Mumbai: Transgender gets a new heart valve for free in unique surgery

MUMBAI: A 60-year-old transgender patient with an immuno-compromised condition, who was refused surgery by many doctors, got a free new aortic valve in a south Mumbai hospital on Wednesday.

The highlight of the procedure was, however, that it was overseen by the French doctor, Dr Alain Cribier, who revolutionised the way aortic valves are replaced in patients. Instead of an open heart surgery, Dr Cribier developed transcutaneous aortic valve implantation (TAVI) in which the valve is placed through a catheter into a blood vessel in the upper leg.

Senior cardiologist Dr Ashwin Mehta, who had performed the city’s first TAVI 10 years ago, led the procedure on the transgender patient at Jaslok Hospital Wednesday.

“At any given time, there are 2 million Indians needing aortic valve replacement, but barely 2,000 TAVI procedures are done in the country every year,” said Dr Mehta.

The aortic valve controls blood flow between the heart’s lower chamber and the body’s main artery (aorta). Over the years, this valve gets worn out in aging persons, reducing blood flow to the body.

“As a young doctor who returned home in the late ’70s after training in Los Angeles, I realised that over 50% of aged patients who get aortic valve stenosis didn’t get a treatment option,” said Dr Cribier. Surgery was then the only option and it was only offered to people under 70 years of age.

“I felt it was a good thing to develop another treatment option,” said Dr Cribier. He first developed a technique to put a balloon in the diseased valve, but found restenosis (narrowing) occurred in a couple of years. Through a lot of research with Dr Helene Eltchaninoff and an Israeli startup company, he came up with the prototype tested in 100 sheep. “As sheep don’t suffer from valve-related disease, we had no way of knowing if the valves worked,” he said.

He was able to place the first aortic valve in 1992 for a patient who was so critical then that he was given only 24 hours to live. The patient recovered within 48 hours and lived for four months before dying of another condition.

open heart surgery

TAVI has since become the chosen option in many countries mainly as patients needing it are elderly and too frail to undergo open heart surgery. In India, however, cost of the valve has been an issue.

“However, we now have made-in-India valves that are affordable compared to imported ones. Also, if more people opt for TAVI, driving up a demand, its cost should come down,” said Dr Mehta.

His team in Jaslok has so far done over 90 TAVI cases. “The beauty of the procedure is that it needs no stitches at all. The valve is merely placed in position and it stays there,” said Dr Mehta.

Courtesy : TOI

Note: This news piece was originally published in timesofindia.com and used purely for non-profit/non-commercial purposes exclusively for Human Rights .