Bhubaneswar: Manipal Hospital Bhubaneswar has successfully performed a highly complex Transcatheter Aortic Valve Implantation (TAVI) on an elderly woman suffering from severe aortic stenosis, marking a significant advancement in cardiac care in the region. T
The procedure, conducted at the hospital’s cardiac unit, was led by Dr Dibya Ranjan Behera, Consultant Interventional Cardiologist, along with a multidisciplinary team. The patient was admitted with recurrent fainting episodes and chest pain and was diagnosed with critically narrowed aortic valve function requiring immediate intervention. Owing to her age and comorbidities, traditional open-heart surgery posed considerable risks, making TAVI the preferred minimally invasive option.
The case was particularly challenging because the patient’s aorta and femoral arteries were severely calcified, creating a porcelain aorta and preventing standard transfemoral access for TAVI. Alternative access routes were evaluated but found unsuitable. To address this, the cardiology team performed intravascular lithotripsy (IVL), a specialized technique used to modify calcium deposits and widen the calcified femoral artery, allowing safe passage of the catheter system. Once the artery was adequately prepared, a balloon-expandable valve was successfully implanted, restoring proper valve function.
The patient has shown remarkable post-procedure recovery and is now symptom-free, able to return to her daily routine with renewed comfort and stability. Reflecting on the complexity and success of the procedure, Dr Dibya Ranjan Behera, Consultant Interventional Cardiologist, said, “TAVI has revolutionised cardiac care for elderly and high-risk patients. Performing a peripheral IVL-assisted TAVI in such a challenging case required precision, planning, and seamless teamwork. This success reinforces our capability to manage even the most difficult cardiac conditions with advanced techniques.”
