00 Cardiology Department Head Dr. Smit Srivastava and team created chimney structure by implanting stent using ultrathin delivery system
Raipur. Advanced Cardiac Institute of Pt. Nehru Medical College and Dr. Bhimrao Ambedkar Smriti Chikitsalaya, Raipur has started the new year 2026 with a historic achievement. Dean of Pt. Jawaharlal Nehru Smriti Chikitsalaya Prof. Dr. Vivek Chaudhary informed that in the year 2025 more than 2600 complex heart procedures were successfully performed by the Cardiology Department. This department which started with just 41 cases in the year 2009, today is performing more than 2000 advanced cardiac procedures every year.

Dr. Smit Srivastava, Head of the Department of Cardiology, reported that the department successfully performed a highly complex transcatheter aortic valve implant procedure in the new year. An elderly woman from Raipur had been suffering from shortness of breath and heart failure for a long time. Investigations revealed that her aortic valve had become completely hardened with calcium, reducing the heart's pumping capacity to only 20 percent. According to Dr. Srivastava, open heart surgery was extremely risky and nearly impossible in this condition. Consequently, a joint heart team, led by Dr. Smit Srivastava, from the Department of Cardiology and Dr. Krishnakant Sahu, Head of the Department of Cardiac Surgery, decided to perform the valve implantation through a leg vein without any incision.

Preparations for the procedure began a month ago with a specialized CT scan analysis and financial approval under the Chief Minister's Special Health Assistance Scheme. The examination also revealed that the patient's leg veins were thin and calcified, making it extremely challenging to deliver the valve delivery system to the heart. Furthermore, due to a congenital anomaly, the coronary arteries of the heart were located very close to the valve, posing a serious risk of blockage of both arteries during valve implantation.
To address this complication, specialists inserted stents into both coronary arteries, creating a chimney structure between them and the valve. During the final stage of the procedure, a blockage occurred in a vein in the left leg, which was immediately restored through balloon angioplasty through the right leg.

After this complex procedure, which lasted approximately four hours, the patient's aortic valve pressure decreased from 80 to zero on the operating table, and the heart's pumping capacity increased from 20 percent to 60 percent. Blood flow in both coronary arteries remained normal, and the heartbeat remained completely stable.
Hospital Superintendent, Prof. Dr. Santosh Sonkar, congratulated the cardiology team for ensuring the availability of all necessary resources for this complex procedure. The procedure was performed by Dr. Shivkumar Sharma, Dr. Kunal Ostwal, Dr. Prateek Gupta, Dr. Soumya, Dr. Vaibhav, and Dr. Prince, under the leadership of Dr. Smit Srivastava. Cathlab technicians Jitendra, Badri, and Premchand, along with staff nurses Anand and Digendra, among others, made significant contributions to the team. Cardiac anesthesiology specialists Dr. Balswaroop Sahu and Dr. Sankalp Dewan also provided special support.
The patient has now recovered from the Heart Command Center and has been discharged home. The patient and his family expressed their gratitude to the ACI team, hospital management, and the Chhattisgarh government, reaffirming their faith in government medical institutions.
Complications in the case, lives saved by accurate decisions:
The heart's pumping capacity was only 20 percent—open-heart surgery was extremely risky and nearly impossible. Therefore, the decision was made to implant a valve through a leg vein.
The leg veins were extremely thin and weak—
previously, a specialized CT scan analysis was performed to develop a thinner, more advanced delivery system.
The coronary arteries were low—
to account for the risk of blockage during valve implantation, a stent was inserted to create a "chimney" structure.
Following the procedure, a blockage in a leg vein
was immediately repaired with balloon angioplasty to restore blood flow in the affected vein.
The
open-heart surgery team was placed on standby for safety reasons. There was a possibility of irregular heartbeats—a temporary pacemaker backup was ensured for 24 hours.
Anticipating post-procedural complications – 
The patient was kept under close observation at the Heart Command Centre, where tele-monitoring was done through remote viewing technology.