A Groundbreaking Medical Procedure in India
In a historic medical breakthrough, doctors at Rajasthan Hospital in Jaipur have successfully replaced a heart valve through the artery in the arm without surgery. This pioneering technique, known as Percutaneous Trans-Axillary TAVI, marks the first time such a procedure has been performed in India. The patient, a 78-year-old man referred to as Hemendra, had severe blockages in both legs caused by calcium buildup, which made traditional methods of valve implantation impossible.
The Challenge
Hemendra’s condition was critical. His heart was functioning at only 25% capacity, and he experienced difficulty breathing, worsening kidney function, and had previously undergone two stent procedures. Typically, Transcatheter Aortic Valve Implantation (TAVI) is conducted by inserting an artificial valve through the femoral artery in the thigh. However, due to the blockage in his arteries, this approach was not viable for him.
An Innovative Solution
Dr. Ravindra Singh Rao, Vice Chairman of Rajasthan Hospital, and his team decided to explore an alternative route. Instead of using the femoral artery, they opted for a rare and complex method involving the subclavian artery near the collarbone in the left arm. Using ultrasound guidance, they punctured the artery with precision, inserted a small tube (sheath), and placed a percutaneous suture system to secure the access point. A larger delivery system was then used to implant the new artificial heart valve.
After the valve was successfully deployed, the artery was sealed using a ProGlide closure device. This case represents the first ever percutaneous trans-axillary TAVI in India, as previous instances of this approach were conducted through open surgery.
A New Beginning for the Patient
The results of the procedure were remarkable. Hemendra’s symptoms improved almost immediately. His breathing became easier, his kidney function normalized, and his heart efficiency significantly increased. He was discharged from the hospital just five days after the operation, fully stable and on the path to recovery.
A Milestone in Indian Cardiology
Dr. Ravindra Singh Rao emphasized the significance of this achievement, stating that around 3-5% of patients suffering from aortic stenosis in India may have blocked femoral arteries, making standard TAVI approaches unfeasible. For these patients, the alternative arm artery route can be life-saving.
This success is not only a milestone for Rajasthan but also a significant step forward for Indian cardiology. It demonstrates that with innovation and courage, even the most complex medical challenges can be overcome.
Key Highlights
- First-ever heart valve replacement through the arm artery without surgery in India
- Conventional femoral route was blocked due to severe calcification
- Patient’s heart functioning only at 25%; kidneys also deteriorating
- Innovative approach led to full recovery; patient discharged in 5 days
- Sets a new path of hope for patients with similar vascular limitations
This groundbreaking success showcases the world-class capabilities of Indian interventional cardiology and opens new horizons in minimally invasive heart procedures. The support of Dr. Kailash Chandra, Dr. Govind Narayan Sharma, and Dr. Prashant Varshney was crucial during the procedure.
