Mumbai: In a groundbreaking achievement, doctors at K J Somaiya Hospital and Research Centre successfully treated a 69-year-old man suffering from two lifelong congenital heart defects—without the need for open-heart surgery. The pioneering procedure combined complex interventions through a minimally invasive approach, bringing new hope to patients with similar conditions.
Patient Lived Decades With Undiagnosed Conditions
The patient had lived for decades with undiagnosed congenital conditions—coarctation of the aorta (a narrowing of the body’s main artery) and bicuspid aortic valve stenosis (a narrowing of the aortic valve). While he believed his chronic leg pain and fatigue were due to aging, doctors later revealed that reduced blood flow from these heart defects was the true cause.
Despite being diagnosed two years ago, the patient initially avoided surgery. As his symptoms worsened, he turned to K J Somaiya Hospital in search of a less invasive solution.
Two-Step Minimally Invasive Strategy Adopted
A multidisciplinary team of interventional cardiologists, imaging specialists, anaesthesiologists, and nursing staff devised an innovative two-step treatment strategy. The first step involved coarctoplasty—using advanced imaging, doctors inserted a covered stent through the femoral artery to widen the narrowed aorta.
“The covered stent ensured better blood flow and added structural support, particularly crucial given the patient’s age and calcification of arteries,” explained Dr. Milind Phadke, chief interventional cardiologist. Within days, the patient experienced relief from his leg pain.
Planning the Valve Replacement
With the aorta successfully treated, the next step is replacing his severely narrowed aortic valve. We plan to perform a TAVR – Transcatheter Aortic Valve Replacement – which allows us to implant a new valve using a catheter inserted through the leg.
The uniqueness of this procedure is that we will be navigating through the very stent we placed in the aorta.
This will allow us to complete both procedures through the femoral artery, avoiding open surgery entirely.
Patient Discharged, Recovery Without Pain
Following the procedure, the patient has been discharged and can now walk without pain. Dr. Manisha Bobade, CEO of K J Somaiya Hospital, called the achievement a testament to the hospital’s cutting-edge capabilities.
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Rare Combination of Coarctoplasty and TAVR Praised
Dr. Phadke added that the unique combination of coarctoplasty with TAVR through a single access point is rare but highly effective. By avoiding open-heart surgery, risks of infection, prolonged hospitalization, and long rehabilitation were eliminated. “This two-pronged approach has transformed a debilitating condition into one with a hopeful prognosis,” he concluded.
