TMVR in Ring: New Catheter-Based Mitral Valve Treatment in Jaipur, Without Open-Heart Surgery

Mitral valve treatment in India has taken a new step forward. Cardiologists at the Eternal Heart Care Centre (EHCC) and Research, Jaipur have carried out a procedure called Transcatheter Mitral Valve Replacement (TMVR) in Ring, which offers a minimally invasive option for patients who have already had a mitral valve ring placed. The work was reported by The Statesman, and the team describes it as a first of its kind in India.

What is the mitral valve and why does it need treatment?

The mitral valve controls blood flow between the upper and lower chambers on the left side of the heart. When it becomes narrowed or starts leaking, patients may develop breathlessness, tiredness, palpitations and swelling in the feet. Traditionally, a seriously damaged mitral valve has been treated with open-heart surgery, either to repair or to replace the valve.

What is TMVR in Ring?

In some patients, especially younger ones, the mitral valve is first repaired with open-heart surgery and a supporting ring is implanted. Many years later, for example after 20 to 30 years, the same valve can develop problems again. A second open-heart operation in such patients can be difficult and carries higher risk.

With TMVR in Ring, a new valve is placed inside the ring that was implanted earlier. The ring acts as a stable base, which makes the catheter-based procedure easier and safer than another open surgery, according to Dr. Prashant Dwivedi.

How is the procedure done?

1. A thin flexible tube (catheter) carrying the new valve is inserted through a blood vessel in the leg.
2. The catheter is guided to the mitral valve inside the heart.
3. The new valve is opened inside the previously placed ring and starts working.
4. The catheter is removed and the puncture site is closed.

Because the chest is not opened, there are no large chest incisions and no need for a heart-lung (cardiopulmonary bypass) machine.

Benefits of TMVR compared with open-heart surgery

• Less pain and less trauma to the body
• Lower procedural risk in selected patients
• Quicker recovery and a shorter hospital stay
• A treatment option for patients who cannot undergo conventional surgery again

Who may be suitable?

TMVR in Ring may be considered for patients who have had a mitral valve repair with a ring earlier and now have a narrowed or leaking valve, particularly when repeat open-heart surgery is risky. Suitability is decided after detailed tests such as echocardiography and CT scan, and after discussion by the heart team.

About the team

Dr. Prashant Dwivedi is the in-charge of the TAVR and Structural Heart Disease Programme at the Eternal Heart Care Centre and Research, Jaipur. He learned this technique along with the group leader, Dr. Samin K. Sharma. The procedure was performed on two patients, one at EHCC, Jaipur and another at a private hospital in Udaipur, Rajasthan.

What is the cost of TMVR in India?

The cost depends on the patient's condition and the type of valve used. At the time of the news report, the cost was said to range from about Rs 14 to 15 lakh. Please contact the hospital for current and personalised information.

Looking for TMVR or mitral valve treatment in Jaipur?

Catheter-based valve treatment is changing how patients across Rajasthan and India are treated. To know more about the technique, read our detailed guide on Transcatheter Mitral Valve Replacement (TMVR). If you or a family member has a mitral valve problem, book a consultation with Dr. Prashant Dwivedi, a structural heart specialist in Jaipur, to find out which treatment option suits you.

In the words of Dr. Dwivedi, each advance in cardiology brings us closer to a better quality of life for patients with heart conditions, and India's entry into TMVR is significant on the international stage.

This article is for general awareness and does not replace personal medical advice. Please consult a cardiologist to know whether this treatment is right for you.