Consultancy Corner: Open heart substitutes too expensive for patients

The only definitive treatment until recently was open heart surgery to replace the diseased valve. Most of these patients are elderly with multiple other health problems, including bad lung condition, renal failure, stroke and arthritis. More than 30 per cent of these patients were not considered for surgery due to these health issues until the lower risk alternative solution became available in 2002 called transcatheter aortic valve replacement (TAVR). 

In Chennai, the first case was treat at Frontier Lifeline Hospital by a team lead by Senior Cardiologist Dr R Anantharaman and Prof K M Cherian in August 2015. 

On April 22, Hemalatha (75) diagnosed with aortic stenosis from Bombay underwent a successful transcatheter aortic valve replacement (TAVR) under local anaesthesia with mild sedation (without general anaesthesia) and without open surgery at Frontier Lifeline Hospital. 

She was awake throughout the procedure and was mobilized and planned for discharged on April 24. 

Her sister Nirmala had undergone the same procedure two years ago in the same hospital and has been doing well since then. Therefore, she recommended the hospital to her sister. 

This procedure involves replacing the diseased valve by inserting a new valve through a tube that is placed through the blood vessel in the groin (Femoral artery) or under the collar bone (sub-clavian artery) without open surgery. TAVR is a lower risk alternative and in a few cases, it is the only option. Even though there are many patients in India who are in need of this life saving procedure, it remains unaffordable for the mass as the procedure costs around Rs 18 to 25 lakhs. 

Hopefully, the newer valves which will be made in India under the Government of India’s Make in India policy will become available in 2019 and if the government takes necessary steps to cap its price it will become a readily available lifesaving procedure.  

Frontier Lifeline Hospital is also involved in the process of developing a TAVR device at the Mediville Science Park along with NAL who had perfected this device for phase 1 study.