Kauvery Hospital, Alwarpet Performs Rare TAVR-in-TAVR-in-SAVR Procedure

Chennai: Kauvery Hospital, Alwarpet has successfully performed one of the world’s first TAVR-in-TAVR-in-SAVR procedures with bioprosthetic valve fracture and dual cerebral protection on a 78-year-old patient, marking a major advance in complex structural heart care.

The patient, who had undergone surgical aortic valve replacement (SAVR) in 2005 and a transcatheter valve-in-valve (TAVR) procedure in 2019, developed recurrent valve dysfunction leading to breathlessness and fatigue. Owing to advanced age and high surgical risk, repeat open-heart surgery was ruled out.

A multidisciplinary heart team led by Dr. Rajaram Anantharaman and Dr. C. Sundar performed the complex transcatheter intervention after detailed evaluation using advanced imaging. To optimise valve expansion, a bioprosthetic valve fracture technique was used. Given the high risk of stroke, dual cerebral protection devices were deployed in both carotid arteries.

Despite challenges related to bicuspid valve anatomy and aortic abnormalities, the procedure was completed successfully. The patient recovered rapidly and was discharged within 48 hours with excellent valve function and no neurological complications.

Kauvery Hospital said the achievement underscores Chennai’s growing role as a centre for advanced transcatheter cardiac interventions.