A minimally invasive surgical procedure to replace the heart’s aortic valve is becoming popular among elderly patients at private hospitals, cardiologists said.

The high-cost factor, however, has stalled its large-scale implementation in government hospitals, doctors pointed out.

The procedure, called transcatheter aortic valve replacement (TAVR), involves inserting a catheter into a blood vessel in the upper leg to replace the defective aortic valve.

An aortic valve can develop problems with age. It can become diseased because of normal wear and tear. Calcium deposits on the walls can also make a valve defunct, doctors said. Earlier, the only way to replace a diseased valve was an open-heart surgery.

“But it was risky for many patients, especially the aged and those with comorbidities. It also involved a long stay at the hospital and a longer recovery time,” said Rabin Chakraborty, senior vice-chairman and head of cardiology, Medica Superspecialty Hospital (part of Manipal Hospitals).

TAVR is a far simpler procedure, done under local anaesthesia. Unlike the traditional open-heart surgery, it does not need a large incision.

“All we have to do is a minute puncture in the artery. A new miniature valve is mounted on a balloon. It is inserted into the artery through the groin. A long sheath is used to advance the valve from the groin to the heart,” he said.

“In most TAVR cases, patients can go home after 24 hours of the surgery. The simplicity of the procedure makes it so popular,” said Chakraborty.

In India, transcatheter aortic valve replacement was introduced around 2016, said Dilip Kumar, the director of the cardiac cath lab and senior consultant interventional cardiologist at Medica.

“Since then, we have done more than 25 TAVR procedures. It is a less time-consuming medical procedure. A faster recovery and a lower risk of infection make the TAVR procedure the preferred option,” he said.

On December 12, the hospital held a news conference with patients who had undergone the procedure and were “back to normal life”.

The procedure is still confined to elderly patients. “Patients with multiple comorbid conditions and those over the age of 65 are currently candidates for TAVR. The valve starts degenerating after 15 years. So, the younger patients are still out of the ambit,” said Chakraborty.

Another private hospital off the EM Bypass, RN Tagore International Institute of Cardiac Sciences, has seen around 30 TAVR surgeries.

“We take 65 as the cut-off age for the procedure,” said Debdatta Bhattacharyya, the clinical director and chief of cath lab at the hospital.

The doctors also said the procedure is expensive and hence, yet to take off at government hospitals.

“TAVR is ideal for elderly patients who need intervention in the aortic valve but have several comorbidities. The cost burden has been a deterrent to its implementation in government hospitals,” said Biswajit Majumder, the head of the department of cardiology at RG Kar Medical College and Hospital.

The cost of a TAVR procedure with an Indian implant is well over Rs 15 lakh and that with an imported device is close to Rs 30 lakh.

“The cost is still prohibitive. Technology has its own price. But we hope the cost will come down over a period of time,” said Chakraborty.