A Conversation with Ashok Seth, FRCP, FACC, FESC, FSCAI, DSc, DLitt
In this issue, Dr. Bhatt talks with Ashok Seth, FRCP, FACC, FESC, FSCAI, DSc, DLitt, chairman of the Fortis Escorts Heart Institute in New Delhi and chairman of the cardiology council at the Fortis Group of Hospitals.
During the past 27 years, Seth has pioneered many angioplasty techniques worldwide and in India and the Asia Pacific region, most recently bioresorbable stents. Moreover, Seth has trained more than 350 cardiologists from India and abroad in the advanced techniques of angioplasty. He was vice president of the Asian Pacific Society of Cardiology, a past president of the Cardiological Society of India and a past member of the Society for Cardiovascular Angiography and Interventions Board of Trustees. He is also the founder and a board member of the Asia Pacific Society of Interventional Cardiology and course director of INDIA LIVE and Asia BRS Summit. Among many other national and international honors, he was awarded the Padma Bhushan by the president of India in 2015 and the Officer’s Cross of the Order of Isabella the Catholic by King Juan Carlos I of Spain in 2010.
Have you ever been fortunate enough to witness or have you been part of medical history in the making?
Dr. Seth: In 2004, I met the French surgeon Jacques Seguin, MD, PhD, who invented the CoreValve (Medtronic) and wanted to start the “first-in-man” study. I did animal implants with him in Paris. The first-ever TAVR with CoreValve (in a patient with aortic regurgitation) was done with me at the Fortis Escorts Heart Institute in September 2004 in a patient with aortic regurgitation as part of the first-in-man study. It was truly miraculous to see severe aortic regurgitation disappear as the valve went into position and started functioning for the first time ever in a human, and the patient did OK. It was an exciting and memorable experience, the first successful human implant, which has transformed the treatment of aortic valve disease and 12 years later has become the standard of care for elderly patients with severe aortic stenosis, with more than 150,000 implants. It clearly was a great moment in history that seemed a miracle 12 years ago.
What has been the greatest challenge of your professional career thus far?
Dr. Seth: The biggest challenge of my professional career was doing my father’s angioplasty. At the age of 84 years, my father started having troublesome angina. I, therefore, performed his angiogram, and he turned out to have complex and calcified severe multivessel disease. At that moment, all within a span of 10 minutes, I had to make a decision of doing his angioplasty myself on the table, as I felt that I could perhaps do it with the greatest safety and results. I did not even reveal to my mother and sisters the seriousness of the case, blanked myself out and did rotational atherectomy and multiple stenting, which took 2 hours. The procedure was successful, and once I finished I was so overwhelmed that the procedure had ended safely, the energy suddenly drained out of me. In that emotionally drained moment I fumbled with the Perclose device and failed to seal his groin puncture and had to press it for the next 3 hours. My father recovered well and continues to remain well, even now at the age of 92 years.
What are your hobbies outside of practicing medicine?
Dr. Seth: I have enjoyed scuba diving over the past many years and try my best to have at least two diving holidays a year. I have dived at some of the best sites in the world. Spending time underwater immerses me in a different, beautiful and peaceful world; it is like meditation. My other hobby is singing. I formally learnt to sing from a music teacher and even held a concert in Delhi, India, 6 years ago attended by the “who’s who” of Delhi. More recently, I haven’t had time to practice, but will get back to it soon.
What’s up next for you?
Dr. Seth: I am looking at transforming the delivery of cardiac care in India through “frugal innovations.” India is the capital of CAD and MI and we need to move much further ahead by making the cost of advanced care affordable to the common man in this country of 1.2 billion people. First, I aim to bring down the cost of advanced cardiac therapy for the people of India by opening up low-cost cardiac centers throughout the smaller cities in India — basic centers providing quality care and moderately advanced procedures at the patient doorstep. Second, I am also enabling indigenous development and trials on the present-generation therapies and devices, like bioresorbable stents and percutaneous aortic valves, to be produced in India at a much lower cost than imports. Third, we are getting into Internet and tele-technology to create a centralized e-ICU in Delhi to monitor and treat numerous critical care patients in small hospitals throughout India where there is a dearth of critical care specialists, thus providing lifesaving expertise at a low cost.
Who has had the greatest influence on your career?
Dr. Seth: Professionally, I would say that I was most influenced by Geoffrey O. Hartzler, MD, who I saw perform angioplasty at a course in Kansas City in 1987. I was impressed by his skills; his ability to do complex multivessel balloon angioplasty; his ability to get wires to any part of the coronary anatomy; his ability to innovate; his meticulous attention to data archival and analysis; and his focus and belief in the procedure. He not only pushed boundaries, but also taught others to do so safely. He became my professional role model. On a personal front, my belief of being focused, passionate, compassionate and ethical has been the biggest influence in my career for its success. For innovations, I am tremendously influenced by John Simpson, MD, PhD, and my friend Alain Cribier, MD. For academics and research, I have been truly influenced by Martin B. Leon, MD and Gregg W. Stone, MD. On a personal front, my belief in being focused, passionate, compassionate and ethical has been one of the biggest contributors to my success.