Breakthrough TAVI procedure for bicuspid valve at Durdans Heart Centre

TAVI procedure in progress 

Durdans Heart Centre recently concluded a breakthrough minimally-invasive Transcatheter Arterial Valve Implantation (TAVI) on a patient with bicuspid valve.

Angiogram of TAVI

Bicuspid valves, a birth anomaly (two leaflets instead of the normal three), quickly leads to narrowing of the valve. The valve replacement was performed using a self-expanding Medtronic Evolut R self-expanding trans-catheter aortic heart valve. This is the first case in Sri Lanka where a bicuspid valve has been treated using a transcatheter aortic valve. 

At the time of the procedure the patient Robin Sathasiwam’s heart function was low after the heart attack and the aortic valve was severely malfunctioning with weakened electrical conduction of the heart. Waiting any longer without intervention would mean open heart surgery for which he would be a high risk candidate. 

After comprehensive analysis by Dr. Pandula Athaudaarachchi on 14 May, the procedure was undertaken by him in the state of the art catheterisation laboratory at Durdans Hospital. Patient was awake with only local anaesthesia (LA). The equipment was navigated to the heart, the abnormal valve stretched open with a balloon and the artificial valve placed above the level of the valve to control the blood flow from the body. 

The procedure lasted no more than 90 minutes. No complications were experienced and the functioning of the valve was excellent. The patient was able to walk 24 hours later and was discharged from the hospital three days later. Sathasivam said: “Since my operation, my breathing has become much easier and I feel more energetic. Obviously, it is still too soon to give any further observations or health improvements. I commend Dr Pandula for his pioneering vision and Durdans Heart Centre for bringing this modern-day heart technology to Sri Lanka, the TAVI cardiac technology and procedure that he has practiced in the UK. It will help numerous people and ease a lot of suffering, pain and anguish for patients and their families- not to mention post-surgery anxiety and trauma.”

In the same session Dr. Athaudaarachchi implanted a balloon expandable aortic valve (different type) under local anaesthetic on an 80-year-old with multiple medical conditions, seeing complete success. 

The first minimally-invasive procedure in the hospital was performed by the same cardiologist back in September 2018, making Durdans Hospital the first cardiac unit in the country to have implanted two different types of percutaneous aortic valves under local anaesthetic with complete success and no complications.