Becomes the oldest person in the country to successfully undergo non-surgical valve replacement procedure
Jyotsna Gujarathi
Gone are the days when a patient who needs a valve replacement had to undergo a risky open-heart surgery. A 76-year old woman, Jyotsna Gujarathi, recently received a new pulmonary valve in her heart in a non-surgical procedure at Sir HN Reliance Foundation Hospital.
Known as Transcatheter Pulmonary Valve Replacement, the procedure was carried out last month by cardiologists Dr Bharat Dalvi and Dr Maulik Parekh. Dr Parekh said that this procedure is carried out only in three hospitals in the country and Reliance Foundation Hospital has performed the procedure on six patients so far including Gujarathi, who is the oldest patient in India.
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Gujarathi, who hails from Dhule and now lives with her family in Thane, was born with a genetic heart defect – a hole in her heart and narrowing of the pulmonary valve. Dr Parekh said that she had difficulty breathing since she was 30 years old due to the damaged pulmonary valve. "She had open-heart surgery in 1975 when the original valve was dilated. Then she had another open-heart surgery in 2012 when the original valve was replaced with a tissue valve. When her symptoms surfaced again in 2015, she underwent an angioplasty," said Dr Parekh.
Age a risk factor
Despite three procedures, her symptoms returned six months ago. Her son, Yatish Gujarathi, said that his mother experienced breathlessness and barely had the stamina to tend to her daily chores. "She was not able to go the bathroom on her own and was bed-ridden at one point. She needed round the clock care. But after the surgery, she can now move around independently and even goes for walks in the evening," he said.
Dr Parekh said that due to her old age, an open-heart surgery was not possible and that is when she opted for the non-surgical procedure. For the surgery, the valve called Melody valve is imported from the Netherlands. "It is not available in India. We have to apply to the Central government under the patient's name and the valve is imported on a special licence. This valve has an average life of 10-15 years," said Dr Parekh.
How the valve works
As part of the procedure, the Melody valve is mounted on a balloon catheter. "The valve which is 22 mm in diameter is crimped until its 5 mm in diameter. The balloon-mounted valve is inserted into the femoral vein at the groin which goes up to the heart. When the position is accurate, the balloon is inflated and it opens up the valve. We then deflate the balloon and pull it back out," said Dr Parekh. Gujarathi was discharged within 48 hours of the procedure.
The Reliance Foundation hospital has also been recognised as a 'solo centre' since they were able to perform the procedure without proctor support. While the hospital waived off some of the fee for the procedure, the family paid around Rs 20 lakh for it.
The surgery
The balloon catheter is inserted into the femoral vein at the groin which goes up to the heart. When the position is accurate, the balloon catheter is inflated which opens up the valve. It is then deflated and pulled it back out.
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