Interventional Cardiology is an advanced branch of heart care. Patients with heart diseases can avoid surgery and choose this method of treatment. Under this, doctors can treat a heart condition by using a catheter (a thin tube) without doing surgery. If you are scared of huge cuts, stitches and a pool of blood, then interventional cardiology is one option to treat heart diseases.
We interacted with Dr. Praveen Chandra, Chairman of Interventional Cardiology and Structural Heart Cardiology at Medanta Hospital Gurgaon. Read on to know more about this type of heart care.
Basics of Interventional Cardiology
Ques 1. What are the most common procedures under this speciality?
Ans. The commonest procedures done under interventional cardiology are angioplasty, stenting and ballooning of the valves. Additionally, procedures for the replacement of the valves have now come up in a very considerable way. The replacement of valves through intervention is known as the TAVR procedure.
We also do pacemaker implantations and RF ablations. Treatments of the congenital problems of the heart are also being done now. Congenital means that some patients have problems like holes in their hearts, since birth. All of these can now be treated by interventions.
Ques 2. What risks are involved in treating a patient using a catheter-based method?
Ans. The catheter-based treatment methods have become very safe. Earlier, there used to be a chance of emergency operation or a patient suddenly developing some rupture of the arteries. However, now these procedures have become very safe and reliable. I will say that the safety angle is very good. The chances of having a complication are less than 1%.
Ques 3. What is the future of interventional cardiology in India? Will it expand and eventually minimize the need for cardiac surgeries?
Ans. Yes, interventional cardiology has been expanding and increasing its treatment options over the last several years. Now many patients are being treated by interventions rather than by surgery. We expect that in the coming years, interventional cardiology is going to further expand. And 90% of the heart patients will be treated by interventions, which mean no surgery, no cut, and no stitch.
Ques 4. What challenges do you face in terms of treatment and patient education?
Ans. Right now, I would say that the challenges are few, not many. The main challenges posed are regarding the cost of the treatment. The interventions that we do cost approximately a lakh or two lakhs. This amount is quite significant for many people in India. So the cost is one of the concerns. But this aspect is being addressed increasingly in the last few years.
The costs are being cut down so that more patients can be treated. As time progresses, many patients who were left untreated will now be treated by the interventions.
Ques 5. You have the credit of performing the first percutaneous aortic valve implantation without surgery in India. Can you share your experience of the same?
Ans. So we started this program of aortic valve implantation or aortic valve replacement without surgery in India a few years back. I must tell you that I am so grateful and gratified that this program has taken off everywhere. Now many patients are being treated for aortic valve stenosis by this technique. It has now become very well established around the world that these patients can be treated by percutaneous valve implantation, also known as TAVI procedure.
Also, read about: TAVI – Non Surgical Alternative to Aortic Valve Replacement
Ques 6. The young adults of India lead a sedentary lifestyle that is one of the prime causes of heart diseases. What advice would you give to this population?
Ans. As we already know that heart disease is a lifestyle disease. So if you change your unhealthy lifestyle, the chance of having a heart problem or a heart attack decreases majorly. Very alarmingly in India and even in other places in the world, we are seeing younger patients coming with heart diseases.
This is all being attributed to the control of lifestyle factors like exercise, eating habits, smoking and stress. These are the few factors that have to be kept under control and moderation for good heart health. And if people eventually enjoy a fit way of living, that is they keep exercising regularly and eat well, then they relax and become less stressful too. Gradually they will be better off and so fewer heart diseases will happen.
Ques 7. Does the sub-speciality, interventional cardiology, work in an interdisciplinary manner? For instance, are there conditions that require the use of catheter-based treatment combined with surgical procedures?
Ans. As things progress, we get patients in whom one thing is better than the other and vice-versa. So we have developed a new approach which is known as the heart team approach. The heart team approach or the multi-disciplinary team approach is taken in those patients where decision making is difficult.
We don’t know several times whether a By-pass surgery would be better or angioplasty would be better. So the heart team, which comprises a cardiac surgeon and a cardiologist, sits together and makes a decision that is best for the patient.
Similarly, many times patients come to us with kidney problems, heart problems, and brain problems. So all three specialists from respective disciplines come together to make a decision as to what should be done, which procedure should be done first, and what the patient can tolerate.
So this brings the best care for the patient. And that is what we do here in Medanta Hospital Gurgaon. We have a multidisciplinary team that is used in the cases of such difficult patients.
About The Doctor
Dr Praveen Chandra is a famous Cardiologist and Chairperson of Interventional Cardiology and Structural Heart Cardiology at Medanta -The Medicity, Gurgaon. He has a rich experience of 31 years in his field.
Dr. Praveen Chandra Performed first Percutaneous Aortic valve implantation without surgery in India. He wrote over 100 articles on cardiology and reviewed a number of medical journals. In 2016, Dr. Chandra has been awarded Padam Shri for his work in Cardiology.
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