In your view, what are the most important technologies of late that has really revolutionized interventional cardiology across the world?
Traditionally, surgical replacement was the gold standard therapy for severe aortic and mitral valve diseases. But with increasing survival, these conditions have become more common in the elderly population with multiple other comorbidities. Such patients are considered to be high
risk and inoperable. Catheter-based therapies have emerged as a low-risk alternative for these patients with unmet clinical needs.
Besides transcatheter aortic valve replacement (TAVR), the other procedures that are rapidly upcoming are transcatheter mitral valve repair/replacement (TMVR), transcatheter pulmonary and tricuspid valve replacement (TPVR / TTVR), left atrial appendage closure for stroke prevention and pulmonary artery denervation for pulmonary hypertension.
The emergence of 3D and 4D imaging now allows physicians to better visualize anatomical structures and morphological anomalies and plan their surgery / transcatheter therapies with more precision and less complications. Personalised medicine, by way of genetic testing for cardiomyopathy, is another major advancement.
How updated are Indian medical and healthcare fraternity to leverage these advancements for the benefit of the patients here?
The major limitation is the availability of access to newer technologies/devices and the cost, as most of them are currently imported and not made in India.
Current status of your key research projects aiming at developing bioprosthetic valves using shark skin and the light-weight artificial heart?
Left ventricular assist devices (LVAD) are used worldwide in developed countries. The cost of these devices are prohibitively high in India. It comes to around Rs.65 to 80 lakhs. We, in collaboration with our Russian counterparts, are developing an assist device called ‘Sputnik Heart’ which will be available at a marginal / affordable cost to help patients with unmet clinical needs.
Our team is undertaking preliminary research, looking at the feasibility of using shark skin for bioprosthetic valves’ fabric. The currently available bioprosthetic valves, which are made of bovine or porcine pericardium, have a high failure rates after 8 to 10 years, especially in young patients due to calcification and degeneration. There is good evidence to show shark skin has good tensile strength and very low calcification and this might be the best substitute to produce bioprosthetic valves.