“I’d rather face death than dialysis”: Doctors found a way to replace 79-year-old man heart valve without harming his kidneys

A 79-year-old doctor in Mumbai knew all too well what it meant to have a heart problem. He had undergone angioplasty for two blocked arteries back in 2022, and he thought that was the worst of it. But about a year later, he started feeling short of breath, even after small walks. The tests this time weren’t good: he had developed heart failure, and on digging deeper, doctors found that his aortic valve, the valve that pushes blood from the heart into the body, was severely narrowed. At his age, this was serious, and left untreated, it could be life-threatening.Normally, patients like him would get a TAVR, a minimally invasive procedure where a new valve is threaded through the groin. Doctors use contrast-based CT scans to measure the valve and make sure it fits perfectly. But this patient wasn’t just any patient. He also had chronic kidney disease, which made using contrast dye risky. His kidneys were already struggling, and he made it very clear he’d rather die than end up on dialysis. That put the team at Dr L H Hiranandani Hospital in a tricky spot.They started with a plain, non-contrast CT scan to figure out the valve size. But even that didn’t make things simple. Six experts looked at the scans and came up with six different numbers, ranging from 518 to 592 mm². That’s a huge difference when you’re trying to pick a valve. One wrong size, and it could’ve caused serious complications, maybe even death. And that’s when they tried Aortic Valve Ultrasound (AVUS). Instead of relying on contrast, the doctors threaded a tiny ultrasound probe up through the leg artery. Suddenly, they could see the valve in real time, from the inside. The measurements were accurate, and the procedure became much safer.Dr. Ganesh Kumar A.V, the hospital’s Director of Cardiology, explained how tense it was. “The patient was brought to the hospital in a condition where he was dealing with severe aortic valve narrowing and chronic kidney disease – a combination that made the usual valve replacement very risky because the contrast dye could harm his kidneys even further. Hence, we chose to do the procedure using ultrasound guidance, specifically Aortic Valve Ultrasound (AVUS), instead of the usual contrast dye.Seeing him recover so quickly and knowing we were able to protect his kidneys while improving his heart function was incredibly fulfilling. Moments like these make the challenges worthwhile and the robust infrastructure at Dr. LH Hiranandani Hospital, empowers to address such cases with utmost precision and safety,” said the doctor.Using AVUS, the team implanted a 26 mm valve. They checked everything with post-procedure ultrasound and confirmed the valve was perfectly in place. And just like that, the patient was walking out of the hospital within 24 hours. No dialysis, no complications, just a healthier heart and safe kidneys.