In a recent expert-led webinar organised by Meril in association with The New Indian Express under its ongoing public awareness campaign 'Treatment Zaroori Hai', leading structural heart specialists discussed the evolving landscape of valvular heart disease, the latest advances in transcatheter therapies, and the importance of timely diagnosis and collaborative care in improving patient outcomes.
As structural heart disease continues to rise in India, driven by an ageing population, increasing life expectancy, improved survival from cardiovascular illnesses, and the persistent burden of rheumatic heart disease, clinicians are increasingly managing a complex spectrum of patients. While degenerative valve disease is becoming more common among the elderly, rheumatic valve disorders continue to affect younger individuals, presenting unique challenges that demand early diagnosis, individualized treatment strategies, and multidisciplinary care.
Advancements in structural heart interventions, including TAVI (Transcatheter Aortic Valve Implantation) and TEER Clip Procedure (Transcatheter Edge-to-Edge Repair), have significantly expanded treatment options for patients who were previously considered too high-risk for conventional surgery. These minimally invasive therapies have transformed the management of complex valvular heart disease by offering safe and effective treatment options for elderly, frail, and high-risk patients, while complementing conventional surgical approaches.
The webinar brought together leading structural heart specialists who shared their insights on the evolving management of valvular heart disease, particularly aortic stenosis and mitral regurgitation, while highlighting the critical role of early diagnosis, advanced imaging, multidisciplinary Heart Teams, and personalized treatment pathways in improving long-term patient outcomes.
Dr Ajit Mullasari S, Chairman and HOD of Cardiology from the Madras Medical Mission Hospital, drew attention to the fact that India faces a unique clinical challenge, with degenerative valve disease in the elderly existing alongside rheumatic heart disease in younger patients. Improved survival following heart attacks and heart failure has also increased the burden of complex valvular heart disease, making individualized treatment strategies increasingly important. While technology has expanded treatment possibilities, he stressed that early diagnosis and timely referral continue to have the greatest influence on long-term patient outcomes.
Dr Sengottuvelu G, Interventional Cardiologist & Clinical Lead – Structural Heart Disease Program from the Apollo Hospital Group, India explained that treatment decisions today extend well beyond determining whether a patient is fit for surgery. Clinicians now evaluate symptoms, anatomy, ventricular function, frailty, co-existing illnesses, patient preferences and quality of life before identifying the most appropriate treatment strategy. He also highlighted the growing role of multidisciplinary Heart Teams, where cardiac surgeons, interventional cardiologists and imaging specialists jointly evaluate complex cases, improving procedural planning and clinical outcomes.
Dr Anantharaman R, Senior Consultant Interventional Cardiologist & Clinical Lead – Advanced Heart Failure, Cardiomyopathy, and Transplantation from Kauvery Hospital, Alwarpet, underscored that many patients continue to present late because symptoms such as breathlessness, fatigue and declining exercise tolerance are often mistaken for normal ageing. Timely echocardiography, he noted, can significantly improve patient outcomes by enabling earlier diagnosis before irreversible cardiac damage occurs.
Prof. Dr Ajith A Pillai, Professor and HOD of Cardiology from Kauvery Hospital, Radial Road, emphasized that progressive breathlessness, chest discomfort, dizziness, syncope, new-onset atrial fibrillation and heart failure symptoms should prompt immediate evaluation. While clinical examination remains essential, echocardiography continues to be the gold standard for diagnosing and assessing the severity of structural valve disease.
Dr Nagendra Boopathy S, Professor of Cardiology, Senior Interventional Cardiologist, Lead Structural Heart Disease Interventions – Sri Ramachandra Medical Centre, explained how aortic stenosis and mitral regurgitation damage the heart through different mechanisms, but ultimately lead to the same consequence if left untreated—progressive and irreversible myocardial damage. He observed that early recognition and timely intervention remain critical to preserving heart function and improving long-term survival.
The experts agreed that present-day transcatheter therapies such as TAVI and TEER Clip Procedure have expanded treatment options for elderly, frail, high-risk and multiply-ill patients, while complementing rather than replacing conventional surgery. Modern practice, they said, has moved beyond the simple question of whether a patient is fit for surgery, towards identifying the most appropriate treatment for every individual.
The second concept that emerged during the discussion was 'Lifetime Management'. As increasing numbers of younger patients undergo structural heart interventions, experts emphasized the need to look beyond the immediate procedure and anticipate future treatment requirements. Keeping future valve replacement options open and planning for the possibility of repeat interventions have now become integral to long-term patient care.
Looking ahead, the panel observed that advances in artificial intelligence, imaging technologies and structured physician training are expected to further strengthen structural heart interventions. However, they maintained that early diagnosis, timely referral, appropriate patient selection and collaborative care will continue to remain the cornerstones of successful structural heart disease management.
Reflecting on the insights shared by the expert panel, Sanjeev Bhatt, Senior Vice President – Strategy, Meril, said, "An enduring commitment to advancing healthcare solutions is the need of the hour so that more patients can live longer, healthier lives. Responding to unmet clinical needs while simultaneously acting as an agent of change is crucial. A strong focus on research and development and the manufacture of scientifically researched medical devices is key to driving progress in healthcare today. Providing next-generation, patient-centric treatment options that deliver value to healthcare stakeholders remains central to our vision."
The through line of the Treatment Zaroori Hai webinar was unmistakable: when a heart muscle has been permanently scarred by years of untreated valve disease, even the most advanced therapies have their limitations. The greatest opportunity therefore lies in recognising the disease early. In structural heart disease, the difference between recovery and irreversible decline may depend on something as fundamental—and as accessible—as getting the right scan at the right time.
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