A 72-year-old woman battling breathlessness, chest pain, and severe fatigue — 14 years after major heart surgery — regained her health through a rare and high-risk intervention at Apollo Hospitals.
A Complex Medical History
Fourteen years ago, she survived an acute aortic dissection after undergoing a complex surgery that replaced her damaged aortic valve and root with a tissue valve. Over time, however, this valve narrowed critically, demanding urgent replacement.
Conventional Route Not Possible
Normally, doctors manage such cases with a minimally invasive Transcatheter Aortic Valve Implantation (TAVI) via the femoral artery in the leg. Yet her condition was anything but routine. A chronic Type B aortic dissection had left her aorta split into two channels — a “true” and a much larger “false” lumen. This anatomical challenge made navigating catheters to the heart extremely risky.
Moreover, open-heart surgery was ruled out due to her age, frailty, and the dangers posed by the residual dissection.
Innovative Valve-in-Valve TAVI Performed
Faced with these challenges, Apollo’s multidisciplinary Heart Valve and Aortic Program team — led by Dr. Gautam Naik and Dr. Niranjan Hiremath — devised an innovative plan. They opted for a rare, complex trans-femoral Valve-in-Valve TAVI procedure, a method reported only in a handful of cases worldwide.
Using advanced imaging and meticulous planning, the team carried out the 3.5-hour procedure entirely through the femoral artery. They successfully implanted a 23 mm Navitor Vision (Abbott) transcatheter heart valve, which restored healthy blood flow.
Smooth Recovery and Conservative Management
As reported by TOI, the patient recovered well and was discharged in stable condition on the fifth day. Doctors detected a small new false lumen after the procedure but managed it conservatively with strict blood pressure control.
Expert’s Perspective
“In complex heart disease, success often depends on finding safe, innovative solutions tailored to the patient,” said Dr. Naik, highlighting the importance of teamwork and precision in high-risk cardiac care.