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05 Sept 2012
New procedure called Transcatheter Aortic Valve Implantation to help seriously ill heart patients

Dattaji Nalawde, the critically ill former Maharashtra assembly speaker and ex–mayor, has received a new lease of life after a team of doctors from Jaslok hospital India performed the minimally invasive Transcatheter Aortic Valve Implantation (TAVI). TAVI, which was done for the first time in Maharashtra, is a non–surgical procedure that replaces (or repairs) the aortic valve that connects the heart to the aorta.

Experts say this procedure will benefit patients like Nalawde, who are seriously ill with critically narrowed aortic valve and are at high risk to undergo open heart surgery.

Dr AB Mehta, director of cardiology at Jaslok hospital, Mumbai, who headed the team that operated on Nalawde said, "Nalawde was first brought to the hospital in February. He needed immediate replacement of the valve which was not available. He was also unfit for surgery." Doctors say Nalawde had known lung problem, he also had renal failure and was on dialysis. "TAVI was the best option we could provide the family in his condition," added Dr Mehta.

The procedure which took an hour, involved implanting the bioprosthetic valve in the disease aortic valve through a catheter. "Unlike open heart surgery, this entire procedure was done under local anaesthesia," said Dr Desai.

Thought the government of India allows the TAVI procedure to be conducted, it hasn’t been given commercial approval. The doctor or the patients’ families had to get permission from the Drug Controller General of India (DGCI) for TAVI treatment.

"In Nalawde’s case it took two months for us to procure the valve after we wrote to DGCI. It was done on compassionate basis," said Dr Desai.

Though Jaslok hospital and Lilavati hospital had permission for TAVI for nearly two years, the exorbitant cost and right candidature for the procedure delayed the doctors to conduct the procedure.

The doctors are also hoping that they will get support of NGOs, corporate sectors and insurance company so that the treatment is made available to underprivileged people too.

"The valve itself costs Rs12.5 lakh. We are tremendously encouraged and are in the process of setting up a heart valve centre," said one of the doctors. Presently the procedure is not covered under medical insurance as it is still not established in India.

The other doctors involved in the procedure were Dr AB Mehta, Dr Ajit Desai and Dr SR Handa.

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