Latest news with #RHL
NDTV
3 hours ago
- Health
- NDTV
From Bat-Signal To Heart-Saver: How India's First Batman Procedure Helped A High-Risk Patient Avoid Open-Heart Surgery
Just ahead of India's 78th Independence Day, the nation has recorded its first electrosurgical valve-in-valve mitral procedure in August 2025-quite a milestone to be celebrated. A technically demanding transcatheter intervention was performed by a select team of doctors at Rajasthan Hospital, Jaipur for a 74-year-old woman with a failing mitral bioprosthesis. Heart valve disease remains a major but underdiagnosed health challenge among India's elderly population, particularly women. This breakthrough highlights the transformative potential of cutting-edge cardiac care for those with limited treatment options. The technique, informally dubbed the "Batman Procedure", used a catheter-based electrosurgical approach to treat a previously operated, high-risk patient without opening the chest, demonstrating a new option for selected inoperable cases. What does this mean for the future of heart health and surgeries in India, especially where making these procedures as minimally invasive as possible? We spoke to Dr. Ravinder Singh Rao, Chairman, RHL Heart Centre & Head - TAVI Program, the head of the team that successfully performed the Batman Procedure, to find out more. What Is The Batman Procedure And Why The Name? "The Batman Procedure refers to a minimally invasive, balloon-assisted intervention for complex mitral valve issues - especially when the mitral valve's anterior leaflet is severely damaged or cannot be repaired," explains Dr Ravinder Singh Rao. He adds that "the 'Batman' name comes from the visual of the inflated balloon in the aorta, which resembles the Bat-signal and helps control the blood flow while the damaged leaflet is treated." These electrosurgical techniques often use specialized electrified wires and laceration tools to modify native tissue or prior devices so a new valve can be implanted through a catheter route - in short, a hybrid of transcatheter valve-in-valve (ViV) ideas and targeted electrosurgery. Why This Is A Rare And Technically Complex Procedure Transcatheter mitral interventions remain among the most complex procedures in structural heart disease. As Dr Rao put it, the procedure is "exceptionally rare and technically demanding. It's only considered when traditional open-heart surgery is too risky or not feasible." The anatomy of the mitral valve, prior surgical repairs or replacements, and the risk of obstructing blood flow to the left ventricle make planning and execution exacting - requiring high-resolution imaging, experienced operators, and a coordinated heart health team. Electrosurgical modifications (for example, lacerating a tethered leaflet or cutting failed clips) have only recently moved from case reports and small series into selected clinical practice. The Jaipur Case: Batman Procedure To The Rescue According to the hospital summary, the 74-year-old patient had previously undergone dual valve replacement and then developed failure of the mitral bioprosthesis. Because her age and comorbid state made repeat open-heart surgery prohibitively risky, the team performed an electrosurgical valve-in-valve mitral implantation using a catheter-based approach. The patient walked within days and returned home soon after - an outcome that highlights the speed of recovery after percutaneous approaches compared with conventional redo sternotomy. "This case proves that even elderly, high-risk patients can receive transformative treatment with the right tools and expertise," Dr Rao said in a statement that underscores both the life-changing potential and the narrow indications for the technique. What Patients And Families Should Know The Batman Procedure is not a first-line therapy. It's reserved for highly selected patients, typically adults with prior valve surgery, failed repairs, or anatomy that makes repeat open surgery too dangerous. "It needs advanced infrastructure (sophisticated cath labs, specialized tools) and an expert team experienced in complex cardiac procedures," Dr Rao cautions, noting that "only a handful of Indian hospitals currently have these resources and capabilities." Post-procedure recovery is usually faster than open surgery, but requires close follow-up and lifelong cardiac care. Why This Matters For India's Heart-Care Landscape Valvular heart disease (VHD) remains common in India, driven by both rheumatic and degenerative causes. A recent review highlights persistent burdens of VHD across Asia and India, with mitral involvement frequently associated with pulmonary hypertension and heart failure. Broadly, cardiovascular diseases are the leading cause of death globally and account for a large and growing share of non-communicable disease mortality in India. Estimates place the pooled prevalence of cardiovascular disease among Indian adults at about 11%, and national data show that CVD causes a substantial share of deaths in middle and older age groups. These trends make accessible, advanced valve therapies an important public-health priority - not to replace prevention, but as a necessary option for those who need it. (PMC, World Health Organization) Limitations And The Road Ahead Will the Batman Procedure become routine? "It will likely remain a rare, last-resort option for select cases," Dr Rao says. That's realistic: barriers include high device and procedural costs, the need for operator training, and availability of round-the-clock multidisciplinary teams. Evidence remains limited to case series and registry data for many electrosurgical mitral techniques, so broader adoption will depend on careful outcome reporting and training programs. Meanwhile, expanding basic valve-disease detection, timely referrals, and equitable access to advanced cardiac centres must proceed in parallel. Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.
