Rohit Shishodia

Doctors at a Delhi hospital have given a new lease of life to a 74-year-old patient with Dextrocardia (heart on the right side), who was suffering from aortic stenosis, where the aortic valve of the heart narrows down, by carrying out a Transcatheter Aortic Valve Replacement (TAVR) procedure on him.

TAVR is a minimally invasive heart procedure to replace the aortic valve that cannot fully open fully due to thickening (aortic valve stenosis). The aortic valve is located between the left lower heart chamber (left ventricle) and the body's main artery (aorta). If the valve does not open correctly, blood flow from the heart to the body is reduced.

74- year old Inderpal Singh had been suffering from breathlessness on exertion for the past one and half years and chest pain for the last few weeks. He also has comorbidities including diabetes, hypertension, high body mass index, and obstructive sleep apnoea.

A team of cardiologists at Fortis Escorts Heart Institute led by Dr Atul Mathur, Executive Director of  Interventional Cardiology successfully carried out the complex procedure, wherein the abnormal heart valve was replaced using a cardiac catheter, thus avoiding a risky open surgery.

The procedure was all the more difficult in the present case, as the patient’s heart is on the right side of the body, thus making the approach challenging for the treating surgeons.

This is the first reported case of a successful TAVR procedure on a patient with a right-sided heart in India and only the fourth worldwide.

In spite of the patient’s anomalous heart condition and comorbidities posing a challenge, the doctors performed the TAVR procedure successfully, giving him a new life on his 74th birthday on May 26, 2022.

After a short hospital stay of three days after the procedure, the patient was discharged in stable condition.

Speaking to Drug Today Medical Times, Dr Atul Mathur said, “This is the fourth case in the world and first in India where TAVR was performed on a patient with Dextrocardia; the previous three procedures performed to date were in the United States.”

Explaining the case, Dr Mathur said, “This was a very rare case, where the heart was not anatomically located in its normal position since birth. The patient was having morbid obesity, and obstructive sleep apnoea component (most common sleep-related breathing disorder and is characterised by recurrent episodes of complete or partial obstruction of the upper airway leading to reduced or absent of breathing during sleep).”

 “All of these made the TAVR procedure a challenging task to perform.  The procedure lasted for five hours.There is a very high risk of such patients dying if the condition remains untreated and in this particular case if the patient was not diagnosed and treated on time, his condition could have deteriorated and he could have suffered a fatal heart attack,” he added.