Bengaluru, 23rd September 2026: Apollo Hospitals, Bannerghatta Road, has successfully performed one of India’s very few absolute Zero-Contrast Transcatheter Aortic Valve Replacement (TAVR) procedures on a 68-year-old kidney transplant recipient who had been considered too high-risk for treatment at multiple centres. By replacing the diseased heart valve without using a single millilitre of iodinated contrast dye, the team was able to protect the patient’s transplanted kidney while delivering a life-saving cardiac intervention.
The patient, weighing just 39 kg, had undergone a kidney transplant in 1999 and had been living with a progressively failing transplanted kidney. Over the past two years, he developed severe aortic stenosis, a narrowing of the heart’s aortic valve that restricts blood flow and if left untreated, can lead to heart failure. His condition was further complicated by severe frailty, heavily calcified blood vessels and dissected femoral arteries, making both open-heart surgery and conventional TAVR extremely high-risk. Having been declined treatment elsewhere, his options had become increasingly limited.
In a conventional TAVR procedure, iodinated contrast dye is used to visualise blood vessels and guide accurate placement of the replacement valve. However, in patients with advanced kidney disease or a transplanted kidney, the dye itself can trigger further kidney damage. To eliminate this risk, Apollo’s Structural Heart team meticulously planned the procedure using advanced multi-modality imaging, including MRI, vascular ultrasound and fluoroscopic guidance, enabling them to complete the entire intervention using exactly 0 mL of contrast dye.
“This was one of the most technically demanding structural heart procedures we have performed,” said Dr. Srinivasa Prasad, Senior Consultant Interventional Cardiologist, Apollo Hospitals, Bannerghatta Road, Bengaluru.
“The challenge was not only replacing the patient’s severely diseased heart valve but doing so without compromising his transplanted kidney. Zero-contrast TAVR demands meticulous planning, advanced imaging and seamless collaboration between cardiologists, imaging specialists and nephrologists. For carefully selected patients who were previously considered too high-risk for treatment, this approach offers a safe and effective alternative while protecting kidney function.”
The procedure successfully restored normal blood flow through the replacement valve while preserving the patient’s renal function. Within 8-12 hours, the patient’s breathing improved significantly as the fluid accumulation in his lungs resolved. He was walking the very next day and was discharged just three days after the procedure. Post – procedural echocardiograms confirmed that the replacement valve was functioning normally, while kidney function remained stable with an early improvement in creatinine levels. At his one-month follow-up, the patient reported complete relief from his cardiac symptoms, healthy urine output and no requirement for dialysis.
The case highlights how advances in multi-modality cardiac imaging, meticulous procedural planning and close collaboration across cardiology, nephrology, imaging and anaesthesia teams are enabling clinicians to safely perform increasingly complex structural heart interventions.
As more patients present with multiple co-existing conditions, innovations such as Zero-Contrast TAVR demonstrate how precision medicine and multidisciplinary care are redefining what is possible, offering new hope to patients once considered untreatable.
Apollo Hospitals
Apollo revolutionized healthcare when Dr. Prathap Reddy opened the first hospital in Chennai in 1983. Today, Apollo is the world’s largest integrated healthcare platform with over 10,400 beds across 79 hospitals, 6,800+ pharmacies, 2,900+ clinics, 500+ telemedicine centres. It is one of the world’s leading cardiac centers, having performed over 3,00,000 angioplasties and 5,00,000 surgeries. Apollo continues to invest in research and innovation to bring the most cutting-edge technologies, equipment, and treatment protocols to ensure patients have access to the best care in the world. Apollo’s 1,20,000 family members are dedicated to delivering exceptional care and leaving the world better than we found it.