Specialists at the Army Institute of Cardio-Thoracic Sciences (AICTS), Pune, have successfully performed a rare and highly complex minimally invasive heart procedure on a patient with a history of valve replacement surgery and severe leakage of the right-sided heart valve.
The doctors said that it is a significant milestone in advanced cardiac care within the Armed Forces Medical Services.
The procedure involved the simultaneous implantation of two prosthetic valves in the superior and inferior vena cava-the two major veins that carry blood into the right side of the heart-to treat severe tricuspid regurgitation without resorting to repeat open-heart surgery.
Such interventions, known as bicaval transcatheter valve implantation (CAVI), are considered among the most challenging catheter-based procedures in structural heart disease and are currently performed only at a limited number of highly specialised cardiac centres across the world.
According to AICTS, the patient had previously undergone heart valve replacement and later developed severe tricuspid valve leakage, a condition that causes blood to flow backward into the body's venous circulation.
Patients with this condition often experience debilitating symptoms such as swelling of the legs and abdomen, liver congestion, fatigue and breathlessness. A second open-heart surgery in such cases carries a significantly higher risk of complications.
The AICTS team adopted a minimally invasive catheter-based approach, implanting two valves simultaneously in the veins leading to the right atrium. The newly implanted valves prevent the backward flow of blood, improving circulation while avoiding the trauma associated with conventional surgery. The patient recovered successfully following the procedure.
Cardiologists describe bicaval transcatheter valve implantation as an emerging therapy for patients with severe tricuspid regurgitation who are considered unsuitable for repeat surgery because of age, previous cardiac operations or multiple medical conditions. Unlike transcatheter aortic valve replacement (TAVR), which has become widely established, bicaval valve implantation remains an evolving intervention with relatively limited global experience.
Medical experts say the successful procedure at AICTS reflects the growing adoption of cutting-edge structural heart interventions in India, particularly within specialised tertiary care institutions. It also highlights the increasing expertise available in catheter-based management of complex heart valve diseases that previously had limited treatment options.
The achievement adds another milestone to AICTS' expanding portfolio of advanced cardiac procedures and reinforces its role as one of the country's leading centres for complex cardiothoracic care. For patients who are too high-risk for repeat open-heart surgery, such minimally invasive interventions could provide a safer and potentially life-changing alternative, while signalling India's growing presence in the rapidly evolving field of structural heart medicine.
