Heart Valve Replaced Without Surgery Through Arm Artery - First Ever Percutaneous Trans-Axillary TAVI in India

VMPL
Jaipur (Rajasthan) [India], July 14: For the first time in India, doctors at Rajasthan Hospital, Jaipur have successfully replaced a heart valve through the artery in the arm without surgery, using a breakthrough technique called Percutaneous Trans-Axillary TAVI. The patient, a 78-year-old man (name changed to Hemendra), had severely blocked arteries in both legs due to calcium buildup, which made the conventional transcatheter valve implantation through the femoral artery impossible.
Dr. Ravindra Singh Rao, Vice Chairman of Rajasthan Hospital, and his team performed this innovative and life-saving procedure, claiming it as the first such case in India. Normally, TAVI (Transcatheter Aortic Valve Implantation) is done by passing an artificial valve through the femoral artery in the thigh. However, in Hemendra's case, this route was blocked, and his heart was functioning at only 25% capacity. He also had difficulty breathing, worsening kidney function, and had previously undergone two stent procedures.
The Arm Artery: An Alternative Route
Refusing to give up, Dr. Rao's team opted for a rare and complex approach. Using ultrasound guidance, they precisely punctured the subclavian artery near the collarbone in the left arm. A small tube (sheath) was inserted, followed by placement of a percutaneous suture system to secure the access point. A larger delivery system was then advanced through the artery, allowing the team to successfully implant the new artificial heart valve.
After valve deployment, the artery was sealed using a ProGlide closure device. Until now, the subclavian artery route for TAVI in India was used only through open surgery. This case marks the first ever percutaneous (completely non-surgical) trans-axillary TAVI in the country.
A New Life for the Patient
The patient's symptoms improved almost immediately after the procedure. His breathing eased, kidney function normalized, and heart efficiency improved significantly. He was discharged from the hospital just five days later, fully stable.
A Landmark in Indian Medical History
Dr. Ravindra Singh Rao stated, "In India, around 3-5% of patients suffering from aortic stenosis may have blocked femoral arteries, making the standard TAVI approach unfeasible. For such patients, this alternative arm artery route can be life-saving."
This achievement is not only a milestone for Rajasthan but also a remarkable step forward for Indian cardiology. The success of the percutaneous trans-axillary TAVI has demonstrated that with innovation and courage, even the most complex medical challenges can be overcome.
Key Highlights:
- First-ever heart valve replacement through the arm artery without surgery in India
- Conventional femoral route was blocked due to severe calcification
- Patient's heart functioning only at 25%; kidneys also deteriorating
- Innovative approach led to full recovery; patient discharged in 5 days
- Sets a new path of hope for patients with similar vascular limitations
This groundbreaking success showcases the world-class capabilities of Indian interventional cardiology and opens new horizons in minimally invasive heart procedures.
Dr Kailash Chandra, Dr Govind Narayan Sharma and Dr Prashant Varshney's support were helpful during procedure.
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