Mumbai : Symptoms such as fatigue, breathlessness, and reduced stamina are often associated with ageing. However, clinicians note that in some cases, these may be early indicators of underlying heart valve disease.
In a recent case, an elderly patient (Mr.Jai Lalwani) experienced a gradual decline in physical activity, including difficulty in walking short distances and increasing breathlessness. These symptoms were initially attributed to ageing, resulting in a delay in further evaluation.
Subsequent medical assessment identified deterioration and leakage in an aortic valve that had been implanted nearly eight years earlier through a Transcatheter Aortic Valve Implantation (TAVI) procedure. The patient also had a prior history of coronary artery bypass graft (CABG) surgery, which made conventional open-heart intervention a higher-risk option. A repeat procedure, referred to as redo TAVI or TAVI-in-TAVI, was considered. This approach involves placing a new valve within the previously implanted one using a catheter-based technique.
“This was a relatively rare scenario. The patient had undergone TAVI eight years ago, and over time, the valve began to leak, resulting in symptoms like breathlessness and fatigue,” said Dr. Ravinder Singh Rao, Interventional Structural Cardiologist at Breach Candy and Lilavati Hospital, Mumbai. “A detailed CT scan was done before proceeding. Redo TAVI can be technically challenging, but in this case, it was carried out safely and effectively.”
The procedure was performed via a minimally invasive route, avoiding open-heart surgery. The patient reported improvement shortly after the intervention and was able to resume routine activities within a short period.
Clinicians note that heart valve disease can progress gradually and may remain under-recognised, particularly when symptoms are mild or attributed to ageing.
“Many patients attribute fatigue, weakness, or breathlessness to ageing and tend to overlook these signs,” Dr. Rao explained.
Early clinical evaluation, including basic imaging such as echocardiography, can help identify valve-related conditions and guide timely management. The case reflects evolving approaches in cardiac care, where minimally invasive techniques are being used in select complex scenarios. It also underscores the importance of recognising changes in physical capacity and seeking medical evaluation when symptoms persist or worsen.