Case Study: TAVR Heart Procedure Saves Life Of Two 85-Year-Old Patients; Know Details

 Aortic valve stenosis can be treated with TAVR heart procedure. Know this case study of two elderly patients. Read on. 

Navya Kharbanda
Written by: Navya KharbandaPublished at: Mar 04, 2022Updated at: Mar 04, 2022
Case Study: TAVR Heart Procedure Saves Life Of Two 85-Year-Old Patients; Know Details

Two 85 year old patients successfully underwent the Transcatheter Aortic Valve Replacement (TAVR) procedure in Mumbai. The advanced procedure was performed by a team led by Dr. Ganesh Kumar, Head of Department Cardiology, Senior Consultant Interventional Cardiologist, Dr. L.H. Hiranandani Hospital, Mumbai. Aortic Valve Stenosis, natural degeneration of aortic valve with age, is a condition of the heart in which the aortic valve, responsible for blood flow to the rest of the body, doesn’t fully open, thus reducing or blocking blood flow to the body. Severe Aortic Valve Stenosis can even be a cause of death.

Aortic valve stenosis in elderly 

One of the lesser known facts about heart conditions in elderly people is Aortic Valve Stenosis or also called Aortic Stenosis which is narrowing of the heart's aortic valve with increasing age. Aortic valve helps in managing the blood flow to the body. When this valve gets narrowed, it prevents the valve from opening completely, and thus obstructing the blood flow from your heart to the main artery of the body. 

In 2019, the life expectancy at birth in India was 69.5 years for men and 72 years for men, which was very much less than 10 years ago. With high life expectancy, the degenerative Aortic Stenosis (the normal aortic valve degenerates and narrows with age) is going to become a burden on the society. Around 5-7% of the population above 65 years of age suffers from degenerative Aortic Valve Stenosis. More than 60 lakh people of the total population suffers from Aortic valve disease and require this treatment.

Also read: True Story: 95 Year Old Allwyn Almeida Receives TAVR Treatment Post Covid Recovery

Common symptoms of aortic valve stenosis 

An individual with such a condition can have chest pain, shortness of breath, fatigue, the heart becomes weaker sometimes, and they can even pass out. Sadly, by the time it is found in most patients, the disease progresses to an advanced stage. India has been epicenter of advancement in healthcare and but we have seen incidences with heart conditions increasing significantly at all age groups. Over the last 10 years, the trans-catheter aortic valve replacement (TAVR), is performed non-surgically in the cath lab, where it has actually replaced the open heart surgery by reducing the risk of life and being minimum invasive.

How has Covid affected the problem?

Covid has further exacerbated this problem. Due to fear of being exposed to Covid, a lot of people especially elderly age group put off doctor visits and check-ups and this does more harm than good as their diagnosis gets delayed. Due to this delay, it can lead to heart failure (the main pumping chamber of the heart know as left ventricle eventually loses markedly its pumping capacity and fails to pump blood across the narrowed aortic valve). This heart failure hastens death. Therefore, these patients need to be attended and their valves have to be replaced before the efficiency of their left ventricle dips or loses its pumping ability. 

Generally, the only treatment option for Aortic Valve Stenosis used is an open heart surgery, which involves surgically accessing the heart and temporarily switching its function to a machine while the surgeon is operating on the organ. It is effective, but is a highly invasive procedure and needs an extremely intensive post-surgical care. It can also affect your body adversely, especially in case of older patients.

Case study of two patients

“The two patients had come to us with severely decreased pumping capacity and wee in advanced heart failure. Both patients avoided early visits to 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,” said Dr. Ganesh Kumar, remembering both cases.

“Transcatheter Aortic Valve Replacement 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. It required a considerably shorter procedure time, causes minimal discomfort and provides an overall better quality of life,” he further added.

Also read: Valve Replacement Surgery: Know How This 60YO Businessman Was Saved, And What Goes Into A Surgery

Mrs. Jaya Sitharaman, an 85-year-old woman with diabetes started experiencing symptoms such as sleeplessness and breathing difficulties. It was found that her left ventricle functioning had dropped down to 20%. She was also advised to have the TAVR procedure. “My procedure was successful and I was discharged soon after the surgery,” said Mrs. Sitharaman. “I no longer face any breathing issues and can efficiently perform my day-to-day activities,” she further added. 

Mr. Manikrao Bhamble is also an 85 year old ex-minister who belongs to the city of Parbhani in Maharashtra. He was experiencing  breathlessness after walking even short distances. After the diagnosis, it was found that the valve in his heart was functioning at just 19% of its total capacity. Mr. Bhamble said, “After a successful procedure, I was able to walk by myself that very evening and now my condition is much better. I am able to move around for longer periods of time on my own, can perform daily activities & is also able to have good sleep without any hindrances." 

His son, Mr. Pramod Bhamble, said, “Considering my father’s age and the severity of his illness, we had given up hope. We are grateful to Dr. Ganesh Kumar and the entire staff of Dr. L.H. Hiranandani Hospital for saving my father’s life.” Dr. Kumar mentioned, “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."

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. After such sustained efforts, TAVR is highly likely to become a much more accessible and preferable procedure for people in the next five years.