Wockhardt Hospitals’ Dr. Nitin Tiwari performs first BTV in Central India on patient with Eisenmenger syndrome

Dr. Nitin Tiwari

Nagpur: Dr. Nitin Tiwari, Sr. Interventional Cardiologist- Wockhardt Hospital, Nagpur has recently performed first ever Balloon Tricuspid Valvuloplasty on patient with Eisenmenger syndrome in Central India. This is first such case reported till now. The procedure- BTV was performed on a 52-year-old woman who had arrived in emergency department of the hospital.

At the arrival, she had complaints of shortness of breath, abdominal distension, swelling all over the body and was discolored blue on lips, fingers, eyes. Even her skin had a bluish tinge. Immediately, her 2D-Echo was performed in which she was diagnosed to have Eisenmenger syndrome with Tricuspid Stenosis. Tricuspid stenosis is the choking of right sided inflow of the heart due to which there is swelling all over the body, breathlessness and abdominal distension.

The patient had to undergo a procedure called Balloon Tricuspid Valvuloplasty in which a small puncture is made in the groin. The balloon is then passed across the choked tricuspid valve and is inflated so that the choked valve gets opened. This decreases the pressure in heart immediately.

The team also included Dr. Sameet Pathak, Cardiovascular and Thoracic Surgeon and Dr. Pankaj Jain Chaudhary, Anesthetist.

“Eisenmenger syndrome is a long term complication of an unrepaired heart defect (hole) that someone is born with (congenital). The syndrome usually develops due to an unrepaired congenital hole between the chambers of heart”, informed Dr. Tiwari. “In such defects, blood flows in a way it normally does not. This increases the pressure in the pulmonary artery. Over the time, this increased pressure damages walls of blood vessels and makes it difficult to get the bloods pumped into lungs”, he added.

This syndrome causes increased blood pressure in the right side of the heart which leads to mixing of low oxygenated blue blood with oxygen rich blood in the left side. In turn, this decreases the overall content of oxygen level in the blood and causes a bluish tint in the skin. It occurs in 1-6% of patients born with heart defects and no such case with Tricuspid stenosis has been reported so far.