In a landmark medical breakthrough, a 15-year-old boy from Mumbai became the city’s first patient to undergo the Harmony Transcatheter Pulmonary Valve (TPV) implantation—a cutting-edge, minimally invasive procedure that replaces the heart valve without open-heart surgery. Doctors at HN Reliance Foundation Hospital performed the successful procedure using a catheter inserted through the groin to deliver an expandable valve into the heart.
A Lifesaving Alternative to Open-Heart Surgery
As reported by Hindustan Times, the teenager was born with a congenital heart defect and had undergone corrective surgery as a newborn to address an obstruction in the right ventricular outflow tract (RVOT)—the passage through which blood flows from the right ventricle to the pulmonary arteries. During that surgery, doctors left the pulmonary valve non-functional, which led to chronic pulmonary regurgitation over time. As a result, his right ventricle gradually enlarged, reducing its efficiency and causing fatigue and decreased exercise tolerance—clear signs of worsening heart function.
Traditional Risks vs. New Possibilities
Typically, patients in such cases would require open-heart surgery involving sternotomy (cutting through the breastbone), a heart-lung bypass machine, and an extended hospital stay. However, considering the risks and long recovery period of open-heart surgery—especially for adolescents—the cardiac team selected the Harmony Valve, an FDA-approved, self-expanding device designed for patients with previously operated, dilated RVOTs.
“The Harmony Valve adapts to irregular anatomies where conventional valves won’t fit,” explained Dr Bharat Dalvi, consultant in paediatric cardiac sciences, who led the procedure. “It restores forward blood flow without the trauma of open surgery.”
Navigating a Challenging Anatomy
After 15 years, the boy’s RVOT had become significantly dilated and misshapen, making the procedure technically demanding. Fortunately, the Harmony Valve’s flexible nitinol frame and porcine tissue structure allowed it to conform and seal securely within the distorted region.
“This technology was built specifically for complex, post-surgical anatomies,” said Dr Dalvi. “It enabled us to bypass a second major operation and still deliver excellent results.”
A Smooth, Swift Procedure and Recovery
The boy was admitted on April 26, and just two days later, underwent the valve implantation under general anaesthesia. Doctors inserted a catheter through the femoral vein in the groin and advanced the crimped valve to the heart under fluoroscopic guidance. Once in position, doctors released the valve. It expanded on its own and immediately restored normal blood flow by stopping the backward leak.
The procedure lasted approximately two and a half hours and was completed without complications. Remarkably, the boy was discharged on April 30—within 48 hours—and cleared to resume school, sports, and daily activities within a week.
“Without this option, he would have faced another major surgery,” said Dr Dalvi. “Instead, he walked out of the hospital in just two days.”
Bringing Global Innovation to India
While the Harmony Valve is widely used across Europe and the United States, it only recently received approval in India. This Mumbai case is among the country’s first, alongside early uses reported in Kerala and Faridabad (NCR Delhi). It also marks the technology’s debut in Maharashtra’s capital.
Experts Highlight Future Impact
Dr Maulik Parekh is the Head of the TAVR and Structural Heart Programme. Dr Shivaprakash Krishna Naik serves as the Director of Paediatric Cardiac Sciences at HN Reliance Foundation Hospital. Both emphasized the broader impact of such innovations.
“These less invasive, high-impact alternatives are vital for children and young adults living with congenital heart disease,” they noted. “As awareness grows and access improves, more Indian patients will benefit from safer, faster solutions like the Harmony Valve.”