A team of valvular heart specialists of Christian Medical College (CMC), Hospital, Vellore, has non-surgically replaced the tricuspid valve in a young patient from Delhi. The doctors implanted the new heart valve through the femoral vein, a blood vessel in the groin.
According to a press release, the 23-year-old patient had undergone open heart surgery for ventricular septal defect at the age of five. He had undergone a repeat open heart surgery to replace the tricuspid valve with a prosthetic heart valve five years ago in Delhi as he developed leakage of blood on the right of his heart through the valve, causing fatigue, leg swelling and rapid heart beating.
He presented with degeneration of the prosthetic tricuspid valve, while a balloon valvuloplasty done at a different hospital did not yield satisfactory results. He approached the Cardiology department of CMC where the structural heart and valve clinic team evaluated him and found that the prosthetic tricuspid valve had become very narrow and was causing his symptoms. If left untreated, this could lead to progressive deterioration of right heart function.
The structural heart team of Cardiology unit-2 has been running a non-surgical or percutaneous valve implantation programme for the last five years. A team of cardiologists of the unit — John Jose, Harsha Teja, Jesu Krupa, Abraham Speedie and Paul V. George — along with the cardiac anaesthetic team planned the procedure.
Doctors said that their experience in replacing the aortic and pulmonary heart valves through the percutaneous route helped in implanting the artificial tricuspid valve. Despite the challenges in the patient — such as risk of acute deterioration of right ventricular function since his pulmonary pressures were already high, risk of valve thrombosis and alteration of anatomy due to previous procedures — the implantation was done without any complications and he was discharged in a week, the release said.