An unwavering focus on building expertise in structural heart interventions-a range of minimally invasive procedures that treat conditions affecting the heart’s structures, such as valves and walls-has enabled Meenakshi Super Speciality Hospital to save the lives of high-risk heart patients and revive organs impacted by heart-related complications.
In recent times, the hospital has successfully performed Thoracic Endovascular Aortic Repair (TEVAR), a minimally invasive procedure used to treat a ruptured thoracic aortic aneurysm in a 70-year-old male; Transcatheter Aortic Valve Replacement (TAVR), a non-surgical method of replacing a severely narrowed aortic valve through a catheter-based approach, on a 68-year-old male with biventricular dysfunction; and Transcatheter Edge-to-Edge Repair (TEER), a technique that clips the leaking mitral valve to reduce mitral regurgitation without the need for open-heart surgery, for a 41-year-old male.
Before the advent of structural interventions, surgeons had to do open-heart surgery, stopping the heart, and using a heart-lung machine to fix or replace valves or walls. Recovery was long and riskier. Today, these advances allow surgeons to treat heart problems through blood vessels using advanced imaging and tiny tools. The procedures offer faster recovery, less pain, and new hope for elderly or high-risk patients who couldn't undergo traditional surgery.
Only a handful of hospitals in South Tamil Nadu can claim the expertise to perform all three advanced structural heart interventions: TEVAR, TAVR, and TEER. Incidentally, for the first time in the rest of Tamil Nadu, MyClip-a mitral valve clip entirely developed and manufactured in India-was used in a structural heart procedure.
These high-risk structural interventions were performed by a multidisciplinary team from the Department of Cardiology at Meenakshi Super Speciality Hospital, comprising expert cardiologists and cardiac anesthetists. The team includes Dr. R. Sivakumar, Head of Department and Director of Structural Interventions; Dr. S. Selvamani, Director of Interventional Cardiology; Dr. N. Ganesan, Director of Academics; Dr. M. Sampath Kumar, Lead in Congenital Interventions; Dr. Jeyapandiyan, Lead in Electrophysiology; Dr. Thomas Xavier, Associate Consultant Interventional Cardiologist; and Dr. S. Kumar, Chief Cardiac Anaesthetist, Dr.R.M. Krishnan, Senior Consultant & Head, Department of Cardiothoracic and Vascular Surgery, Dr. Rajan, Senior Consultant, Department of Cardiothoracic and Vascular Surgery, Dr. Prabhu Kumarappan Chidambaram, Consultant, Department of Vascular Surgery. Mr. Dileep Bernard, from the hospital was also present in this press meet.
In his comments, Dr. R. Sivakumar, HOD and Director, Structural Interventions, Meenakshi Super Speciality Hospital said, “In cardiology, structural interventions represent our evolving frontier - a shift from purely pharmacological management to precise, often minimally invasive, mechanical solutions that directly address anatomical defects of the heart. These interventions represent the future of cardiac care, offering life-saving solutions with minimal risk and faster recovery, especially for patients who are too high-risk for open-heart surgery. At Meenakshi Super Speciality Hospital, we have consistently invested in building a dedicated, skilled team and advanced infrastructure to offer these cutting-edge procedures. These recent complex cases highlight our commitment to saving lives and delivering world-class care right here in Madurai.”
Giving additional details about the patients, Dr. Sivakumar explained that the 70-year-old man was suffering from a life-threatening bulge in the major artery of his chest-a thoracic aortic aneurysm. He was in cardiogenic shock, a critical condition where the heart is unable to pump enough blood. A CT aortogram revealed that the aneurysm had ruptured into the oesophagus, making the situation extremely grave. Doctors performed TEVAR, placing a stent graft inside the damaged artery through a small puncture in the leg. The rupture was immediately sealed, leading to a remarkable recovery. The patient's blood pressure and kidney function improved significantly, and he was discharged with medication and is now doing well under close follow-up.
Regarding the TAVR case, Dr. Sivakumar said the 68-year-old man had severe narrowing of the aortic valve (aortic stenosis) and was admitted with congestive cardiac failure (CCF). He had biventricular dysfunction with a reduced heart pumping capacity (ejection fraction of 35%), kidney failure (AKI), ascites, and pulmonary hypertension. After evaluation and stabilisation with dialysis, the team performed TAVR, replacing the diseased valve through a small puncture in the groin. Once the new valve began to function, the patient showed rapid improvement in heart and kidney function. His liver condition also began to stabilise, and he was discharged in a stable condition.
As for TEER, Dr.Selvamani, Director of Interventional Cardiology, Meenakshi Super Speciality Hospitalsaid that it was performed on a 41-year-old man with a history of coronary artery disease (CAD) and prior angioplasty. During a routine follow-up, he was diagnosed with ischemic dilated cardiomyopathy, with all four heart chambers enlarged and severe mitral regurgitation (MR)-a condition where the mitral valve fails to close properly, leading to backward flow of blood. This was causing recurrent episodes of heart failure. To address the issue, the team performed TEER, guiding a Made-in-India valve clip (MyClip) into the heart through a catheter and attaching it to the mitral valve to improve closure. The leakage was significantly reduced, and the patient made a strong clinical recovery.