On August 7, Kauvery Hospital, Vadapalani, has achieved a pioneering feat by successfully performing a next-generation Transcatheter Aortic Valve Implantation (TAVI) using a motorised transfemoral delivery system, combined with electrophysiological guidance, in a high-risk 73-year-old patient with bicuspid aortic valve stenosis, a rare and complex heart condition. This marks one of the first reported uses of a motorised valve deployment system for a bicuspid anatomy in India.
Unlike the typical tricuspid valve, a bicuspid valve has only two leaflets and poses significant technical challenges during replacement due to its asymmetric shape and calcification patterns. Traditional open-heart surgery or even standard TAVI systems often carry higher procedural risks in such patients, especially elderly ones. In this case, the Kauvery team chose a new-age valve platform featuring a motorised transfemoral delivery mechanism. This technology allows precise and controlled valve deployment, significantly reducing the chances of misplacement and paravalvular leak. Unlike conventional systems that rely on manual release, this unique motorised system offers superior control, especially crucial in anatomically complex cases like bicuspid valves.To further enhance patient safety, electrophysiological guidance was integrated during the procedure, helping the team anticipate and prevent rhythm disturbances or conduction blocks, which are common risks post-TAVI.

Prof. Dr. P. Manokar, Clinical Lead – Department of Cardiology, commented, This case required us to think beyond the standard approach. The combination of a bicuspid valve and age-related risks demanded a very refined solution. We used a unique valve system that allowed motorised and precise deployment rather than manual delivery which gave us better control during positioning. This greatly improves outcomes in such anatomically challenging scenarios.”
Dr. C. Sundar, Clinical Lead – Structural Interventional Cardiology, added, “The risk of heart blocks is significantly higher in patients undergoing TAVI especially with bicuspid valves. With intra-procedural EP monitoring and timely pacing intervention, we could avoid the need for a permanent pacemaker post-procedure. This collaborative approach is the future of structural heart care.”
Dr. Aravindan Selvaraj, Co-founder and Executive Director, Kauvery Group of Hospitals, said, “This case reflects our continuous pursuit of cutting-edge, patient-first innovations across the Kauvery group. The successful use of a motorised valve delivery system, a first of its kind, in such a complex scenario demonstrates the strength of our clinical expertise and multidisciplinary collaboration. Kauvery Vadapalani continues to raise the bar in delivering advanced cardiac care with compassion and precision.”
The patient recovered well and was discharged in stable condition, without any need for surgical backup or device related complications.