Amid the corona pandemic, the first of its kind emergency Transcatheter Aortic Valve Replacement (TAVR) surgery was performed on a Thane farmer at the Sir H. N. Reliance Foundation Hospital, an official said on July 22.

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On June 20, 62-year-old farmer was rushed from Navi Mumbai (Thane) to the hospital after he was gasping for breath, suffering from low blood pressure, no urine output and body-swelling which indicates a severe heart failure.

A team of heart specialists including Dr Maulik Parekh (TAVR expert, Proctor), Dr Anvay Mulay, Dr Manoj Mashru, Dr Ajit Menon, Dr Pravin Kulkarni, Dr Talha Meeran, Dr Niranjan, Dr Himanshu, Dr Bhavesh Vora assessed him in the emergency ward. "We knew he had severe heart failure because of dysfunction of one of his artificial heart valves that was implanted in an open heart surgery six years ago. We put him on dialysis and multiple medicines to support his dropping blood pressure," said Dr Parekh. Though certain he required a valve replacement, a repeat open heart surgery was considered extremely high risk because of his critical condition and previous surgery, he added. Hence, he was offered the safer alternative of TAVR -- which is a Valve-in-Valve procedure -- that was performed within 4 hours, again considered a record in itself.

"The TAVR is a complex minimally invasive cardiac procedure to treat severe narrowing (stenosis) of the aortic valve (valve between heart and the main blood vessel)," Parekh explained. Normally, the TAVR is a planned/elective procedure which takes 15-17 days to organize as it involves a battery of diagnostic tests, planning of team of doctors, deciding on the right size of the valve.

In the patients case, the planning of the TAVR was a herculean task as he was critical and was not fit for a CT scan to determine the right size of the valve. With his deteriorating health, it was a race against time to arrange logistics for ordering the right size valve in a short time. Luckily, he had undergone an angiography a week before he was brought to Sir HNRF, which helped the doctors to judge the exact type and size of the previously implanted valve and source it for him.

In the hour long procedure, the cardiologists inserted a new valve inside the previously implanted valve which had failed without opening the chest, and the TAVR proved to be lifesaving as within two hours of the operation, all his vital parameters were in control and he was discharged on July 2, said Parekh.

The patient's nephew, Dr Sanjay Kadam termed the development as "a rebirth" for his uncle, who is now leading a normal life. In the lockdown, this was the third TAVR case at Sir HNRF hospital, but the earlier two were planned procedures and all the patients are doing well.