Expressnews
Chennai, 2022: A 68-year-old farmer got a new lease of life post a challenging Redo Sutureless Aortic Valve Replacement at Fortis Hospital, Vadapalani. The farmer had earlier undergone an aortic valve replacement surgery in 2017 as he had suffered from calcified aortic valve leading to severe aortic stenosis (Aortic Valve Stenosis is a valvular disease, which reduces or blocks blood flow from the heart to the aorta and to the rest of the body). The surgery was performed to install bioprosthetic valve to save the patient’s life. Over the period, the valve got degenerated due to calcium deposits, which made the heart valve opening narrow leading to blocked blood flow.
In November 2022, the patient was admitted under Dr.Govini Balasubramani, Head – CTVS, Heart & Lung Transplant Program at Fortis Hospital, Vadapalani as he experienced breathlessness. Diagnosis reports revealed that the heart valve had degenerated with severe calcific aortic re-stenosis and aortic regurgitation (a condition that occurs when your heart’s aortic valve does not close tightly). As a result, the blood pumped out of the heart’s left ventricle leaks backward. If left untreated, a leaky valve could lead to heart failure and even death.
Giving details of the surgery, Dr. Govini said, “We evaluated different options to treat the patient and even considered TAVI (Transcatheter Aortic Valve Implantation) procedure – a minimally invasive procedure where a new valve can be inserted inside the degenerated valve without removing the valve. However, the doctors’ team faced another challenge during Transesophageal Echo. Patient’s aortic valve, which is supposed to be 21mm in normal condition, was found to be less than 20 mm. This is risky as the strength of aortic valve may get weak or damaged while dilating. Considering the risks factors, we decided to go ahead with Redo Sutureless Aortic Valve Replacement.”
Dr Govini elaborates further “The patient’s breastbone was separated via sternotomy to remove the degenerated valve. The native damaged valve was replaced with a 21mm bioprosthetic/sutureless valve. Sutureless valve replacement is typically recommended for elderly patients or patients with comorbidities as it does not require sewing the new valve into position, the surgery is less complex with quick recovery time. In most cases, placing the sutureless valve takes less than 3 minutes. It also reduces post-operative complications such as blood transfusions, renal failure, atrial fibrillation, prolonged ventilation. Post-surgery the patient has recovered well and was discharged within 3 days.”
Mr. Venkata Phanidhar Nelluri, SBU Head at Fortis Hospitals Chennai added, “This was an incredibly challenging case considering the condition and age of the patient. However, timely assessment and treatment by our team of specialists helped the patient get a new lease of life. We are proud of Dr. Govini Balasubramani and his team of Cardiothoracic Surgeons, ICU Specialists, Cardiac Anaesthesiologists, the Cardiologists and nurses to have helped the patient recover quickly.”
