Paravalvular leak closure by device done at SSH

By Vikas Vaidya

Department of cardiology in Government Medical College and Hospital (GMCH-SSH), has added another feather in its cap by successfully implanting a percutaneous device for closure of a paravalvular leak in a patient who had a  mitral valve replacement surgery 10 years ago.
This 38 year old female patient came with a history of haemolytic anaemia and heart failure due to development of a hole beside her replaced valve and was in sick condition. The development of hole is generally due to dehiscence of suture line, or by infection, said Dr P P Deshmukh, working as Associate professor in the department. Generally such holes need another surgery which has a mortality of nearly 50%, and more so, in sick patients. Surgeons are reluctant to take such patients as it may entail same problem after redo surgery and it is technically extremely challenging, explains Dr P P Deshmukh.
This case was successfully done by percutaneous route in local anaesthesia via a device which was meant to close another heart hole called patent ductus arteriosus, in resource constrained setting, by a team work headed by Dr P P Deshmukh, and assisted by Dr Sandeep Chourasiya, Dr Ahlesh Tiwari, Dr Mahendra Maske, Dr Bhavesh Talavia. Dr Mukund Deshpande who is Head of the Department, and Dr Sunil Washimkar, Associate Professor gave invaluable inputs during the procedure.
The procedure needs immense amount of precision and accuracy as the device is placed just adjacent to prosthetic valve whose function should not be affected by this device. This needs fluoroscopic as well as echocardiographic imaging simultaneously and warrants multiple catheter exchanges with very sound judgement.
Only handful of centres across India are performing such technically challenging procedures. This has been widely appreciated by Cardiology fraternity of Nagpur

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