Interview/ Dr Saibal Kar, director, structural heart disease interventions, Los Robles Health System, Thousand Oaks, California
India is witnessing a rapid expansion of transcatheter valve procedures. Are we ready for this transition?
Yes. There is a rapid growth in such procedures in the past one or two years. This will continue to rise because there is a significant need in this population. There are patients who have a lot of comorbid conditions. There are older patients [with] other medical problems, which make them not great candidates for surgery. Therefore, transcatheter valve therapy is an appealing option for physicians.
Cost remains a major obstacle for patients.
It is a major impediment for transcatheter therapies. Surgery is cheaper in India. But the good news is that multiple companies are developing therapies. When there is competition, the prices often come down.
What is the one question about Indian patients that you believe the India Valves Registry could answer?
We do know that the body surface area of Indian patients is smaller. Their aortas are smaller. The annulus of the valve is smaller. And so, what we can find out from these Indian registries, number one, is whether the peri-procedure complication rate is higher or lower than what it is overseas. Number two, we can test the recovery of these patients, and number three, we can test the durability of valves in these patient populations, because they’re often smaller valves, so we want to see whether these smaller valves last longer. I don’t know how long these registries are going to follow these patients. If it’s only one year, then we’ll only know the acute and medium complications, not the long-term.
