What is India Valves Registry and why is it a landmark for heart patients?

For decades, when a heart valve failed—be it from narrowing or leaking—open-heart surgery was the only solution. Then came a transformation. Doctors learnt how to repair valves through catheters, often without opening the chest.

India has been performing transcatheter valve procedures since 2011, but it has never had a continuous national record of who underwent them, which devices were used, what complications occurred and how patients fared over the years.

Enter the India Valves Registry. “Structural therapies, which include multiple interventions in aortic, mitral, tricuspid and pulmonary valves, are increasing,” says Dr G. Sengottuvelu, interventional cardiologist and clinical lead of structural heart interventions, Apollo hospitals, and the founder and course director of India Valves Registry. “Earlier, it started with one valve, but it is growing tremendously. Particularly TAVI (transcatheter aortic valve implantation) procedures are quite high; we are doing almost 5,000 to 6,000 procedures a year. But currently we have one NIC (National Intervention Council) registry. That is an overall registry for all interventional procedures. We don’t have a dedicated valve registry.”

Vice President C.P. Radhakrishnan launched the registry in Chennai on September 5. It is being positioned as India’s first continuing national record of transcatheter valve therapy. It is a clinician led, multi-centre initiative to collect standardised data on valve interventions and follow patients longitudinally.

The idea might sound administrative, but it could have profound implications for clinical decision-making, medical research, device surveillance, health care policy and, ultimately, the patient sitting across the table from a cardiologist.

The registry will be a permanent record, beginning with TAVI and M-TEER (mitral transcatheter edge-to-edge repair) procedures, and expanding to others later. At present, the registry has 45 participating centres, 49 registered investigators and representation from 16 states.

“Beyond education and clinical practice, India Valves Registry seeks to foster multidisciplinary collaboration and strengthen India’s contribution to global structural-heart research,” says Sengottuvelu. “Through multi-centre research, scientific exchange and the development of India-specific clinical insights, the registry will support more equitable, evidence-based and cost-conscious approaches to advanced valve therapy.”

Without a national denominator, it is difficult to know the true incidence of complications, differences in outcomes between centres, geographical access, long-term durability or how Indian patients compare with populations on whom many international recommendations are based. “The registry argues that Indian TAVI patients tend to be younger than patients in Europe and North America, and that Indian practice encounters a greater prevalence of bicuspid aortic valves, smaller annular dimensions and rheumatic disease, including post-rheumatic mixed-valve disease,” says Sengottuvelu. “This registry is particularly important because the Indian patient may not fit neatly into the western template.”