Mumbai (Maharashtra) [India]: In a first in the field of cardiology in India, a LAMPOON –TMVR was performed on a cardiac patient who had already undergone an Open Heart Surgery a few years back.
Interventional Structural Cardiologist Dr. Ravinder Singh Rao and his Team has successfully performed India’s first LAMPOON- TMVR with a Made in India valve on a 76-year-old cardiac patient at Lilavati Hospital in Mumbai.
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The LAMPOON (Laceration of the Anterior Mitral Leaflet to Prevent Outflow Obstruction) procedure is a transcatheter electrosurgical technique to split the anterior mitral valve leaflet immediately prior to TMVR (Transcatheter Mitral Valve Replacement).
The LAMPOON procedure is recommended for any cardiac patients who have already undergone a previous open heart surgery and are considered at high risk of survival to undergo any related surgery.
Speaking about the LAMPOON procedure, Dr. Ravinder Singh Rao informs “Mitral Valve Stenosis or narrowing of the valve restricts blood flow into the main pumping chamber of the heart and we recommended TMVR as the more effective and minimum invasive treatment in elderly patients and with previous degenerated mitral valve. But in certain cases, the heart leaflet is pushed back blocking blood flow causing the Left Ventricular Outflow Tract (LVOT) obstruction and this is a common and a life threatening complication in TMVR. We do Electrosurgery wherein we would cut the leaflet with electrified wire. The safety and outcomes of such complex procedure depends on the experience of the team. The team comprised of Dr. Anand Rao, Interventional Cardiologist, Dr. Namrata Kothari, Cardiac Anesthetist & Dr. O.H. Jaiswal, Cardiac Surgeon”.
In the LAMPOON procedure, two catheters are inserted through the patient’s groin area into the patient’s heart flowing through the blood vessels. An electrified wire woven through the catheter is used to split open the leaflet and post this procedure, the patient can then undergo TMVR.
Speaking about the elderly patient, Dr. Ravinder Singh Rao informed “The subject had earlier undergone an open heart surgery was required to undergo a TMVR procedure, but his heart leaflets were causing obstruction”.
“Our patient has a long history of hospitalization with a Mitral Valve Replacement surgery in 2008, right sub mandibular salivary gland excision performed in 2015, a gallstone pancreatitis admission in 2020 and a Laparoscopic Cholescystectomy performed in 2020 too” added Dr. Rao.
A LAMPOON procedure was performed and with electro surgery, the previous valve was replaced with a new valve.
“Lampoon procedure is a boon for senior citizens above the age of 65 years that are at high risk of mortality for TMVR. The hospitalization period is also limited with the patients needing to spend one day in ICU and about 4 days in the ward for continuous monitoring” adds Dr. Rao.
Lt.Gen.(Dr.) V. Ravishankar, VSM (Retd.) COO & Cardiac Surgeon at Lilavati hospital said, “Routine transcatheter aortic and mitral valve replacement at Lilavati, ensures that every member of team were experienced to take care of these patients with safe outcomes”.
