OU Health, the University of Oklahoma’s academic health system, has successfully performed a rare and technically complex heart procedure, placing two artificial pulmonary valves simultaneously using a minimally invasive catheter-based approach.
The procedure offers a potential treatment option for patients who may not be candidates for open-heart surgery or conventional transcatheter valve replacement.
The bilateral transcatheter pulmonary valve placement, performed using Medtronic Harmony valves, involves delivering two replacement valves via catheter and implanting them in the right and left branch pulmonary arteries, avoiding the need for open-heart surgery.
The approach is extraordinarily complex, requiring advanced imaging, precise planning and exact placement to ensure blood flow to the lungs is not compromised.
The procedure was performed on a man in his 50s with advanced heart failure and multiple serious health conditions, including renal failure, diabetes and obesity. His enlarged heart and overall condition made both conventional surgery and standard transcatheter valve replacement too risky. Without intervention, his prognosis was poor.
“He was told he was not a surgical candidate and not a traditional valve candidate,” said OU Health interventional and structural cardiologist Dr. Subhrajit Lahiri, M.D., FAAP, FSCAI, FPICS, assistant professor at the University of Oklahoma College of Medicine, who led the procedure. “Without doing anything, his heart was going to continue enlarging. He was already in heart failure and only in his 50s.”
Thanks to this innovative procedure, the patient now has two functioning pulmonary valves.
Based on a review of published medical literature, only one other recorded case of this kind of procedure being done has been found, placing OU Health University of Oklahoma Medical Center among just two medical centers globally to have performed it.
Innovative Planning and Precision Execution
Dr. Lahiri worked with OU Health chief of pediatric cardiology and cardiac imaging specialist Arshid Mir, M.D., associate professor at the University of Oklahoma College of Medicine, and OU Health cardiologist Anjan Shah, M.D., associate professor at the University of Oklahoma College of Medicine to successfully perform this procedure. The collaboration reflects OU Health’s unique continuum of care, where specialists often follow and care for patients with congenital heart disease from childhood through adulthood, ensuring seamless, patient-centered treatment at every stage of life.
Using advanced cardiac CT imaging, the team created a virtual 3D model of the patient’s anatomy and conducted a virtual valve implantation before the procedure.
The team determined that placing valves in the right and left branch pulmonary arteries — rather than in the standard location in the main pulmonary artery — could succeed if positioned with extreme precision to avoid blocking the many smaller arteries that fan out into the lungs.
“The valve is designed to fit the anatomy of the main pulmonary artery. It was not engineered for the branch arteries,” Dr. Lahiri said. “One of the most challenging parts was making sure the valve would sit stably while keeping blood flowing to all the smaller arteries branching into the lungs. The way we planned the virtual implantation made this possible.”
Before proceeding, Dr. Lahiri consulted the physician who performed the only previously published case. “Our patient was far more medically complex than the previous case,” he said. He had renal failure and multiple other conditions that made surgery potentially fatal. But we executed the plan exactly as designed, and it worked perfectly.”
OU Health’s Expertise Makes the Difference
This achievement highlights OU Health’s integration of patient care, research and education to deliver leading-edge, highly specialized care for patients with the most complex heart conditions. The health system’s advanced cardiac imaging program processes nearly 1,000 cardiac CT scans annually, enabling the precise 3D anatomical modeling that made this procedure possible.
OU Health’s Adult Congenital Heart Disease (ACHD) program is the most comprehensive program of its kind in Oklahoma, combining the expertise of a dedicated adult congenital heart surgeon, congenital cardiologist and cardiothoracic surgery team. Together, they provide highly specialized care for patients with complex heart conditions, including those who may have been told they have few or no remaining treatment options.
“A fully integrated ACHD program — combining the expertise of a surgeon, an interventional cardiologist and a physician — is critical for managing this level of complex care,” Dr. Lahiri said. “Success depends on every member of the team working seamlessly together.”
Expanding Hope for Future Patients
Without this procedure, the patient would likely have faced a long, uncertain wait for an experimental valve trial out of state. The success of the case has already prompted the valve manufacturer to invite OU Health physicians to author a formal case report, while cardiologists across the country are reaching out to learn from their expertise and innovative approach.
OU Health plans to offer this procedure to any patient with similar contraindications to standard surgical or transcatheter valve replacement. Dr. Lahiri estimates roughly 1 in 40 pulmonary valve per year replacement candidates at OU Health could benefit from this specialized technique.
For patients across Oklahoma and the surrounding region with complex, high-risk heart conditions, OU Health’s structural and interventional cardiology team provides the most advanced, life -saving care available close to home.
“This is exactly what OU Health is here to do,” Dr. Lahiri said. “When a patient runs out of options somewhere else, we find a way.”
About: OU Health is radically transforming health outcomes as the University of Oklahoma’s academic health system. We are the destination of choice for complex care — with an unstoppable drive to change lives through discovery and healing. Patients turn to OU Health for leadership in clinical care, research and education, where advanced treatments and leading-edge therapies are developed and delivered by a nationally connected network of experts.
Our physicians serve as faculty at the OU College of Medicine and collaborate across all seven health professions colleges on the University of Oklahoma Health Campus — training the next generation of healthcare professionals and accelerating innovation that drives patient outcomes and fuels economic development.
With more than 11,000 employees and over 1,300 physicians and advanced practice providers, we serve all 77 Oklahoma counties and beyond with the state’s only comprehensive children’s hospital (Oklahoma Children’s OU Health); National Cancer Institute-designated cancer center (OU Health Stephenson Cancer Center); and the flagship academic hospital and Oklahoma’s leading Level I trauma center (OU Health University of Oklahoma Medical Center). With selfless collaboration and Oklahoma Proud spirit, we deliver care that reflects our deep commitment to the communities we serve.
For more information, visit OUHealth.com.