TAVI with Dual Chamber Leadless Pacemaker without Surgery

MGM Healthcare Malar, Adyar has achieved a significant milestone in completely catheter-based cardiac care by successfully performing India’s first combined Transcatheter Aortic Valve Implantation (TAVI) to treat a structural valve defect, along with the implantation of a dual chamber leadless pacemaker to correct a serious cardiac electrical disorder, in a single patient, thereby avoiding open-heart surgery. The patient, a 75-year-old woman with a history of bypass surgery, presented with severe breathlessness that significantly affected her daily activities. She also experienced three episodes of loss of consciousness within a span of three months, indicating a serious underlying cardiac condition. Comprehensive evaluation, including a CT Aortogram, revealed severe aortic stenosis, a condition in which the heart’s main valve becomes critically narrowed, and a 2:1 atrioventricular (AV) block, causing disrupted electrical conduction in the heart. The combination of these conditions placed the patient at high risk, particularly given her age and prior cardiac surgery. Given the complexity and high surgical risk, the multidisciplinary cardiac team, led by Dr. Madan Mohan, Senior Consultant - Interventional Cardiologist, opted for a fully percutaneous, minimally invasive approach instead of conventional open-heart surgery. The team first performed TAVI to replace the diseased aortic valve. This was followed by implantation of a dual chamber leadless pacemaker system, where two miniature devices were placed directly inside the heart chambers. Unlike traditional pacemakers, this system eliminates the need for surgical pockets and lead wires, enabling wireless communication between devices to regulate heart rhythm effectively. Both procedures were performed through a blood vessel in the leg, avoiding open-heart surgery, reducing post-surgical care, extended stay in ICU, infections and significantly improving recovery outcomes. The patient was discharged within 48 hours of the intervention. In his comments, Dr. Madan Mohan said, “This milestone marks the first in India where both TAVI and dual chamber leadless pacemaker implantation were successfully performed together in a single patient, setting a new benchmark in minimally invasive cardiac treatment. This combined approach represents a major advancement in structural and rhythm management therapy and highlights the growing shift toward fully catheter-based, device-driven cardiac care for high-risk patients.” Mr. Venugopal Bhat, Chief Operating Officer and Vice President - Group Strategic Initiatives, said: “This milestone reflects the future of cardiac care, where complex heart conditions can be treated with precision, safety, and minimal invasiveness. This combined approach offers a promising option for high-risk patients and reflects a growing shift towards procedures without surgery, device-based cardiac care.”