Business Standard
5 days ago
- Health
- Business Standard
Pioneering 'Batman Procedure' Offers New Hope to High-Risk Heart Patients
VMPL New Delhi [India], August 8: Doctors at Rajasthan Hospital Limited (RHL), Jaipur have successfully performed India's first electrosurgical valve-in-valve mitral procedure, informally called the "Batman Procedure", giving a 74-year-old woman from Srinagar a new lease on life. Fatima Bano, who had previously undergone open-heart surgery to replace two valves, was once again facing heart failure. Medical investigations revealed her mitral valve was failing, but her advanced age and health condition made her too high-risk for another conventional open-heart surgery, according to specialists at Srinagar and AIIMS, New Delhi. With her condition worsening and traditional surgery deemed too risky, her family turned to Dr. Ravinder Singh Rao, Chairman, RHL Heart Centre & Head - TAVI Program. Dr. Rao and his team performed the complex procedure using an advanced electrosurgical technique. Using a minimally invasive catheter-based approach, Dr. Rao's team employed precision electrosurgical tools, including a fine electrified wire, to precisely open part of the malfunctioning mitral valve and implant a new one, all without opening the chest. This complex but swift procedure, rarely attempted in such high-risk patients, enabled Fatima to walk within days and return home to her routine life shortly after. "This case proves that even elderly, high-risk patients can receive transformative treatment with the right tools and expertise," said Dr. Rao. This case represents a significant milestone in India's cardiovascular care landscape: the nation's first electrosurgical valve-in-valve intervention for a failed mitral valve in a previously operated patient. The procedure demonstrates the possibility of safely treating complex heart valve disease in elderly, high-risk patients once deemed inoperable.
News18
5 days ago
- Health
- News18
Pioneering Batman Procedure Offers New Hope to High-Risk Heart Patients
VMPLNew Delhi [India], August 8: Doctors at Rajasthan Hospital Limited (RHL), Jaipur have successfully performed India's first electrosurgical valve-in-valve mitral procedure, informally called the 'Batman Procedure", giving a 74-year-old woman from Srinagar a new lease on Bano, who had previously undergone open-heart surgery to replace two valves, was once again facing heart failure. Medical investigations revealed her mitral valve was failing, but her advanced age and health condition made her too high-risk for another conventional open-heart surgery, according to specialists at Srinagar and AIIMS, New Delhi. With her condition worsening and traditional surgery deemed too risky, her family turned to Dr. Ravinder Singh Rao, Chairman, RHL Heart Centre & Head – TAVI Rao and his team performed the complex procedure using an advanced electrosurgical technique. Using a minimally invasive catheter-based approach, Dr. Rao's team employed precision electrosurgical tools, including a fine electrified wire, to precisely open part of the malfunctioning mitral valve and implant a new one, all without opening the chest. This complex but swift procedure, rarely attempted in such high-risk patients, enabled Fatima to walk within days and return home to her routine life shortly after.'This case proves that even elderly, high-risk patients can receive transformative treatment with the right tools and expertise," said Dr. case represents a significant milestone in India's cardiovascular care landscape: the nation's first electrosurgical valve-in-valve intervention for a failed mitral valve in a previously operated patient. The procedure demonstrates the possibility of safely treating complex heart valve disease in elderly, high-risk patients once deemed valve disease remains a major but underdiagnosed health challenge among India's elderly population, particularly women. This breakthrough highlights the transformative potential of cutting-edge cardiac care for those with limited treatment options.P.S: The name of the patient has been changed to protect their privacy(ADVERTORIAL DISCLAIMER: The above press release has been provided by VMPL. ANI will not be responsible in any way for the content of the same)
.jpeg%3Ftrim%3D0%2C0%2C0%2C0%26width%3D1200%26height%3D800%26crop%3D1200%3A800&w=3840&q=100)
The Independent
25-03-2025
- Business
- The Independent
Labour costs are set to shoot up - but there's another hidden cost about to hit UK businesses too
Awful April is the term coined for next month when people might be hit by rising costs: changes to energy bills, contracted costs like broadband or mobile phones and so on, as the new financial year kicks into gear. But for businesses this year it's likely to be even worse: the rise in National Insurance costs and an increased minimum wage means SMEs and multinational corporations alike across the UK will have been planning and working out for weeks now how they can absorb, or pass on, the increased expenses. The knock-on effects may be higher prices or lower investment, fewer jobs or reduced hiring - but there's another factor in the works too, which might have an equally significant hit on certain sectors. That's the effective rise in costs for business rates in the Retail, Hospitality and Leisure (RHL), due to come into play on 1 April 2025 after being confirmed in Rachel Reeves ' October budget. Right now, shops, bars, gyms and other businesses in RHL benefit from a 75 per cent rate relief scheme (up to a £110,000 cash cap), introduced in late 2022 as businesses struggled amid surging costs, inflation and the wider post-pandemic recovery. As of next month, that relief is set to drop