City-based doctor achieves rare feat

Wednesday, 10 April 2019

Dr Suhas Hardas performs two Transcatheter Aortic Valve Replacement independently

PUNE: A city-based cardiologist Dr Suhas Hardas at Poona Hospital and Research Centre, Pune, has successfully performed two Transcatheter Aortic Valve Replacement (TAVR). Dr Hardas became the first interventional cardiologist of the city who performed it independently. 

Two patients, a male patient of 87 years with kidney failure and diabetes from Baramati and a female patient from Pune of age 78 years with weak lungs were operated on recently with successful implantation of new prosthetic aortic valve at the hospital.

Dr Hardas said, “TAVR was done for patients with aortic valve disease. This disease is a condition in which the valve between the main pumping chamber of your heart (left ventricle) and the main artery to your body (aorta) do not work properly.”

“Aortic valve is located between the big artery aorta and heart chamber called left ventricle. Now, the function of this valve is to allow unidirectional flow from the left ventricle into the aorta but not backwards. Over a period of time due to a lot of stress and strain on this valve, it undergoes a lot of degeneration and become narrow. Due to which the pressure on the left ventricle keeps rising and therefore it fails over a period of time. So, this critically narrow valve must be replaced.” Dr Hardas said.

According to Dr Hardas, there are two methods of replacing the valve. “Earlier, the options were surgical where you actually cut open the chest, deflate the lungs, put the patient on the ventilator, stop the heart and move the entire circulation to the heart-lung machine until the time of surgery which may be more than an hour. This method involves a lot of side effects of the heart-lung machine itself but then the original valve is chocked, removed and a new valve is implanted and is surgically sutured. This method is very traumatic and invasive, as a lot of problems like on table death, infection, ventilation related problems, blood transfusion-related problem, bleeding, strokes, paralysis and many other such problems,” Dr Hardas added. 

He further added, “The TAVR is a new method in cardiac therapeutics. It is very simple as it involves the introduction of a catheter or a tube through a groin artery called femoral artery (the femoral artery is a large artery in the thigh and the main arterial supply to the thigh and leg) through the valve is inserted which expands as soon as it comes out of the catheter. It is then taken to the site of the aortic valve and the new valve is implanted within the existing valve. And it is done through the artery in the groin and then the tube through which the valve is taken up is removed.” 

- The time of the whole procedure is about one or one and a half hours
- No trauma 
- The whole procedure cost is about Rs 15 to 30 lakh. The valve is expensive but over a period of time, the cost of it will come down
- In most of the cases, the active aortic valve is damaged after 60 to 70 years of age
- The patient can ambulate in less than 24 hours and can be sent home within a couple of days

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