Mumbai: When 81-year-old Wada resident Narayan Patil reached civic-run KEM Hospital in Parel after six months of worsening breathlessness, doctors found he needed treatment for both blocked coronary arteries and a leaking heart valve. But his age and frailty made conventional open-heart surgery a high-risk option.Patil had severe mitral regurgitation, in which the mitral valve fails to close properly and allows blood to leak backward from the left ventricle into the left atrium. He also had significant blockages in all three major coronary arteries.Doctors in Palghar had initially advised bypass surgery and mitral-valve repair or replacement. At KEM, however, the cardiology team opted for a less invasive approach, performing two procedures seven days apart.The first involved angioplasty to treat two of his coronary blockages. Seven days later, on Sept 23, the team performed mitral transcatheter edge-to-edge repair (M-TEER). In the procedure, a small clip is guided through a vein in the leg to the heart, where it brings the mitral-valve leaflets together and reduces the leak without opening the chest.Patil’s son, Sandesh, who works with a private firm in Palghar, said the family approached KEM instead of a private hospital because of the high cost of treatment. “The quote for M-TEER at a private Mumbai hospital was almost twice what we paid at KEM,” he said, adding that he has applied to his insurance company for the Rs 15-lakh reimbursement. The angioplasty, he added, was carried out free under govt schemes.His father was discharged within a couple of days after each procedure and his breathlessness has reduced substantially. “We are happy we took him to a public hospital,” Sandesh said.Patil’s case reflects the growing use of minimally invasive heart-valve procedures for elderly and high-risk patients in Mumbai. KEM has steadily expanded its structural-heart programme in recent years, with expertise in procedures such as transcatheter aortic valve replacement (TAVR), which replaces a diseased aortic valve through a catheter rather than open-heart surgery.“Over the past three years, we have performed over 60 TAVR procedures, putting us among the busiest programmes of its kind in the state,” said KEM cardiology department head Dr Ajay Mahajan. The hospital has also performed 10 M-TEER procedures over the past four years, he said.“With govt schemes now funding TAVR, more people can benefit,” said Dr Mahajan, who is the proctor for the heart valve programme at state-run JJ Hospital, Byculla.The growing use of minimally invasive valve procedures is not limited to KEM. “Over the past few years, Mumbai has witnessed a steady increase in the adoption of minimally invasive cardiac therapies, particularly TAVR,” said Dr Haresh Mehta, director of interventional cardiology at SL Raheja Hospital, Mahim. Advances in imaging, technology and procedural planning have enabled doctors to treat higher-risk patients while reducing recovery time, he added.
