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NDTV
5 days 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
17-06-2025
- Health
- Business Standard
Lilavati Hospital Doctors Save Life of 78-Year-Old Woman with Serious Heart Disease
PRNewswire Mumbai (Maharashtra) [India], June 17: Lilavati Hospital have successfully saved the life of a 78-year-old woman suffering from a serious heart condition known as Mitral Annular Calcification. The patient received a new lease on life through a Transcatheter Transatrial Mitral Valve Replacement (TMVR) surgery. This procedure, performed at Lilavati Hospital in Mumbai, marks India's first successful transatrial TMVR surgery. India's First Successful Transcatheter Transatrial Mitral Valve Replacement Surgery Performed at Lilavati Hospital. The surgery was conducted by a team of specialists led by Dr. Ravinder Singh Rao, Interventional Structural Cardiologist, Dr. Kaushal Pandey, Cardiac Surgeon, and Dr. Uday Gandhi, Cardiac Anaesthesist. Sujata Sakpal (Name changed), had been suffering from severe breathlessness for months. She couldn't sleep lying down and experienced discomfort while eating, walking, or even bathing. Despite undergoing treatment from several doctors, there was no improvement. Realizing the seriousness of her condition, the family admitted her to Lilavati Hospital. Medical tests revealed that her mitral valve was damaged and heavily calcified. Considering her age, the condition of her lungs, and the extensive calcification in her heart, a traditional surgery was deemed extremely risky. Many other hospitals had declined to perform the procedure. However, doctors at Lilavati Hospital took up the challenge and opted for the advanced TMVR procedure. Dr. Ravinder Singh Rao, Interventional Structural Cardiologist, Lilavati Hospital Mumbai said, "Given her age and frail condition, traditional surgery was not an option. So, we chose the Transcatheter Transatrial Mitral Valve Replacement technique. We used an Edwards Sapien 3 valve for the replacement. A small incision was made in the heart to remove the damaged valve and implant the new one. The entire procedure was completed in a very short time. The patient was kept in the ICU for just one day and discharged within four days as her condition improved. Three months later, she is now able to walk again, sleeps well, and lives independently without any breathing issues." "This procedure offers a ray of hope to patients for whom traditional treatment is not possible," concluded Dr. Rao. Dr. Niraj Uttamani, COO of Lilavati Hospital Mumbai said, "This surgery is not just a medical achievement but a landmark for India and the entire Asian continent. It reflects Lilavati's commitment to medical excellence and brings new hope to patients suffering from critical illnesses." Sharing her feelings, Patient Sujata Sakpal said, "I had breathing problems for many years. I couldn't sleep or even eat properly. Other doctors had refused surgery, and I was scared. But the doctors at Lilavati Hospital treated me in time and gave me a second chance at life. I'm deeply grateful to them."
