 which was not working properly due to age factor it has shrink a little bit so Vaike Mishra was normally we came here we had a long discussion with 2-3 meetings with Dr Vaike Mishra they are given an estimate also and to have a second opinion went to different hospitals even to the government hospital also but finally when everything was fine here budget wise also because it was a big you can say surgery has to be taken place that is called tagging and his experience Dr Vaike Mishra so we all, my family members my wife, my son and our son we all decided that finally we have to go here only on 27th she was admitted here 28th surgery was done very successful as per the schedule as per the budget also and we are happy and today we are getting a discharge finally and she can walk now as per the recommendations recovery will be done in 2-3 days only and it is done only and she can walk until bathroom and she had a walk also for 1-2 minutes she is taking diet also and all medications are done very properly I prefer this hospital very much and I liked it and my wife is in government job so that's why we are on a CGSS panel also finally we are very happy we recommend everybody for Dr Vaike Mishra as age advances the risk of heart surgery becomes more and more considering this aspect I would like to highlight a 90 year old patient who came to us with the history of breathing difficulty we investigated and found that patient had severe aortic stenosis with calcification of the valve now considering her age and fragility if we have asked for conventional open heart surgery the risk would have been tremendous to keeping this in mind we opted for a newer technology to treat aortic valve stenosis which is Taur that is a catheter based perpetaneous treatment of aortic valve disease we carried out appropriate investigative procedures and found that patient definitely need replacement of aortic valve but she do had some issues like calcification which was extending into the left ventricular cavity which may procedure more difficult we planned the surgery with perpetaneous routine cath lab and we did a tower which lasted for 3 hours after procedure patient was shifted into ICU the best thing for this case was that we carried out the procedure while the patient was awake we did not put on to the ventilator which is advantage and because of this we could able to shift the patient into ICU in a fully conscious conditions she remained in the ICU for 2 days 3rd day she was shifted into the ward and after 5 days we could able to discharge these patients now this is a technological evolution which has given us opportunity to treat these complex heart problems in a patient who are in a geriatric group particularly this patient was 90 year old and she had a very uneventful outcome hence our effort in Manipal hospital is to utilize these development in the area of heart problems like tower like robotic technology like mineral access bypass surgery and mineral access well repair and replacement thank you