- Conventional TAVI procedures carried the potential risk of aggravating kidney-related complications due to the use of contrast media: Doctor
- In patients over 80 years of age, the mortality rate is around 0.5 per cent to 0.8 per cent
- The total cost of the treatment was Rs 11 lakh and it was cashless as the patient was having insurance cover
- We have used Hydra, transcatheter aortic valve manufactured by Surat-based Sahajanand Medical Technologies, which has a life span of eight to 12 years.
- Transcatheter aortic valve replacement (TAVR), also known as TAVR or transcatheter aortic valve implantation (TAVI), is a procedure to treat aortic stenosis, a narrowing of the aortic valve
GOWRI MANICKAVASAGAM
AHMEDABAD, SEPT 6
In what is said to be the first-of-its-kind medical feat in Western India, an Ahmedabad-based cardiologist has successfully performed a zero-contrast Transcatheter Aortic Valve Implantation (TAVI) on an octogenarian suffering from severe aortic stenosis (narrowing of aortic valve) and troubled with chronic kidney disorder.
Speaking with Navjeevanexpress.com, Dr Abhishek Rajpopat, who had undergone a specialized training for TAVI in Copenhagen, Denmark, said, “Transcatheter Aortic Valve Implantation (TAVI) is known for its complex nature, particularly in elderly patients. These cases become notably intricate when such patients simultaneously present with kidney disease. In this case, patient KiranShah’s elevated creatinine levels indicated impaired kidney function. The patient was experiencing breathlessness, chest pains, giddiness, swollen legs, general tiredness, and various other challenges due to severe aortic stenosis. Conventional TAVI procedures carried the potential risk of aggravating kidney-related complications due to the use of contrast media.”
Throwing light on his decision, Dr Abhishek said, “Given the patient’s high-risk profile due to the aortic stenosis and CKD, I opted for a zero-contrast TAVI. This technique was chosen to minimize the risk of contrast-induced nephropathy and protect the patient’s compromised kidneys during the aortic valve replacement procedure. These complications demand an exceptional level of skill to execute the procedure without access to the critical element, which is unavailable as an option during the pivotal stages. So far I have performed an impressive array of 500 TAVI procedures independently.”
Dr Rajpopat further explained, “In this patient, administering contrast media during the TAVI procedure could have posed severe threats to the already compromised kidneys, potentially leading to kidney failure. To mitigate this risk, I opted for a contrast media-free approach. I am happy that we were able to successfully perform the surgery with minimum risk.”
The patient’s recovery has been remarkable, marked by improvements in overall well-being and the alleviation of initial symptoms. Post-operative rehabilitation is currently underway to ensure the patient’s sustained progress.
Replying to a query on the risk factors and the cost of treatment, Dr Rajpopat said, ”In patients over 80 years of age, the mortality rate is around 0.5 per cent to 0.8 per cent. Kiran has to take only blood thinners along with regular medicines. The total cost of the treatment was Rs 11 lakh and it was cashless as the patient was having insurance cover. We have used Hydra, transcatheter aortic valve manufactured by Surat-based Sahajanand Medical Technologies, which has a life span of eight to 12 years. This has resulted in reducing the treatment cost.”
Kunal Shah, son of the patient Kiran Shah, 80, said, “My is a diabetic patient with high blood pressure, below normal kidney functioning, and implanted with a pacemaker. He had undergone cardiac surgery at Zydus Hospital in 2018. Before undergoing this treatment three months ago, he used to run out of breath even if he walked just 15-odd steps. We have consulted many eminent doctors and my dad was diagonised with aortic stenosis and needed immediate treatment. They opined that medicines do not work in case of aortic stenosis and open heart surgery or TAVI is the only options. In government-run hospitals one has to wait for months for this surgery. After due consultation, we have zeroed on Dr. Abhishek Rajpopat, a distinguished interventional cardiologist, to save my dad’s life. Now, my dad takes care of himself without anyone’s help and also breathing easily.”
“I am feeling really good. I do not need anyone’s help in my daily routine,” Kiran Shah said.
What is TAVI?
TAVI, also referred to as transcatheter aortic valve replacement (TAVR), is a cutting-edge and minimally invasive surgical technique devised to treat aortic valve stenosis, primarily in patients categorized as high-risk candidates for conventional open-heart surgery. During this procedure, an artificial valve is introduced without removing the diseased valve. This new valve is implanted within the aorta, where it expands and pushes aside the damaged valve components, thus regulating blood flow.
