Pacemaker implant performed on patient with ‘rare anatomical condition’ at Kolkata hospital

Doctors at Manipal Hospital, Kolkata have successfully completed an extraordinary cardiac intervention by implanting a permanent pacemaker in a 62‑year‑old woman with an artificial bicaval valve system , a rare anatomical condition documented only once before in global medical literature. This marks the first such case in India and only the second reported worldwide .

The procedure was led by Dr Soumya Patra , Senior Consultant of Cardiology and Director of the Cath Lab, with support from Dr Subhasish Deb and the cardiac team. The patient, Shyamali Biswas of Sonarpur in South 24 Parganas district, had a long history of severe heart disease. In 2023, she underwent tricuspid valve replacement surgery in Vellore after extensive damage to her natural valve. Because of advanced heart failure, she received an artificial bicaval valve system in which prosthetic valves were placed in both the superior and inferior vena cava — a structure intended for patients at high risk or with limited surgical options.

Earlier this year, Biswas developed complete heart block , a serious electrical disorder causing the heart to beat abnormally slowly, and was admitted to the hospital on February 2. Doctors advised urgent pacemaker implantation. However, the presence of an artificial valve in the superior vena cava presented a significant challenge, as conventional pacemaker leads normally pass through these veins. Even minor misplacement could damage the valve or impair blood flow.

The team opted for a carefully planned technique that allowed successful placement of a conventional pacemaker despite the altered anatomy. Dr Patra said documenting such technological adaptations could help clinicians faced with similar complex scenarios. Biswas’s daughter, Nabamita, said her mother is currently on BiPAP support and under regular medical follow‑up, with the family hopeful for her recovery.

Officials noted that pacemaker implantation in patients with artificial tricuspid or bicaval valves is extremely rare , underscoring a significant milestone in advanced cardiac care .