Purshotam Lal | |
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Born | 1954 (age 69–70) Moga, Punjab |
Nationality | Indian |
Education | MD, AB (USA), FRCP (C), FACM, FICC, FACC, FSCAI (USA), D. Sc (hc) |
Alma mater | Government Medical College, Amritsar |
Occupation | Cardiologist |
Known for | Interventional Cardiology |
Purshotam Lal is an Indian Interventional cardiologist who has to his credit the pioneering of over 20 interventional cardiology procedures for the first time in India, some of which were the first time in the World. [1] [2] Trained in UK, US and Germany, and he has held various faculty positions including Professor, Advisor, etc.
He has the unique distinction of pioneering the highest number of procedures in the field of interventional cardiology for the first time in the country, such as Slow Rotational Angioplasty, atherectomy, rot ablation, stenting, heart hole closure (ASD Closure), [3] etc. He has developed his own techniques for aortofemoral bypass support [4] (partial artificial heart) and the opening of tight heart valves using echocardiography without a cath lab. He performed world's first non-surgical aortic valve replacement using Core Valve. He has been invited by countries such as Italy, Germany and China to present the first care of Transcatheter Aortic Valve Implantation (TAVI) using the COREVALVE. Additionally, he introduced Inuoe Balloon Mitral Valvuloplasty in the country and was the first investigator. [5]
He presented and published scientific papers on all these new techniques for the first time in the country & these were published in Indian Heart Journal. He has been monikered as Father of Interventional Cardiology in India by Adnan Kastrati, Chief Physician and Deputy Director, Cardiovascular Disease Clinic, DHM, Germany for introducing all these techniques in the country. He is a highly decorated interventional cardiologist, having received the highest of Padma Awards - Padma Vibhushan, [6] along with Padma Bhushan and the Dr. B. C. Roy Award [7] by the President of India for his contributions in the development of Interventional Cardiology in India. Additionally, he has been honoured with the Distinguished Achievement Award of the Highest Order by the National Forum of Indian Medical Association for performing the largest number of angioplasties/stentings in the country as a single operator. [8]
He was also recognised by Hans Bonnier, [9] one of the first interventional cardiologists in the world, who congratulated him for his skills & achievements for doing the highest number of angioplasties in the country and was impressed with his endeavour to provide affordable healthcare to poor patients without compromising quality of healthcare delivery. He added that, his hospital model should be adopted by other hospitals as well. [10]
Lal was born in 1954, in a small village of Firozpur District, Punjab, India. He got his early education in his village where there was no electricity. He completed his pre-medical education at DAV College, where he was inducted into the Hall of Fame as on of 80 distinguished alumni in the college's 100-years history. He pursued his medical degree from Medical College, Amritsar and was national merit scholarship holder. After finishing his MBBS from Amritsar, he went to United States in 1977 for further studies.
Lal aimed to share his expertise with his fellow countrymen and spent time at Apollo Hospital, Chennai, where he introduced several cardiology techniques for the first time in India. In 1996, he returned to India as the Coordinator of the Department of Cardiology at Apollo Hospital, Delhi. In 1997, with the mission of providing affordable healthcare to low- and middle-income patients, he established the Metro Heart Institute.
He developed multiple hospitals at the doorsteps of the lover-middle class people, after leading flourishing career at US, with the mission that "no patient should ever be returned for want of money". Lal has been an advocate against the commercialisation of medical services in India, particularly when it negatively impacts access for lower-income individuals, particularly of rural areas. In recognition of his contributions, he was named the "Creator of Affordable Healthcare" by prestigious healthcare magazine Express Healthcare.
Further to achieve his goal of creating medical facilities in the rural areas, he joined Medical Council of India as Board of Governors for two years & developed three-point formula to make specialists to go to villages. Since he lost his father in his 40's due to non-availability of doctors in the village, this always been his goal to find out the ways where the specialists have to spend time in the village.
But so far he has not been successful in this particular mission, probably it requires some changes in government policies.
He is certified by the American Specialty Board, he has been a fellow of American College of Cardiology, Society for Cardiovascular Angiography and Interventions (USA), American College of Medicine, Royal College of Physicians (Canada), Indian College of Cardiology and British Cardiovascular Intervention Society (BCIS). He is also a member of German Centre for Cardiovascular Research. Lal earned a Doctor of Science degree by Rajasthan University of Health Sciences.
