A Mumbai-based cardiologist has carried out a rare Transcatheter Aortic Valve Replacement (TAVR) procedure on a 65-year-old man through his carotid artery, the blood vessel in the neck. Commonly, TAVR, a minimally invasive procedure to replace a narrow aortic valve, is carried out through the blood vessels in the leg or arms but in this case, the doctor had to opt for a new route to insert the catheter in the patient due to a blockage.
‘First TAVR in India’
“It wasn’t possible to introduce the catheter into the patient through the groin region or the arms due to severe calcification. Therefore, we had to approach it through the carotid artery,” said cardiologist Dr. A.B. Mehta, who operated on the patient in a south Mumbai hospital. Dr. Mehta claimed that this is first such TAVR procedure in India, carried out in October last year.
“The carotid artery supplies blood to the brain and any mishap with that could have led to a massive brain stroke,” said Dr. Mehta. It was also a high-risk case because the patient had earlier undergone a kidney transplant and also had diabetes, he said.
Aortic stenosis, which the 65-year-old man was suffering from, is a common valve disease. “When the aortic valve gets degenerated and starts narrowing, it restricts the flow of blood to the body, putting an additional burden on the heart to pump the blood. It can lead to symptoms like chest pain, fainting and breathlessness and after the development of these symptoms, the life expectancy is six months to two years,” Dr. Mehta said.
The cost of TAVR ranges from ₹25 lakh to ₹30 lakh in a private set-up. Affordability is thus a major factor in TAVR procedures.
“TAVR can be offered only to those who can bear the cost. A few hundred TAVR operations are conducted in the country every year but those through the carotid artery are rare,” said Dr. N.O. Bansal, cardiologist from the State-run J.J. Hospital.
Cardiologist Dr. Prafulla Kerkar from KEM Hospital agreed. “It is rare to carry out the procedure through the carotid artery and is commendable. Although the carotid artery is one of the ways, preventing a stroke is a major challenge,” he said.