Scary Heart Procedure Customized for Elders

By: Dhananjay Kumar

New Delhi: 76 years old Mrs Rama Dhamani is raring for a ‘new leg’ of active life, thanks to a landmark innovation by globally renowned interventional cardiologist, Dr. Purushottam Lal, Chairman of Metro Group of Hospitals.

Serious heart conditions, needing hard, risky and traumatic open heart surgery, coupled with bad knees had brought Mrs Dhamani’s life to a grinding halt. But after repair of her sinking heart by Dr. Lal’s innovative, friendly and non invasive procedure, it is a leap of faith of sorts for her. She is part of the history in the sense that she is the first beneficiary of the virgin procedure. Her joys knows no bounds at the prospect of living some good years in the midst of her caring family. But for Dr. Lal’s benign innovation, she would have been left to count her days which could have ended any time soon. Her family now have decided to go for her knee transplant, so that she can have legs too to lead an active life.

Unveiling his landmark innovation to media on November 30, Dr. Lal Chuckled and said, ‘successful outcome of this hybrid procedure is going to be a hallmark in the pursuit of making hard procedure like open heart surgery a thing of the past. This innovation was need of the hour as hundreds of old people are denied new lease of life.’

Cardiac patients of this age are advised against gruelling open heart surgery because one, it is risky and two, it is regarded as harshness perpetrated on old people whose days might be numbered. The family of Rama Dhamani too had said point blank that, come what may, she must be spared of the trauma of open heart surgery. But the innovative procedure devised by Dr. Lal may change all that. Rama Dhamani is the first trophy of success of Dr. Lal’s resourceful mind. Already, many aged heart patients are lined up to his Noida Metro Hospital to undergo this so simple and benign procedure. And you can be pretty…

sure, this breakthrough technique, like all his previous procedure innovations is bound to be adopted world over after initial scepticism. If allowed, the open heart surgery on Mrs. Dhamani would have taken 4-5 hours but the repair was successfully done in less than 45 minutes without surgery.

Dr. Lal’s technique has come for Mrs Dhamani as manna from heaven. She was in a very precarious condition of health.

Mrs. Rama Dhamani was burdened with past history of hypertension since 15 years, hypothyroidism since 10 years, COPD (bad lung), and severe osteoarthritis of both knees. She has been complaining severe difficulty in breathing and chest pain. Hospitalization had become a routine affair. Her heart firmed up by this friendly repair, she can now look for leading a better life for many more years to come.

The name of this revolutionary non surgical heart procedure is Trans Catheter Aortic Valve Replacement (TAVR). Along with valve repair, angioplasty with stenting of her heart’s main artery, which had critical blockage, was also done on her in the same sitting.

The procedure was done under local Anaesthesia from the groin area like any other angiography procedure. Initially Angioplasty with Stenting of the main artery was performed followed by 26 mm size pre-crimped self expandable valve. Post procedural Angiography and ECHO study showed no leak or tightness in the valve and the patient was sent home after three days. Now the patient has come for three weeks follow-up and is doing well.

She had Aortic stenosis condition. It is the abnormal narrowing of the aortic valve of the heart which restricts the blood flow to the whole body. It is one of the most common and most serious valve diseases.

Patients usually complained breathlessness, chest pain, fainting etc. It mainly affects older people due to scarring and calcium built up and usually starts after the age of 60 but does not shows symptoms until age of 70 or 80. More than one in eight people over the age of 75 may have moderate or severe aortic stenosis. Since we are seeing more and more elderly patients, its condition may become an important public health problem. The mortality rate is almost 50% in the first two years after the symptoms among the untreated patients. In clinical practice at least 30% of patients with severe symptomatic aortic stenosis do not undergo surgery for replacement aortic valve, owing to advanced age or presence of multiple co-existing conditions. This group of patients who are either unfit for surgery or at high surgical risk, a less invasive treatment like Transatheter Aortic Valve Replacement (TAVR) is a big blessing. This particular procedure constitutes combination of innovative pre-crimped self expandable, ready to use valve Replacement along with Angioplasty with Stenting of the main artery.

Mrs Dhamani is cheerful.

Thanking Dr. Lal’s vision, she said, ‘It was difficult and scary time for me as my health was deteriorating each passing day and there was no option but to live with it. I was not fit to have the open heart surgery due to my age and other health problems. But my hopes were rekindled when I learned about the possibility of having the procedure without the surgery and minimal complications involved. I had my health back after having the treatment successfully,’


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