An aortic valve replacement at a city hospital using the patient’s own pulmonary valve and without any blood transfusion, holds out hope for the young with aortic valve disease.

The “bloodless� pulmonary autograft operation was performed “for the first time in eastern India at the BM Birla Heart Research Centre, which has been at the forefront of performing bloodless heart surgery in the region�, claims the hospital management.

When 19-year-old Salauddin Ansari was brought to the Alipore speciality cardiac centre complaining of severe breathlessness and palpitation, the doctors were in a dilemma. The aortic valve of the young farmer was badly damaged and required replacement.

But, the usual device, a mechanical prosthesis, was not a happy option, since it requires life-long anti-coagulation with close monitoring of blood clotting, entailing regular blood tests. There was also the risk of bleeding problems, since he was a manual worker.

“The alternative in such cases is tissue valves, which tend to degenerate very quickly, especially in young people. So, we picked the pulmonary autograft operation, an infrequently-performed procedure worldwide, where the patient’s own pulmonary valve is used to replace his diseased aortic valve,� says cardiac surgeon Srirup Chatterjee, who carried out the procedure on Salauddin last month.

A tissue valve conduit is used to replace the pulmonary valve. This operation is usually very complex and requires multiple blood transfusions.

But Chatterjee and his team, through “a meticulous eye for detail at every stage�, managed to perform the surgery on the boy without any blood transfusion.

The pulmonary valve autograft is an operative technique used in select cases for replacement of a diseased aortic valve. “This technique could be particularly beneficial for the younger generation, since the replacement valve can grow along with the aorta in the case of growing children. The haemodynamics is also better and the adverse effects of a bad valve are reversed more easily,� observes Chatterjee.

No requirement of blood transfusion also cuts down the risk of cross-infection and reduces morbidity in the patient, adds the doctor.

The tissue valve conduit used in the pulmonary area works for a longer period, thanks to the low-pressure system prevailing in that region, resulting in “excellent prognosis�, the doctor opines.