Narayana Health City saves patient with a rare heart condition through a unique procedure


Narayana Health City gives a new lease of life to a bus conductor from Tamil Nadu who was suffering from a rare heart condition through a unique procedure called Percutaneous Balloon Mitral Valvuloplasty under fluoroscopic and Intra Cardiac Echocardiography guidance (ICE).

45 year old Thulukkanam was born as a dextrocardia, a rare heart condition in which the heart is positioned on the right side of the chest instead of being on the left side. Though he was leading a normal life, recently he started developing difficulty in breathing while walking. On investigations, it was revealed that he was suffering from mitral stenosis, wherein the mitral valve or the valve that lets blood to flow from one chamber of the heart to the other had become narrow and there by blocked the blood flow. Though mitral stenosis is a commonly seen heart ailment, mitral stenosis in dextrocardia is extremely rare. A fatal condition, it has the potential to gradually lead to blood clot and even stroke or heart failure.

Speaking about the condition, Dr. Uday Khanolkar, Senior Interventional cardiologist, Narayana Institute of Cardiac Sciences, Narayana Health City said, “Narrowing of the mitral valve in a person whose heart is positioned on the right side is an extremely rare condition with a global prevalence of 1 in 2,00,000 people. Until recently the condition was treated by performing a surgery involving valve change. In this case we performed a minimally invasive procedure. Further, as Interventional Cardiologists we are used to performing procedures on the left sided heart, so the orientation was also a challenge. However, ICE (Intra Cardiac Echocardiography guidance) played an important role in making the complex procedure easy and efficient.”

Percutaneous balloon mitral valvuloplasty involves insertion of a thin flexible tube through an artery in the between the abdomen and the thigh area which is then threaded into the heart. Once the tube reaches the narrowed mitral valve a balloon located at the tip of the tube is inflated. As the inflated balloon presses against the valve it enables the narrowed mitral valve to stretch open. This thereby increases the size of the mitral valve opening and improved the blood flow. While this whole process takes place inside the heart, Intra Cardiac Echocardiography (ICE) helps in visualising it and carrying it out efficiently.

“While percutaneous balloon mitral valvuloplasty is common, performing the same through ICE is rare. ICE is a technique that enables to see the structures of the heart from inside without opening the heart” added Dr. Kapil Kumawat, Senior Interventional Cardiologist & Electrophysiologist, Narayana Institute of Cardiac Sciences, Narayana Health City

Having treated mitral stenosis in Dextrocardia, Narayana Health City is among the few hospitals that has the expertise to successfully treat rare cardiac conditions.

Expressing his happiness, Mr. Thulukkanam said, “I never imagined that I would recover owing to my rare condition. Today, I am not only fine but also can lead a normal life again. I am so grateful to Dr. Uday and Dr. Kapil for giving me a new life.”