Complex aortic valve replacement successfully completed at Jaslok Hospital

Jaslok Hospital & Research Centre announced the successful completion of a complex aortic valve replacement surgery on Kapil Gala, a 39-year-old patient with achondroplasia. Facing a sudden onset of paraplegia, Gala was admitted under the care of a multidisciplinary team of specialists. They diagnosed him with severe aortic stenosis, necessitating urgent intervention. The surgery, led by Dr Upendra Bhalerao, involved careful planning and execution, ensuring the patient’s safety and long-term health.

The patient, employed in the financial industry and independently managing his family, faced a sudden onset of paraplegia a year ago, threatening his mobility and independence. Upon admission to Jaslok Hospital, he was under the care of Dr Raghvendra Ramdasi, Dr Manish Kothari, and Dr Nihar Mehta. During the preoperative workup for spinal surgery, Kapil was diagnosed with severe aortic stenosis due to a congenital bicuspid aortic valve defect, requiring urgent intervention before any spinal surgery could be considered.

A multidisciplinary team, including Dr Nihar Mehta (Associate Director- Structural Heart Diseases), Dr Anand Bhabhor (Additional Director- Critical Care), Dr. Upendra Bhalerao (Consultant-Cardiovascular & Thoracic Surgery), Dr Rajashri Agaskar (Consultant- Cardiac Anaesthesiology), Dr Manish Kothari (Consultant Spine Surgery & Endoscopic Spine Surgeon), and Dr Purnima Shah (Consultant- Neurology & Neuromuscular Specialist), convened to determine the best course of action. 

After a thorough review of echocardiograms, blood tests, CT scans, and MRI reports, the team identified several key concerns during the consultation.Gala’s bicuspid valve lacked the necessary calcium for a minimally invasive TAVI procedure, and contractures and small arteries in his feet made TAVI a less suitable option. However, his lung function was deemed capable of handling surgery with pre-surgery exercises.

The team concluded that an open-heart surgery to implant a mechanical (metal) valve, which could last approximately 15-20 years, was the safest and most effective option. Dr Nihar Mehta performed a coronary angiography to ensure no blockages were present. With the use of a flexible video laryngoscope, strategic planning  and conscious sedation patient was anaesthetised. The Aortic valve replacement surgery was successfully conducted by Dr Upendra Bhalerao.