The diagnosis and treatment of cardiac diseases has to be safe, quick, efficient and cost-effective

Dr Sanjay Cherian, Consultant Cardiologist, Frontier Lifeline Hospital in an interaction with Kalyani Sharma highlights the role of TAVR technology in cardiac care sector and ways to increase the penetration and reach of such technologies in rural areas

What is the importance and limitations of minimally invasive techniques such as TAVR?

Over the past few decades, cardiac diagnostic and treatment procedures have evolved into minimally invasive techniques. These techniques have several advantages:

• Smaller scars when compared to conventional  open heart surgeries
• Reduced post procedure stay in the hospital
• Reduced rate of infections

However, these minimally invasive techniques are a lot more expensive than conventional surgeries. These procedures such as TAVR were initially indicated only in very elderly and high-risk patients who were unfit for anesthesia and surgery. This is unfortunately being used even in young patients who are fit for surgery.

Furthermore, the long-term efficacy of these new techniques and also the complication rates associated with these procedures need proper validation.

Can you throw some light on the role of such technologies in the cardiac care sector? How is it going to change the way patients are diagnosed and treated?

The diagnosis and treatment of cardiac diseases has to be safe, quick, efficient and cost-effective. Minimally invasive cardiac procedures if used judiciously in the correct subset of patients, can reduce the length of stay and offer good quality of life in otherwise in-operable patients.

How can we increase the penetration and reach of such technologies in rural areas? 

In most rural areas across India, the awareness of cardiac diseases, early diagnosis and the availability of quality treatment is very limited. The government must partner with healthcare providers to set up cardiac care centers in rural areas. Cardiac camps conducted in  rural areas can improve in the early diagnosis.  Educating patients can also increase the awareness of  heart disease.

• Experts in the field of minimal invasive cardiology/cardiac surgery must be encouraged and incentivized to teach junior doctors and perform such procedures under supervision in  smaller towns.
• Governmental and private health insurance schemes must help to cover the costs of such procedures.

What according to you is the need of the hour as far as achieving affordable and accessible healthcare is concerned? How crucial is the role of ‘Make in India’ in this direction?

Reducing the cost of healthcare delivery, especially these minimally invasive procedures is needed.  For this to happen, the software and hardware equipments, catheter, instruments, valves etc  used  in these procedure should be manufactured and produced in India itself.  This will effectively make these procedures affordable and accessible to needy patients across the country.

It will also give a boost to the biomedical/pharmaceutical/medical devices manufacturing sectors in our country and help to improve our Indian economy.