to 40 per cent. While that means the actual direct value or amount of rates aren't necessarily changing, the real cost to businesses - the amount of money they'll have to fork over for them - will absolutely do so. In some cases they could nearly double; for others it is estimated they may face as much as a 140 per cent increase. RLH businesses aren't the only organisations set to be affected, though they may well see the most notable impact. Also, the reduction of the discount rate isn't the only change, with the 'multiplier rate' - the figure used to work out the cost of rates in conjunction with the building valuation - also going up for more expensive premises. The outcome will be higher income for councils and the government but, as property consultancy company Montagu Evans told The Independent, the changes last year were made with an expectation that the nation would perhaps see more economic growth than it has done so far. 'April 2025 will see both a 1.6 per cent increase the standard multiplier (for rateable values greater than £51,000) coupled with a material reduction in the RLH scheme discount,' said Josh Myerson, head of rating advisory at the firm. 'Public schools will also lose their access to the mandatory 80 per cent relief on their liability. 'The net result will be an increase in business rate receipts but at this point it's not possible to quantify the exact levels. The changes were made at a time when the economic landscape was expected to be rosier, and it remains to be seen whether this will be enough to make an impact on the wider economic environment.' To offer a real-terms example, a business with a premises liable for £25,000 rates would right now, with 75 per cent discount, be paying £6,250 a year without any other relief they may be entitled to. Once the 40 per cent discount replaces it, that increases to £15,000 a year. Colliers estimate, per LLB, that retailers will see average rises in business rates bills from £3,751 a year to £9,003. For restaurants it's an average change from £5,563 to £13,351 a year. And for gyms it's from £2,942 to £7,060 as of April. In terms of how impactful that'll actually be for businesses, it will in part depend on how much they can pass on to customers. Price elasticity can be very different across industries or even regions: you might be prepared to pay a lot more if there's a limited number of hotels in a spot you want to visit, but fewer people may be keen on paying comparably more for the same dinner at two nearby restaurants, where one has to pass on increased costs and the other does not. Looking at hotels specifically, economist Stephen Rooney of Oxford Economics explained it may be more difficult for them to pass on higher pricing than it has been previously. 'Ultimately the impact depends on the extent to which the sector feels able to pass on these added costs. Since the pandemic, hotel demand at least did prove to be fairly price inelastic,' Mr Rooney told The Independent. 'However, consumers will obviously have a limit in this regard and there is a growing base of evidence to imply that this limit has been reached, with travel demand now becoming more price elastic. This view is supported by our in-house survey results (Travel Industry Monitor and Travel Trends Survey) which show cost is a big concern and travellers are increasingly seeking value for money.' If hoteliers, restaurants and the like cannot pass on the increased costs, it means lower profitability for them. If they do pass them on, it could make the UK (or some parts) more costly to visit than other locations, reducing their competitiveness and potentially losing out on custom anyway, Mr Rooney explained. It can be hoped that the smallest of businesses and many SMEs may not see any impact at all. Rates are not payable at all if the value of a property is under £12,000, according to while there's an additional small business rate relief on properties up to values of £15,000. And going forward, small businesses at least know what's facing them for the upcoming year. But it's still a big jump for those in hospitality and the like to absorb. 'The government has taken steps to freeze the small business multiplier for 2025/26. This should mean that most SMEs occupying properties with qualifying assessments should see no increase in liability in the next rate year,' Mr Myerson said. 'However, the effect of reducing the RLH discount will be keenly felt by SMEs operating in the retail, leisure and hospitality sectors in particular, with many those ratepayers facing dramatic increases as a result.' Reform is coming, businesses will be - presumably, probably - pleased to know. A 2026 update to the rating system is on the cards and RLH businesses may benefit in the long-term, but others could need to shoulder some of the burden as a result. 'Government is currently involved in a consultation on their upcoming reforms of the rating system. The introduction of a "super supplement" of up to 10p in the pound to fund a reduced multiplier on qualifying RLH properties will have the greatest impact,' Mr Myerson explained. 'Whilst this ought to provide for a more predictable position for RLH properties, no longer being at the whim of a relief that changes year by year, it will give rise to a significant additional burden for those ratepayers coming within scope of the supplement, with values greater than £500,000.' And, in the meantime, before that reform and certainty arrives, there are only more and more increasing costs to deal with. The very real concern is that one additional consequence of Awful April is businesses finding one too many rising cost pressures, resulting in some closing the doors for a final time.
