Kozhikode doctors perform rare minimally invasive pulmonary valve replacement

A 24-year-old man from Nilambur walked into the cardiology department at Kozhikode Government Medical College with a problem that would have meant another open-heart surgery. Years earlier, he'd undergone major cardiac surgery at the Sathya Sai Institute to address a congenital heart condition. Now his pulmonary valve—the gateway between the right ventricle and the pulmonary artery—had begun to leak significantly. The standard response would have been familiar to him by then: crack the chest, stop the heart, run it on a bypass machine, replace the valve, close everything back up. Recovery would take weeks.

Instead, the cardiology team at Kozhikode chose a different path. Led by Dr M P Sreejayan, who serves as both superintendent of the cardiology, anaesthesia, and cardiothoracic surgery departments and principal of the medical college, the team decided to attempt a transcatheter pulmonary valve replacement—a procedure that avoids the operating room entirely. The approach is rare enough in India that when it works, it warrants attention.

The procedure itself is elegantly simple in concept, though demanding in execution. Rather than opening the chest, the surgical team threaded a 35 mm Myval valve through an artery in the patient's leg. The valve traveled through the vessel system until it reached the damaged pulmonary valve, where it was positioned and deployed. No bypass machine. No sternotomy. No weeks of wound healing. The patient's own circulation remained intact throughout.

The work required precision and coordination across multiple specialties. Dr G. Rajesh, head of the Cardiology Department, worked alongside Dr Khadar Muneer, Dr Sajeer, and others. The anaesthesia team, led by Dr Radha, managed the patient's sedation and vital signs. Dr S Rajesh, heading the Cardiothoracic Surgery Department, stood ready should complications arise. The catheterization laboratory team—nurses Ambily and Latha, technicians Mansoor, Shajith, Harsha, Akshay, Salma, and Aishwarya—handled the equipment and imaging that made the procedure possible. Dr Edwin, a senior paediatric cardiologist from Aster Medcity in Kochi, supervised the technical aspects.

What makes this case significant is not just that it succeeded, but what it represents about the evolution of cardiac care. Minimally invasive valve replacement has transformed treatment for certain patients in developed healthcare systems, but it remains uncommon in many Indian hospitals. The technique reduces trauma to the body, shortens hospital stays, and lowers the risk of complications associated with open-heart surgery and prolonged bypass. For a young patient who had already endured one major cardiac operation, avoiding a second one carries real weight.

The patient's case also illustrates something about modern cardiology: the same congenital condition that required open-heart surgery a decade ago now has alternative pathways. Technology has caught up to need. A valve designed to be delivered through a catheter, rather than implanted by a surgeon's hands, opens possibilities that didn't exist before.

For Kozhikode Medical College, the successful procedure marks a milestone in the hospital's cardiac program. It signals capability and confidence in a technique that many regional centers have not yet adopted. For the patient, it means recovery measured in days rather than weeks, and a return to normal life without the scar tissue and complications that accompany traditional surgery. The real test, as always, comes in the months and years ahead—whether the valve holds, whether the leak resolves, whether the patient remains well.