New
Delhi, 5th May, 2026 : A 58-year-old Kenyan woman with advanced
right-sided heart failure has been successfully treated at Indraprastha Apollo
Hospital, New Delhi, in what doctors describe as a rare and pathbreaking
cardiac procedure, marking one of the early such interventions in India.
The patient had
previously undergone surgical tricuspid valve replacement in 2011 using a bioprosthetic
valve (Perimount 29 mm) in the context of a right atrial mass. Over time, the
valve degenerated, as is typical with bioprosthetic valves, occurring in her
case after nearly 15 years. When she presented again, she was found to have
torrential tricuspid regurgitation along with significant valve gradients
(peak/mean: 16/10 mmHg) and severe right ventricular dysfunction, placing her
in a very high-risk category.
Given the complexity of
her condition, she had been declined for further intervention at multiple
leading centres across the country.
At Indraprastha Apollo
Hospital, New Delhi, the Heart Valve team, led by interventional cardiologist
Dr Gautam Naik as the primary operator, undertook a transcatheter
valve-in-valve procedure, an advanced, minimally invasive technique. Surgical
expertise and post-procedural intensive care support were provided by Dr Mukesh
Goel and Dr Deepa Sarkar respectively, in conjunction with the hospital’s
cardiac intensive care team.
A Sapien Ultra Resilia
29 mm transcatheter heart valve was successfully implanted within the failing
surgical valve. Intra-procedural transesophageal echocardiography confirmed
complete elimination of the regurgitation, with an excellent immediate
post-procedural gradient of just 2 mmHg.
The post-operative
period, however, posed significant challenges. The patient continued to have
right ventricular dysfunction, accompanied by low blood pressure and reduced
urine output in the initial days. She required intensive care support,
including inotropes and careful fluid management.
Over the following
days, her condition steadily improved. Right ventricular function began to
recover, urine output normalized, and her blood pressure stabilised, allowing
gradual withdrawal of inotropic support.
She was discharged
within six days in stable condition. At one-week follow-up, she reported
dramatic symptomatic improvement and has since returned to her home country.
Doctors at Apollo
described the case as a “grand success,” highlighting not just the technical
achievement but the meaningful clinical recovery in a patient who had exhausted
conventional options.
“This case underscores
the evolving role of transcatheter therapies in managing complex valvular heart
disease, especially in patients considered inoperable,”
said Dr Naik. “What makes this especially rewarding is
the patient’s recovery despite significant pre-existing right ventricular
dysfunction.”
The case adds to the
growing body of evidence supporting minimally invasive valve-in-valve therapies
and reinforces the capability of Indian centres in performing cutting-edge
structural heart interventions.
