TAVI procedure executed with ongoing CPR for the first time ever: Paves way for new life saving protocols

TAVI illustration Picture

The 91-year-old patient being the second oldest patient in Mumbai to undergo the TAVI procedure

Apollo Hospitals Navi Mumbai (AHNM)

NAVI MUMBAI, 18 APRIL, 2024 (TGN):  Two highly complex TAVI cases successfully treated at Apollo Hospitals Navi Mumbai (AHNM) in senior patients. Amidst the complexities of medical care, a 91-year-old man embarked on a planned surgical procedure, while a 70-year-old woman faced the dire urgency of cardiac arrest and multiple organ failure. Through the resolute dedication of healthcare teams, both patients were granted a remarkable second chance at life, embodying the triumph of hope over adversity. Through complex Trans Catheter Aortic Valve Implantation (TAVI), damaged heart valves were replaced in both patients, who had severe aortic stenosis, a narrowing of the heart valve that limits blood flow from the heart to the body.  Setting new standards for cardiac care, this was the first TAVI surgery carried out in a patient while CPR was still being administered.

Dr. Rahul Gupta – Senior Consultant Cardiology at Apollo Hospitals, Navi Mumbai said, “In a first of its kind case in Navi Mumbai a 70-year-old female from Dombivli was brought to the ER with severe breathlessness at rest, low blood pressure, decreased oxygen saturation, multi organ failure, she had suffered a cardiac arrest, requiring CPR and defibrillation for revival. Tests showed her to have severe aortic stenosis. Given the critical condition of the patient and the impracticality of conventional open-heart surgery, an emergency Transcatheter Aortic Valve Implantation (TAVI) procedure was conducted to save her life. Throughout the procedure, the patient was intubated and ventilated, with CPR administered continuously due to a cardiac arrest occurrence.  Due to the risk of coronary artery obstruction a serious complication in this case we used specialised technique known as Chimney Stenting (helps to maintain blood flow in the arteries) during the TAVI procedure.”

Dr. Mahesh Ghogare – Consultant Cardiology, Apollo Hospitals, Navi Mumbai said, “91-year-old Mr. Govind Gadekar, a resident of Vashi, was brought to the emergency room (ER) of Apollo Hospitals as he had lost consciousness after a sudden onset of giddiness. He had 2 similar episodes of fall due to giddiness in the last 15 days. Investigations revealed, he had severe aortic stenosis. Considering his age, conventional cardiac surgery was not possible and he was advised TAVI to address the severity of symptoms. Many patients above the age of 70 years have aortic stenosis, but it is often underdiagnosed. In senior patients, recurrent breathlessness, giddiness, chest discomfort, chest pain, and swelling of feet are attributed to old age. People should be aware that if these symptoms persist, the patient should undergo regular and thorough cardiac check-ups. 2D echo assessment is vital in such cases, as not only blockages in the heart vessels, but also blockages in the heart valves are important at this stage. In the successful case of the TAVI procedure on a nonagenarian patient, who is subsequently the oldest patient to go through this procedure in Mumbai, despite age being risk factor the patient has responded and recovered very well.  We are hopeful that with the assistance of the current generation of valves the patient will live to see 100 years, as he seems in a healthy condition. CVDs are a growing concern in urban India. Almost everyone above the age of 40 years should do proactive checks regularly to understand their heart health.”

Mr. Gadekar mentioned, “This journey has been nothing short of a miracle. From the depths of cardiac arrest to the light of renewed hope, I am forever grateful to the incredible team at Apollo Hospitals for their skill and compassion. With each beat of heart, I’m reminded of the preciousness of life and the power of perseverance.”Ends/ TGN

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