Hyderabad: Cardiologist at The Apollo Medical College, Hyderabad, performed an extremely challenging and critical minimally invasive procedure to successfully treat a sixteen year old boy with a past history of open heart surgery and presented with difficulty in breathing and chest pain. Dr Manoj Agarwal, Sr. Cardiologist, Apollo Health City, Hyderabad and Dr Amol Gupta, Paediatric cardiologist, Apollo Medical Hospital, Hyderabad; briefed media about the procedure at a press conference today at The Apollo Medical College, Hyderabad. The boy and his parents were present on the occasion.
The boy Sai Nandan, presented at the Apollo Medical College with extreme breathing difficulty and chest pain on January 2, 2024. He had undergone open heart surgery for congenital heart disease at the time of his birth, 15 years ago. That surgery was performed to correct Tetralogy of Fallot (TOF), a congenital heart disease with large hole between the two lower chambers of heart and obstruction of outflow tract to lung in 2007. Evaluation with Echo and Cardiac MRI revealed poor function of Right Ventricle (RV) with severe leakage from pulmonary valve into RV, causing dilatation in the right side of the heart. This is usual after repair of TOF as the outflow tract is opened with an artificial patch which leads to the leakage of blood into RV which gradually over time leads to Poor function and dilatation of right side of the heart, such patient at 16-17 years of age become more symptomatic and require open heart surgery again to replace the pulmonary valve (which is present between RV and lung artery).
The Cardiologists at Apollo Medical College treated him with minimal invasive procedure. Though the problem seemed complex to be treated with minimally invasive procedure, the cardiologists preferred not to opt for the Open Heart Surgery. As the redo surgery is always difficult and has lots of complications and long duration of stay of 7-10 days in ICU for recovery. A transcatheter pulmonary valve implantation using 35mm Myval, an artificial bioprosthetic valve, was placed precisely in the right ventricle in cathlab, with utmost dexterity using fluoroscopy and angiography guidance. The patient has since recovered after the procedure showed no leakage with excellent results and improvement in heart Function. He is ready for discharge after 2 days hospital stay.
The ideal option for a patient in such critical condition was an open heart surgery, however we wanted to avoid surgery considering his previous history of an Open Heart Surgery, young age, complications associated with a surgery, the prolonged hospital stay and recovery time. The patient can now lead a normal life like any other boy of his age, says Dr Amol Gupta.
The patient Sai Nanadan said, I hail from Mahaboobnagar district, the Doctors at Apollo Medical College, gave me two options one was open heart surgery and newly introduced minimally invasive TAVR procedure, open heart surgery involves risks, therefore preferred the TAVR procedure. Pakora photos the interview.
Patient Sai Nandan’s father said, he is the only son of ours, he used to suffer with panting while climbing stairs, pain in the left arm and had other problems, therefore got him treated here.
Ms Aparna Reddy, COO, Apollo Institute of Medical Sciences & Research, Hyderabad; said, the Apollo Medical college has competence, expertise and experienced cardiologists to perform such complex and high risk procedures. As this family couldn’t afford the cost of the procedure, we did it at a concessional price. We are doing paediatric cardiac surgeries free of cost at the Apollo Medical College. We did over 200 surgeries for children born with birth defects in an year. We also conduct camps, patients can attend such camps and seek help.