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Rare procedure on Sri Lankan girl

2014 Mar 08

Kaveesha Samarakoon had gone through two major surgeries but, her heart continued to malfunction.

When the Sri Lankan teenager arrived at Madras Medical Mission a few weeks ago, there was blood leaking from her lungs back into her heart, as there was no pulmonary valve to stop it, The Hindu newspaper reported today.

Instead of wielding the scalpel once again, a team of doctors here decided on another procedure — implanting a transcatheter valve mounted on a small stent from the groin, via a puncture in her femoral vein.

“This is the first time such a procedure has been performed in India,” said K. Sivakumar, head of paediatric cardiology at the hospital.

Dr. Sivakumar said doctors in Lanka had placed a cow’s valve in her heart. However, within two years this had shrunk from 22 mm to 3.5 mm, severely obstructing blood flow. A second procedure had relieved the obstruction but not stopped the leakage.

“The normal procedure would be to open the heart, remove the damaged portion and put in the new valve. But what we did was, get a valve, mount it on to a small stent, pass it through the groin and deploy it on to her pulmonary artery. The valve successfully stopped the leakage, and within 18 hours, Kaveesha was with her parents again. All of this was done without an incision,” he said.

The benefits of this procedure, he explained, were faster recovery, a shorter hospital stay and fewer complications, compared to a surgery that would involve using the heart-lung machine.

While the procedure costs around Rs. 23 lakh, (involving mainly costs of the valve), doctors said that costs had been brought down for this patient. The family will have to pay around Rs. 3.5 lakh.

Other members of the team were Roy Varghese, senior paediatric cardiac surgeon, and Benjamin Ninan, cardiac anaesthesiologist.

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