MUMBAI, May 29 -- A 15-year-old Mumbai boy with a congenital heart defect is the city's first to receive the Harmony Transcatheter Pulmonary Valve-a cutting-edge valve-replacement procedure, where an expandable valve was delivered through a catheter via the groin. Performed at the HN Reliance Foundation Hospital, the minimally invasive procedure avoided open-heart surgery by using a catheter to place the valve in the heart, restoring normal blood flow, and enabling rapid recovery. The boy had undergone corrective heart surgery as a newborn to relieve an obstruction in the right ventricular outflow tract (RVOT), the region of the heart where blood exits the right ventricle and flows into the pulmonary arteries. While the defect was addressed, doctors had to leave the pulmonary valve non-functional, resulting in chronic pulmonary regurgitation. Over time, this caused the right ventricle to enlarge and pump inefficiently. Recently, the boy began experiencing fatigue and reduced exercise tolerance-symptoms of worsening valve insufficiency and heart dilation-prompting the need for valve replacement. Traditionally, cases like this require open-heart surgery involving sternotomy (splitting the sternum or breastbone to access the heart and lungs), heart-lung bypass and prolonged hospitalisation. However, due to the risks and recovery burden of open surgery, especially for adolescents, the team opted for the Harmony Valve-an FDA-approved, self-expanding device designed for patients with previously operated, dilated RVOTs. Its flexible nitinol frame and porcine tissue valve are engineered to accommodate complex anatomies, offering a safer and quicker alternative in suitable patients. In this case, the region where the new valve needed to be placed had become significantly dilated and distorted over 15 years, making the procedure clinically challenging. The Harmony Valve's design allowed it to seal securely despite these anatomical changes. "This technology is specifically made for cases where conventional valves won't fit," said Dr Bharat Dalvi, consultant in paediatric cardiac sciences, who led the intervention. "It adapts to the irregular shape and restores forward blood flow without requiring open surgery." The procedure began with admission on April 26. Just two days later, under general anaesthesia, a catheter was inserted through the femoral vein in the groin and guided to the heart's RVOT. The collapsed Harmony Valve, crimped on the catheter, was advanced into position under fluoroscopic guidance. Once aligned, it was released, self-expanding into place and immediately halting the backflow of blood. The entire procedure took around two and a half hours. The boy was discharged on April 30-within 48 hours-without complications. He was cleared to resume normal activities, including school and sports, within a week. Compared to the weeks-long recovery typically required after open-heart surgery, this transcatheter approach drastically reduces hospital stay, pain and rehabilitation needs. "Had this not been available, he would have faced another major surgery," said Dr Dalvi. "Instead, he walked out of the hospital in two days." While widely used in Europe and the United States, the Harmony Valve has only recently been approved in India. This case is among the first few in the country and marks its debut in Mumbai....