He got involved in the development of various new procedures in the field of interventional cardiology, as an alternative to open heart surgery. He has held the position of assistant clinical professor & attending physician at Michigan State University and Cornell Medical Centre USA, respectively in the Department of Interventional Cardiology. He was also the visiting consultant in UK & Germany where he was involved with advanced interventional cardiology techniques under the guidance of Professor Kaltenbach, including long-wire and slow rotational angioplasty techniques. He has also been appointed as a professor and advisor in the department of interventional cardiology at Rajasthan University of Health Sciences [11] and has served as an honorary professor and member of the National Advisory Board at Jaipur National University Institute for Medical Sciences and Research Centre.
Lal has been at the forefront of cardiac innovations in India, performing several landmark procedures such as the first slow rotational angioplasty, coronary atherectomy, and non-surgical closure of atrial septal defects. His contributions have paved the way of advanced, minimally invasive treatments, significantly improving outcomes for patients with complex cardiovascular conditions.
Angioplasty, also known as balloon angioplasty and percutaneous transluminal angioplasty (PTA), is a minimally invasive endovascular procedure used to widen narrowed or obstructed arteries or veins, typically to treat arterial atherosclerosis.
Aortic stenosis is the narrowing of the exit of the left ventricle of the heart, such that problems result. It may occur at the aortic valve as well as above and below this level. It typically gets worse over time. Symptoms often come on gradually with a decreased ability to exercise often occurring first. If heart failure, loss of consciousness, or heart related chest pain occur due to AS the outcomes are worse. Loss of consciousness typically occurs with standing or exercising. Signs of heart failure include shortness of breath especially when lying down, at night, or with exercise, and swelling of the legs. Thickening of the valve without causing obstruction is known as aortic sclerosis.
Restenosis is the recurrence of stenosis, a narrowing of a blood vessel, leading to restricted blood flow. Restenosis usually pertains to an artery or other large blood vessel that has become narrowed, received treatment to clear the blockage, and subsequently become re-narrowed. This is usually restenosis of an artery, or other blood vessel, or possibly a vessel within an organ.
Interventional cardiology is a branch of cardiology that deals specifically with the catheter based treatment of structural heart diseases. Andreas Gruentzig is considered the father of interventional cardiology after the development of angioplasty by interventional radiologist Charles Dotter.
Andreas Roland Grüntzig was a German radiologist and cardiologist, with foundational interest, training and research in epidemiology and angiology. He is known for being the first to develop successful balloon angioplasty for expanding lumens of narrowed arteries. He was born in Dresden.
A catheterization laboratory, commonly referred to as a cath lab, is an examination room in a hospital or clinic with diagnostic imaging equipment used to visualize the arteries of the heart and the chambers of the heart and treat any stenosis or abnormality found.
Aortic valvuloplasty, also known as balloon aortic valvuloplasty (BAV), is a procedure used to improve blood flow through the aortic valve in conditions that cause aortic stenosis, or narrowing of the aortic valve. It can be performed in various patient populations including fetuses, newborns, children, adults, and pregnant women. The procedure involves using a balloon catheter to dilate the narrowed aortic valve by inflating the balloon.
Percutaneous coronary intervention (PCI) is a minimally invasive non-surgical procedure used to treat narrowing of the coronary arteries of the heart found in coronary artery disease. The procedure is used to place and deploy coronary stents, a permanent wire-meshed tube, to open narrowed coronary arteries. PCI is considered 'non-surgical' as it uses a small hole in a peripheral artery (leg/arm) to gain access to the arterial system; an equivalent surgical procedure would involve the opening of the chest wall to gain access to the heart area. The term 'coronary angioplasty with stent' is synonymous with PCI. The procedure visualises the blood vessels via fluoroscopic imaging and contrast dyes. PCI is performed by an interventional cardiologists in a catheterization laboratory setting.
A drug-eluting stent (DES) is a tube made of a mesh-like material used to treat narrowed arteries in medical procedures both mechanically and pharmacologically. A DES is inserted into a narrowed artery using a delivery catheter usually inserted through a larger artery in the groin or wrist. The stent assembly has the DES mechanism attached towards the front of the stent, and usually is composed of the collapsed stent over a collapsed polymeric balloon mechanism, the balloon mechanism is inflated and used to expand the meshed stent once in position. The stent expands, embedding into the occluded artery wall, keeping the artery open, thereby improving blood flow. The mesh design allows for stent expansion and also for new healthy vessel endothelial cells to grow through and around it, securing it in place.
Sri Jayadeva Institute of Cardiovascular Sciences and Research (SJICR) is a tertiary care autonomous healthcare institute run by the Government of Karnataka, in Bengaluru, with additional centers in Mysuru and Kalaburagi. At the Bengaluru campus, it presently has 1150 in-patient beds for cardiology, cardiothoracic surgery and pediatric cardiology, spread over two twin eight story buildings and is considered one of the largest dedicated heart hospitals in Asia. This new building which was opened in 2001 and was built at a cost of US$17 million.
