Advanced heart procedure saves life of two 85-year-old patients

Manikrao Bhamble, former minister who hails from Parbhani, used to suffer from breathlessness after walking short distances. On diagnosis, it was found that the valve in his heart was functioning at just 19% of its capacity.

Bhamble’s son Pramod said, “Considering my father’s age and the severity of his illness, we had given up hope. We are grateful to the doctors for saving his life.” After the procedure, he is able to move around for longer periods of time on his own and can perform daily activities.

Jaya Sitharaman, an 85-year-old woman with diabetes, started experiencing sleeplessness and breathing difficulties. It was found that her left ventricle functioning had dropped down to 20%. Based in Mumbai, she was recommended for the TAVR procedure.

“The two patients had come to us with severely decreased pumping capacity and in advanced heart failure. Both patients avoided early visits to the hospital due to fear of contracting Covid. Considering their age, we immediately ruled out Open Heart Surgery on account of its invasiveness and toll on the body and opted for TAVR,” Dr Ganesh Kumar told The Indian Express.

One of the lesser-known heart conditions among elderly people is Aortic Valve Stenosis — or Aortic Stenosis — which is narrowing of the heart and aortic valve with age.

Aortic valve helps in controlling the blood flow to the body. When this valve is stenosed, it prevents the valve from opening fully, and thereby obstructing the blood flow from the heart into the main artery of the body. The life expectancy at birth in India in 2019 was 69.5 years for men and 72 years for men. “With increasing life expectancy, the degenerative Aortic Stenosis (the normal aortic valve degenerates and narrows with age) is likely to become a burden. Approximately 5-7% of the population above 65 years suffers from degenerative Aortic Valve Stenosis,” Dr Kumar said.

“A person with such a condition may experience chest pain, shortness of breath, fatigue, the heart becomes weaker and sometimes, they may even pass out. Unfortunately, by the time it is found in many patients, the disease has progressed to an advanced stage,” Dr Kumar added.

He further said, “Traditionally, the only treatment option for Aortic Valve Stenosis used to be open heart surgery, which involved surgically gaining access to the heart and temporarily switching over its functioning to a machine while the surgeon operated on the organ. While effective, this is a highly invasive procedure and requires intensive post-surgical care and takes a huge toll on the body, particularly in the case of older patients.”

TAVR is a newer, much less invasive alternative which does not involve opening up the chest cavity and access to the heart is instead gained via a small blood vessel in the leg using advanced imaging techniques. TAVR requires a shorter hospital stay and recovery is much faster.

For a while now, TAVR has been performed non-surgically in the cath lab, where it has actually replaced the open heart surgery by reducing the risk of life and being minimally invasive.

“TAVR has the potential to replace open heart surgery as the first choice or treatment for Aortic Valve Stenosis for older people with Aortic Stenosis and because of its minimally invasive nature it is safer than open heart surgery and can be opted by older people,” said Dr Kumar.

Doctors, trained in this procedure, are heading up this cause across India by visiting various cities in the country, educating people and training other doctors to make people aware about this potentially life-saving alternative.