tricuspid valve in 2013. Since she had a relative in the United States, she travelled to Iowa to undergo a valve repair.
As her condition suddenly deteriorated, doctors ended up replacing her valve with a tissue valve. Tissue valves usually made of bovine pericardium, or a cow’s valve, have a shelf life of only 10 to 15 years. Unfortunately for this woman, her valve degenerated and began failing after hardly three years.
Doctors placed a permanent pacemaker after her heart had gotten blocked, but the degenerating valve was causing severe narrowing and leakages through it.
It was a year later, that the national was referred to Coimbatore. “A repetition of the old procedure including stopping her heart and opening it up would have been risky. Such surgeries have a mortality rate of 10% to 15% in the United States,” said cardiac surgeon Dr Prashant Vaijyanath, who performed the procedure. “It would also mean a long and difficult recovery including a month long stay in the intensive care unit and three-hour long surgery,” he said.
“This procedure we devised was done without having to stop the heart and attaching the patient on a heart lung machine,” he added. “Hardly 24 hours after the surgery was performed, the patient was transferred to her room and began consuming semi-solids too,” said Dr Vaijyanath.
Dr Vaijyanath was also a part of the team who performed the surgery for the first time in the country in Chennai.