The history of invasive and interventional cardiology is complex, with multiple groups working independently on similar technologies. Invasive and interventional cardiology is currently closely associated with cardiologists, though the development and most of its early research and procedures were performed by diagnostic and interventional radiologists.
Lourdes Heart Institute and Neuro Centre (LHINC) is a new block set up in Lourdes Hospital, Cochin, Kerala, India, to cater to tertiary level care for the entire spectrum of cardiovascular and neurological disease. It was inaugurated on 16 March 2007, by Mr. A. K. Antony, the Defence Minister of India. This institute was started to meet a long-felt need to provide cardiac and neurological interventional facilities, and especially to provide interventional neurological facilities for the treatment of strokes, including selective thrombolysis and primary angioplasty for stroke which was hitherto unavailable in this part of India.
A hybrid cardiac surgical procedure in a narrow sense is defined as a procedure that combines a conventional, more invasive surgical part with an interventional part, using some sort of catheter-based procedure guided by fluoroscopy imaging in a hybrid operating room (OR) without interruption. The hybrid technique has a reduced risk of surgical complications and has shown decreased recovery time. It can be used to treat numerous heart diseases and conditions and with the increasing complexity of each case, the hybrid surgical technique is becoming more common.
Mathew Samuel Kalarickal is an Indian cardiologist widely known as the father of angioplasty in India. He specializes in coronary angioplasty, carotid stenting, coronary stenting and rotablator atherectomy.
Ashok Seth is an Indian interventional cardiologist, credited with the performance of over 50,000 angiograms and 20,000 angioplasties, which has been included in the Limca Book of Records, a book for achievements and records from an Indian perspective. He is a Fellow of the Royal Colleges of Physicians of London, Edinburgh and Ireland and serves as the chief cardiologist, holding the chairs of the department of cardiovascular sciences and cardiology council at the Fortis Healthcare. Seth, a recipient of the Order of Isabella the Catholic, was honored by the Government of India with the fourth highest Indian civilian award of Padma Shri, in 2003, followed by Padma Bhushan, the third highest Indian civilian award, in 2015.
Tejas M. Patel is a cardiologist from Ahmedabad, India and chairman and chief interventional cardiologist at Apex Heart Institute, Ahmedabad. Patel, who has received the Dr. B. C. Roy Award, the highest Indian medical award, was honoured by the Government of India in 2015 with the Padma Shri, the fourth-highest Indian civilian award. In 2024, he was further recognized with the Padma Bhushan, the third-highest civilian award of the Republic of India, for his outstanding contributions to cardiology.
Alain Cribier, FACC, FESC was a French interventional cardiologist, Professor of Medicine and Director of Cardiology at the University of Rouen's Charles Nicolle Hospital. Alain Cribier was best known for performing the world's first transcatheter aortic valve implantation in 2002, first transcatheter mitral commissurotomy in 1995, and first balloon aortic valvuloplasty in 1986.
Donald S. Baim was a researcher and clinician in the field of interventional cardiology. Baim's primary research focused on coronary blood flow, catheter intervention in heart disease, and congestive heart failure. His work helped to shift the use of catheters from a purely diagnostic tool to a therapeutic tool. After receiving a medical degree from Yale and initial medical training, residency and a fellowship at Stanford University Medical Center, Baim spent the bulk of his career at Beth Israel Hospital and at the Brigham and Women's Hospital in Boston. In 1993, Baim founded the Beth Israel Hospital's Cardiovascular Data Analysis Center (CDAC) -- later to be named Harvard Clinical Research Institute (HCRI). Baim died of cancer in November 2009. In October 2016, HCRI changed its name to the Baim Institute for Clinical Research.
Transcatheter pulmonary valve replacement (TPVR), also known as percutaneous pulmonary valve implantation (PPVI), is the replacement of the pulmonary valve via catheterization through a vein. It is a significantly less invasive procedure in comparison to open heart surgery and is commonly used to treat conditions such as pulmonary atresia.
Samin K. Sharma is an American philanthropist of Indian descent and an interventional cardiologist who co-founded the Eternal Heart Care Centre and Research Institute in Jaipur (EHCC). Sharma has served on New York State’s Cardiac Advisory Board since 2004. As of 2021, he is Senior Vice-President, Operations & Quality at The Mount Sinai Hospital in New York and runs the Dr. Samin K. Sharma Family Foundation Cardiac Catheterization Laboratory. As of 2018, he is Chairman Board of Trustees, Association of Indians in America (AIA). As of 2022, he has been an investigator on 86 grants and multi-center trials and authored 486 peer-reviewed articles that have been cited 21,734 times.