Rare Heart Case: Kolkata Doctors Implant Pacemaker in Patient with Unique Valve System

Pacemaker Implant Success in Kolkata for Patient with Rare Anatomical Condition

Doctors at Manipal Hospital in Mukundapur, Kolkata, have successfully implanted a permanent pacemaker in a 62-year-aged woman presenting with a highly unusual anatomical challenge: an artificial bicaval valve system. Officials at the hospital state this is the first such case reported in India, and only the second documented globally. The successful procedure, led by Dr. Soumya Patra, offers a significant advancement in cardiac care for patients with complex heart conditions.

The Patient’s Complex Case

Shyamali Biswas, a homemaker from Sonarpur in South 24 Parganas district, had a history of severe heart disease. In 2023, she underwent tricuspid valve replacement surgery in Vellore after her natural valve was extensively damaged. Due to advanced heart failure, she received an artificial bicaval valve system, a less common approach where valves are placed in both the superior and inferior vena cava, rather than a conventional valve repair. This system fundamentally alters the typical anatomy of the heart.

Earlier this year, Biswas developed complete heart block – a condition where faulty electrical signals cause the heart to beat too slowly – and was admitted to Manipal Hospital on February 2nd. Doctors determined an urgent pacemaker implantation was necessary. However, the presence of the artificial valve in the superior vena cava presented a substantial obstacle. Pacemaker leads typically travel through these veins to reach the heart, and the altered anatomy complicated this process.

Navigating Anatomical Challenges During Pacemaker Implantation

Dr. Soumya Patra, Senior Consultant of Cardiology and Director of the Cath Lab at Manipal Hospital, explained the difficulty. “The superior vena cava valve makes lead placement particularly difficult. Pacemaker implantation in the presence of an SVC valve needs precision and thorough planning, as even minor misplacement can damage the valve or compromise blood flow. It can lead to difficult pacemaker lead negotiation and placement,” he said.

Alternative options, such as leadless pacemakers and epicardial pacemaker implantation, were considered. Leadless pacemakers are more expensive, although epicardial implantation requires surgical intervention. The medical team opted for a technique allowing successful placement of a conventional pacemaker despite the anatomical complexities created by the caval valve. Dr. Patra emphasized the importance of adapting techniques to manage such complex scenarios, potentially benefiting other patients in the future.

Understanding Pacemakers and Their Role in Cardiac Care

A pacemaker is a small, battery-powered device implanted in the chest to help control the heartbeat. It sends electrical impulses to the heart when the natural electrical system isn’t functioning correctly. According to the American Heart Association, pacemakers can improve quality of life and help people with certain heart conditions remain active.

The implantation process typically involves threading thin, insulated wires (leads) through veins to the heart chambers. These leads deliver the electrical impulses. In Biswas’s case, the existing artificial valve complicated this process, requiring a highly skilled and carefully planned approach.

Dr. Soumya Patra: Expertise in Complex Cardiac Procedures

Dr. Soumya Patra is a well-known Cardiologist associated with Manipal Hospital (Formerly AMRI), Mukundapur. He has over 21 years of experience in cardiology and is an expert in cardiac device implantation, TAVI (Transcatheter Aortic Valve Implantation), and complex coronary angioplasty, as noted on the Manipal Hospitals website. He is also an active member of several prominent cardiology societies, including the Cardiological Society of India, the American College of Cardiology, and the European Society of Cardiology.

According to HexaHealth, Dr. Patra completed his MBBS from NRS Medical College and Hospital, Kolkata in 2004, his MD in Paediatrics from Lady Hardinge Medical College, New Delhi in 2009, and his DM in Cardiology from Rajiv Gandhi University of Health Sciences, Bangalore in 2014.

What’s Next for Shyamali Biswas?

Following the successful pacemaker implantation, Biswas is currently on BiP (Bilevel Positive Airway Pressure) support and under close medical supervision. Her daughter, Nabamita, expressed the family’s relief and hope for her mother’s recovery. Dr. Patra indicated that long-term follow-up will be crucial, including regular pacemaker programming and echocardiography to monitor her condition.

Confirmed vs. Unclear

Confirmed: A pacemaker was successfully implanted in a 62-year-old woman with an artificial bicaval valve system at Manipal Hospital, Kolkata. The procedure was led by Dr. Soumya Patra. This is reportedly the first such case in India and the second worldwide.

Unclear: Specific details regarding the type of pacemaker implanted were not provided. The long-term prognosis for Biswas remains unclear, whereas regular monitoring is planned. The exact nature of the “technique” used to overcome the anatomical challenges was not detailed in available reports.

This successful intervention represents a significant milestone in advanced cardiac care, demonstrating the potential for overcoming complex anatomical challenges in pacemaker implantation.