Doctors in Navi Mumbai have successfully given a new lease of life to a 71-year-old woman with a critical heart condition, avoiding high-risk heart surgery in the process.
Sheshabai S. Toraskar from Nerul lived with constant fear and discomfort. Simple daily activities like walking a short distance or carrying out household work had become exhausting because of severe chest pain, breathlessness, restlessness, and extreme fatigue. Despite taking all prescribed medications regularly, her symptoms continued to worsen, deeply affecting her quality of life and independence. He was severely breathless on routine aerated, requiring family members’ help. The man was in follow-up with Dr Keshav Kale for two years. His health worsened recently. Hence, he was advised to undergo open surgery and Alcohol Septal Ablation.
The procedure was led by Dr. Keshav Dada Kale, Senior Interventional Cardiologist at Medicover Hospitals, who the hospital says, has successfully carried out Navi Mumbai and Raigad district’s first Alcohol Septal Ablation, an advanced minimally invasive cardiac procedure performed in highly selected high-risk patients. The elderly patient had been living with severe hypertrophic obstructive cardiomyopathy (HOCM) and continued to experience severe chest pain, breathlessness, tiredness, and difficulty walking despite receiving maximum medical treatment. With conventional open-heart surgery carrying a major risk because of her age and multiple health issues, the medical team carefully planned this challenging procedure, which helped relieve the dangerous obstruction in her heart and enabled a stable recovery within two days.
Dr Kale explains, “The patient was a known case of hypertension, diabetes, and hypertrophic obstructive cardiomyopathy (HOCM), a serious heart condition in which the heart muscle becomes abnormally thick, narrowing the pathway through which blood leaves the heart, for 5 years. This obstruction can reduce blood flow and lead to severe chest pain, breathlessness, dizziness, dangerous arrhythmias, palpitations, fainting episodes, heart failure, and even sudden cardiac death if left untreated. Investigations such as an echocardiogram, heart angioplasty, and cardiac MRI revealed that Mrs. Toraskar had severe Left Ventricular Outflow Tract (LVOT) obstruction with a dangerously high pressure gradient of more than 100 mm Hg despite receiving all possible medical therapy. Her condition had reached a stage where doctors had to consider advanced intervention urgently. Initially, the option was septal myectomy, a major open-heart surgery usually performed to relieve the obstruction. However, considering the patient’s age, multiple co-existing illnesses, and high surgical risk, we were reluctant to proceed with such a major operation.”
Dr Kale further added, “This was an extremely challenging and high-risk case because the patient had severe hypertrophic obstructive cardiomyopathy with very high LVOT obstruction despite optimal medications. Recognising the seriousness of her condition and the limited treatment window available, we decided to perform Alcohol Septal Ablation, a rare and technically demanding minimally invasive cardiac procedure that had never been performed before at the hospital and is considered the first such case in Navi Mumbai and the Raigad district. The complex procedure was successfully carried out under local anaesthesia. Alcohol Septal Ablation is a highly specialised procedure where we intentionally create a small controlled infarction in a selected portion of the heart muscle using alcohol injection. It requires great technical precision because we are deliberately reducing a part of the thickened heart muscle to relieve obstruction and improve blood flow. During the procedure, we carefully identified the specific septal artery supplying the thickened portion of the heart muscle responsible for the obstruction. A controlled amount of 95% alcohol was then injected into the artery to intentionally create a small, targeted heart muscle infarction. This helped reduce the thickness of the obstructing heart muscle and improve blood flow from the heart.”
Given the delicate nature of the procedure and the intentional creation of controlled damage to heart tissue, the treatment required extreme precision and close monitoring. “A temporary pacemaker was also implanted during the procedure for additional cardiac support and safety. The procedure was completed successfully within 2 hours. We noted a nearly 70% reduction in the LVOT gradient immediately after the intervention, with no evidence of heart block or bleeding complications. Within 2 days, the patient showed improvement in her symptoms and was discharged in stable condition after three days. She has now been advised regular follow-up, lifestyle precautions, and continued medications to support long-term heart health,” said Dr. Keshav Dada Kale.
The patient’s family members share, “We were constantly worried seeing her struggle even for small daily activities like walking or climbing a few steps. We were scared when we were told that surgery would be very risky for her. After the procedure, seeing her breathe comfortably and recover safely has brought immense relief and happiness to our entire family.”