Nagpur: In a first for Central India, an 83-year-old man got valve replacement done without surgery and under local anaesthesia thanks to the Transcatheter Aortic Valve Replacement (TAVR) procedure.Dr Jaspal Arneja and his team performed the exclusive procedure which completes the valve replacement in just 90 minutes as compared to six hours in the traditional format.According to Dr. Arneja, the previous type of surgery is considered to be a ‘major’ operation because of the dynamics involved. “First is obviously the chest being opened through surgery, then heart is stopped and put on an artificial support after which the valve is replaced. This required almost 10 days of hospitalization,” said Dr Arneja. But under the TAVR the patient can be discharged within three days plus the advantage of not having even a single incision anywhere on body.Explaining the process, Dr. Arneja said that just a needle puncture is made in the groin. “The groin is chosen because it provides an opening that’s wide enough for the bio-prosthetic valve to travel all the way without obstruction to the heart. Since the procedure is non-invasive, the patient can be completely active from the next day itself. Even the groin site where the needle puncture is made, is repaired immediately and that too without stitches,” said Dr Arneja.But this simple form of surgery is not for everyone — from both a financial and health point of view. There are only two FDA approved companies that make this special valve and it costs a whopping Rs25 lakh. But the patient at Arneja Heart & Multispeciality Hospital got his for free as that valve is part of a study and indigenously made Indian product by a company called Meril Life Sciences.Dr. Arneja, said, “This indigenous valve has received all approvals and will be available commercially very soon. Its cost will definitely be much lower, probably less than 50% of its imported counterpart.” The valve has life of about 10-15 years.Dr. Arneja added, “About 55 procedures have been done using the indigenously made valve and all of them have been a success. Metallic valves have a long life but need an open heart surgery on the patient.” From a health point of view, TAVR is advised for patients of critical aortic stenosis, which means that the valve between left heart chamber and main artery has become narrow, and in whom surgical risk is high.

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