Upbeat!

A CUTTING-EDGE TECHNIQUE TO REPLACE VALVES IN ELDERLY PATIENTS AND ANOTHER TO DETERMINE RATIONAL USE OF STENTS ARE CHANGING THE FACE OF CARDIAC CARE

- Namita Kohli

The end seemed near. There were just too many issues plaguing N. Ramanathan—a chronic obstructive pulmonary disease, a debilitating cough and a valve disease.

Four years ago, Ramanathan, 69, suffered a bad bout of pneumonia. During the treatment, doctors found that his aortic valve (one of the three valves in the heart) was calcified, and had been obstructing the blood flow from his left ventricle to the aorta. This thickening, inflexibility and narrowing of the aortic valve is called aortic stenosis, caused due to ageing. It could also be the result of a congenital defect called bicuspid valve, where the valve has two leaflets instead of the normal three.

The aortic stenosis was making Ramanathan's heart pump harder to push the blood through the narrow opening of the valve. The strain on the heart made him breathless and tired, making it difficult for him to walk or do his daily chores.

By December 2016, things had worsened, recalls Ramanathan. The valve disease had also caused a fluid buildup in his lungs. “I had incessant cough, and could barely sleep at night. For days on end, I would lie in an inclined position to avoid the cough. I also had chest pain, and had to be put on oxygen,” says the Chennai resident. “It just felt like I was waiting for my last day.”

Open heart surgery was not an option for Ramanathan, owing to his age and weak condition. Fortunately for people like him, who are sick, infirm, old and unfit for an open heart surgery, a new procedure called Transcatheter Aortic Valve Replacement (TAVR) has shown great results. Most cardiologists that THE WEEK spoke to define TAVR as “revolutionary” and say the procedure has changed the face of cardiac care globally.