Doctors at PGIMER successfully implanted a pulmonary valve in a 25-year-old congenital heart patient through a non-surgical procedure.
The new technique eliminated the need for open heart surgery in the patient who had already undergone two of these procedures.
Pulmonary valve replacement by catheter (TPVR) was the first procedure of this type carried out by the institute in a patient with a known case of tetralogy of fallot (TOF), for which he was operated for the first time at the age of 11 months, according to a press release from PGIMER. mentionned.
TOF patients have had surgery in the past, but may have a leaky or narrowed pulmonary valve, especially if they have had a previous surgical replacement.
The technically difficult pulmonary valve implantation procedure was performed recently by Dr Manoj Kumar Rohit, Professor of Cardiology, Postgraduate Institute of Medical Education and Research, Chandigarh.
“We have many postoperative TOF patients who develop right heart failure during long-term follow-up due to pulmonary regurgitation,” said Rohit.
He said TPVR in these patients decreases the risk of morbidity and mortality and that long-term results remain comparable to those with surgically implanted valves.
Due to severe pulmonary regurgitation and an enlarged right heart, the male patient underwent another open heart surgery in 2009 when a pulmonary valve was implanted.
Pulmonary regurgitation is a condition where the pulmonary valve, which regulates blood flow from the right side of the heart to the lungs, does not close properly and part of it drains to the right side of the heart.
About 11 years after the second surgery, the implanted valve became dysfunctional.
Open heart surgery for the third time would have been a technically difficult procedure, which is why the patient was taken for a percutaneous procedure, the statement said.
The intervention was successful and the patient returned home and is doing well.
The TPVR is used to replace the pulmonary valve in a non-surgical way, thus reducing the number of cardiac surgeries that a patient will need in their lifetime.
In the procedure, a catheter is placed through a small incision in the femoral vein (in the groin) or the jugular vein in the neck.
A compressed tissue heart valve is placed on a balloon catheter, advanced through the vein to the heart, and is positioned directly inside the diseased pulmonary valve.
Once in position, the balloon is inflated by expanding the stent and the valve is secured in place. The new valve immediately begins to operate. The catheter is then withdrawn.
A second TPVR procedure was performed in a 56-year-old woman, also a known case of TOF who underwent intracardiac repair at the age of 35.
PGIMER doctors noted that the transcutaneously implanted pulmonary valve, in addition to being less traumatic, has a lifespan similar to the surgically placed valve.
The short and long term results of the valve are