Medica Superspecialty Hospital spreads hope, while the TAVR procedure offers the cure

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Medica Superspecialty Hospital

Hyderabad/Kolkata, 11th March 2023: Medica Group of Hospitals, the largest private hospital chain in Eastern India, organized a panel discussion on ‘Transcatheter Valve Replacement’ at Hotel Peerless Inn in Kolkata. The goal was to educate the common people and community about Heart Valve Replacement by simple heart catheters inside the Cath Lab by Interventional Cardiologists instead of Valve replacement by Cardiac Surgeons inside the Surgical Operation Theatre, under prolonged general anesthesia and ventilation. Aortic Valve replacement with the help of a Cardiac Catheter is popularly known as Transcatheter Aortic Valve Replacement or TAVR. Medica has performed more than 20 such procedures over the last three and half years and this number is progressively rising. Prof. Dr. Rabin Chakraborty, Senior Vice-Chairman & Senior Interventional Cardiologist, Medica Superspecialty Hospital, Dr. Dilip Kumar, Director of Cardiac Cath Lab – Senior Consultant Intervention Cardiologist & Electrophysiologist, Medica Superspecialty Hospital, and Dr. Anup Banerjee, Senior Interventional Cardiologist, Medica Superspecialty Hospital were among those who attended the panel discussion.

TAVR procedures are now well established and worldwide more than 120,000 patients have TAVR in 50 countries. In India, as of now, 5000 procedures were done over the last 10 years. In Eastern India, the highest number of TAVR procedures has been performed in Medica Superspecialty Hospital by an experienced and skillful team of Interventional Cardiologists led by the Head of the Department Prof. Dr. Rabin Chakraborty and Director of Cath Lab Dr. Dilip Kumar. It is important to understand that Worldwide Trans-catheter Valve replacement is always done by a specialized team of doctors called “HEART TEAM”. In this team, there are Senior Interventional Cardiologists, Cardiac anesthetists, Non-invasive cardiologists, and Clinical Cardiologists along with technicians and experienced nursing staff.

The hour-long programme took attendees through clinically oriented topics such as advanced TAVR management with the support of effective case studies and the current state of TAVR in India as well as its success rate.

While talking about TAVR, Prof. Dr. Rabin Chakraborty, Senior Vice-Chairman & Senior Interventional Cardiologist, Medica Superspecialty Hospital, said, “When heart valves are operated on, it is typically an open-heart surgery under full anesthesia where the valves are replaced. However, surgeons no longer need to open the heart to access the valves, as transcatheter valve replacement has become the norm in valve replacement procedures. The dosage of anesthesia is milder in these cases, and patients can return home in the span of a few days following surgery. When transcatheter valve replacement is done in the aortic valve, it is referred to as Transcatheter Aortic Valve Replacement” (TAVR). Unlike surgical aortic valve replacement, TAVR is a less time-consuming medical procedure. In India, transcatheter valve replacement was introduced in 2016, gaining popularity rapidly. At Medica, we have successfully performed over 20 transcatheter valve replacement procedures in the past three and half years, which is the highest in Eastern India.” He further added, “The Heart Team in Medica Superspecialty Hospital has now gained the reputation and expertise in performing this complex Heart Valve Replacement Operation through Catheter with a minimum hospital stay. There was no complication in any of those cases in our center.”

Three critical TAVR case studies that Medica recently witnessed were also highlighted by the panel members during the panel discussion.

A 72-year-old woman from Kolkata had rheumatic heart disease and had already undergone open heart surgery and mitral valve replacement surgery earlier in another hospital. However, her prosthetic mitral valve soon got degenerated, causing her to have difficulty breathing and carrying out her daily tasks. During her admission to Medica, the cardiology team of doctors determined that in addition to the Mitral Valve the Aortic valve also was severely, affected. She required double valve replacement. She was not fit to undergo long-term general anesthesia because of her very frail physical condition and associated lung disease; so, the Heart Team decided to perform a Transcatheter Replacement of both Heart Valves. In Rheumatic Valve disease Transcatheter Valve Replacement of 2 Valves was not reported in the Literature. It is a very challenging and complex procedure. But Medica Heart Team successfully performed this operation, a landmark procedure that has been performed by Cardiologists of Medica Hospital in the History of Interventional Cardiology. Given that rheumatic heart disease is a rare condition that is mostly found in South Asian countries, the Medica team was the first in India to use a transcatheter to replace two valves on a patient.

In a second notable case, one patient 68 years gentleman from Kolkata had a severe blockage in the left main coronary artery as well as a severely diseased aortic valve. The patient was physically weak, having trouble breathing, and was experiencing chest pain along with advanced chronic kidney disease. In these circumstances, a surgical valve replacement could have been fatal. The patient underwent high-risk angioplasty of the left main coronary along with the TAVR procedure after a thorough examination by the expert Heart Team of Medica Hospital, Kolkata. The TAVR procedure was completed in 40 minutes with only mild anesthesia. A stent was inserted into the left main artery while the TAVR procedure the aortic valve was replaced by a prosthetic valve in the same sitting. Within the next two-weeks period, a similar case was admitted, and the same procedure was performed by the heart team. These are complex and unique cases first of its kind in India.

Dr. Dilip Kumar, Director of Cardiac Cath Lab – Senior Consultant Intervention Cardiologist & Electrophysiologist, Medica Superspecialty Hospital, stated, “A faster rate of patient recovery, a lower risk of infection, and cost-effectiveness make the TAVR procedure the preferred option. Like an angioplasty, the technology used in the TAVR procedure is accepted in the global medical community. Ideally, it is performed on patients over the age of 60. The team at the department of cardiology at Medica has expertise from many years of performing sensitive surgical procedures such as angioplasty and has successfully incorporated the TAVR procedure into their practice, providing a safe and effective option for elderly patients. The team believes in providing ample information and preparing the patients mentally and physically so they can have the best chance of healing and recovery.”

Echoing the thoughts of Dr. Kumar, Dr. Anup Banerjee former DGAFMS and senior most cardiologist in armed forces, Presently Senior Interventional Cardiologist, Medical Superspecialty Hospital, Kolkata, averred, “TAVR is a one-of-a-kind and complex procedure. However, with an experienced heart team like the one we have at Medica Hospital, such complex cases can be achieved without any complications. Catheter-Based Valve Replacement will soon be the procedure of choice for heart valve disease. Patients with multiple comorbid conditions and those over the age of 65 are currently candidates for Transcatheter Valve Replacement because they are not medically fit to undergo long-term general anesthesia.”

Mr. R Udayan Lahiry, Director, Medicasynergie Pvt. Ltd., said, “Medica has always believed in bringing advanced technology and clinical know-how to the eastern region so that patients can benefit without having to travel to other parts of the country. The double TAVR case in a rheumatic heart is one such first-time case in the world, and we at Medica are proud to bring world-class medical technology to the citizens of West Bengal and Eastern region.”

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