“Upon arrival, the patient was in a critical condition. She had low blood pressure and was severely symptomatic with breathlessness and giddiness,” said a doctor.

A high-risk patient with a history of severe comorbidities, two strokes, and two angioplasties, underwent a heart procedure that saved her life. No, it was not a heart surgery, but the implantation of a TAVR (valve procedure) that prevented sudden cardiac arrest and improved her well-being. The 72-year-old — who was diagnosed with severe calcified aortic valve stenosis (causing narrowing of the aortic valve in the heart, leading to dizziness with falls, chest discomfort, and severe breathlessness) — was in the safe hands of doctors from Wockhardt Hospitals, Mira Road, Mumbai. Calcified aortic valve stenosis, it is understood, is more common in elderly people above the age of 65. In this case, the patient also presented a low ejection fraction (EF), which is measured as a percentage of the total amount of blood pumped out from the heart with each heartbeat.

Life-Saving Transcatheter Aortic Valve Replacement (TAVR) Procedure

A team of doctors carried out one of the first successful life-saving transcatheter aortic valve replacement (TAVR) procedures on the septuagenarian. According to hopkinsmedicine.org, TAVR is a procedure that replaces a diseased aortic valve with a man-made valve. Aortic valve replacement can also be performed with an open-heart surgery, a procedure that is known as surgical aortic valve replacement (SAVR). It states that while the aortic valve controls blood flow from your heart to your body, if it becomes stiff, it leads to a condition called ‘aortic stenosis’. The heart may then have to work too hard to pump blood through the small valve opening to the rest of your body, leading to a risk of heart failure.

The Patient’s History Of Heart Problems

• In this patient’s case, she suffered a major heart attack and underwent two angioplasties in 2010 and 2014.
• She continued to struggle with her health when she had a stroke in 2018, followed by another stroke in 2021.
• Her condition deteriorated when she developed progressive narrowing of the aortic valve last year.
• Upon examination, the doctor found her EF was low due to a previous heart attack, leading to restrictions on physical activities.
• The elderly patient experienced severe dizziness, low blood pressure, and breathlessness in September and July last year.
• She was admitted to the hospital in December 2023. Later, Wockhardt doctors performed TAVR on her.

“Upon arrival, the patient was in a critical condition. She had low BP and was severely symptomatic with breathlessness and giddiness. The focus was on the aortic valve, which was getting narrow. It results in the valve not fully opening, reducing or blocking blood flow to the body. In severe cases, aortic valve stenosis causes sudden cardiac arrest and death,” warned Dr Anup R Taksande, consultant interventional cardiologist at Wockhardt Hospital, adding that this condition is commonly seen in people over 65 years, with comorbidities like coronary artery disease, stroke, and chronic obstructive pulmonary disease (COPD).

TAVR, A Non-Surgical Procedure

The doctor added that TAVR is a non-surgical procedure that minimises ‘invasiveness’ and reduces the risk of ‘morbidity and mortality’. It is performed under mild anesthesia and is suture-less through the groin. “The uneventful procedure lasted for 30 minutes and the patient was shifted to the ICU for a day and made to walk after 12 hours. She was shifted to the ward for a day and then discharged in stable condition [earlier this year]. She returned after 10 days for a follow-up,” said the expert. Patient was ‘asymptomatic’ with no further complaints of giddiness or breathlessness.