First-of-its-Kind TAVI in a Transgender Done at Jaslok Hospital & Research Centre, Mumbai

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The 60 year old transgender patient with immuno-compromised condition gets a new heart valve at Jaslok Hospital & Research Centre, Mumbai.

Mumbai, November, 2022: Recently, a 60 year old transgender patient with immuno-compromised condition got a new heart valve in a unique surgery performed at Jaslok Hospital. The first of its kind surgery was successfully conducted by Dr. Nihar Mehta, Dr. Nikesh Jain, Dr. Ashwin B. Mehta and Dr. Handa & the Jaslok TAVI team in November 2022. 

Initially, the patient started to develop breathlessness and difficulty in performing daily activities. On thorough evaluation, Jaslok TAVI team detected that the patient has a life threatening disease called Severe Aortic Stenosis. Due to the patient's immuno-compromised condition, two surgeons were not in favour of performing the required surgery.  The TAVI team at Jaslok Hospital then took upon the case and successfully performed the TAVI for the patient. 

The aortic valve allows blood to be pumped from the heart to all organs of the body. If this valve gets choked up, which happened in this case (aortic stenosis) the patient begins to develop symptoms of chest pain, breathlessness and can even lose consciousness or pass out frequently. This will eventually lead to heart failure and death in the span of 1-2 years. In this case, the only option left for patients is to replace the aortic valve with a new valve. 

Transcatheter Aortic Valve Implantation (TAVI) is a procedure in which a diseased aortic valve is replaced by a brand new valve without open heart surgery or any cuts, stitches or sutures. This is done under local anaesthesia through a catheter in a blood vessel in the upper leg.  The patient can comfortably talk to the doctors throughout the procedure and can have a cup of tea immediately after! Patients are usually discharged within 3 days of the procedure. The TAVI in this patient was done with a valve made by an Indian company. While performing the surgery, the team came across a blockage that was found in a coronary artery which was also fixed with a stent.

Commenting on the unique surgery, Dr. Nihar Mehta, MD, DNB, (Medicine), DNB (Cardiology), FRCP (London), FICP, said, "The success of the surgery will give a true boost to the support for the transgender community which has long faced ridicule and neglect. This case will also open the doors for several patients with Aortic stenosis to undergo this life saving TAVI procedure.” The Aortic Valve Replacement can be done surgically or via the transcatheter route. Transcatheter Aortic Valve Replacement (TAVI) is done via the artery in the leg and is done under local anaesthesia without any cuts, scars or stitches. Some of the most complex unique TAVI cases are already done at Jaslok Hospital, which was actually refused by other centres due to high risk. TAVR of this transgender patient was one of such unique cases who was refused by 2 surgeons due to multiple comorbidies and immunocompromised state, said Dr. Nikesh Jain, Senior Interventional Cardiologist at Jaslok Hospital. 

Dr. Ashwin B. Mehta (Padmashree) Director, Cardiology Department at Jaslok Hospital. said whereas two million patients deserve TAVI Treatment, for multiple reasons only 2000 patients receive TAVI treatment in India yearly.

The Jaslok TAVI team has done over 90 TAVI cases till date. However, this was the first time in India that a TAVI has been done for a transgender patient. The transgender community in India has always faced prejudice and has been socially outcast. They also face medical and financial problems and do not always have access and options to the best medical care. Thus, as a kind gesture the valve and stent was made free by the company and the entire hospital bill was waived off by Jaslok Hospital.

About Jaslok Hospital:

The Jaslok Hospital & Research Centre is one of the oldest tertiary care, multi-specialty Trust hospitals of the country. In the late 60s, when the establishment of large private hospitals was not common, the institution was conceptualized & endowed to the city of Mumbai by Seth Lokoomal Chanrai. Seth Chanrai came from a family of philanthropists who had businesses in many countries. The family had already supported many small & large projects. Seth Lokoomal entrusted Dr. Shantilal Mehta the task of establishing an ultra-modern centrally located medical center where people of all races and creeds could receive the benefits of advanced health care. Jaslok Hospital is situated at Dr. G Deshmukh Marg, Peddar Road which is a main artery of South Mumbai and overlooks the Arabian Sea. The name Jaslok was derived from the names of Seth Lokoomal & his wife Smt. Jasotibai. Seth Chanrai’s vision was implemented and brought to reality largely by his Brother-in-law Dada Mathradas Assomull. The hospital was inaugurated on 6th July 1973 by the erstwhile Prime Minister Mrs. Indira Gandhi.

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