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Hot Seat
Full of Heart
Dr Praveen Chandra (47), Chairman, Interventional
Cardiology, Medanta Hospital speaks to Rita Dutta about his years of learning
at Escorts, his reasons for leaving Max and what excites him about Medanta
 When
Dr Naresh Trehan's Medanta Medicity, the much-awaited and much talked about
health city in Gurgaon, recently opened its doors, patients welcomed it heartily
by pouring in, in large numbers. Besides the reputation of its larger-than-life
founder and immense faith in his creation, its renowned doctors attract these
patients in droves. One such leading name is Dr Praveen Chandra, Chairman of
the Department of Interventional Cardiology. Dr Chandra, whose unit performs
over 2,500 cardiac diagnostic procedures and 2,000 percutaneous interventions
each year, is responsible for setting up the entire operations and processes
for cardiac catheterisation services at Medanta.
So, one evening when I met Dr Chandra at Medanta, the first question I shot
at him was about his reasons for joining Medanta. "It has to be for Dr
Trehan, under whom I worked at Escorts and always looked up to. The other factors
are cutting-edge technology, clinical protocol and focus on training and research
at Medanta. The vision of Dr Trehan is to bring the highest level of medicare
with compassion and this is what drove me to Medanta," quips Dr Chandra
in his petal-soft voice, giving a glimpse of a humble person who still remembers
and acknowledges people who moulded his career. Soon, I discover that one of
the endearing qualities about Dr Chandra is how he holds his mentors—Dr
Trehan and Dr Ashok Seth (who now works with Fortis) — in high esteem and
often during the interview mentions how this duo had groomed him.
The Start
Dr Chandra started his professional journey in May 1985 in
King George Medical College, Lucknow as an intern. After his postgraduate training
(MD) in Internal Medicine and postdoctoral training in Cardiology (DM) from
the same college, he wanted to work in the corporate sector. While most cardiologists
preferred starting their career in either the public sector or private practice,
why did he want to join the corporate sector? "Because work in the corporate
sector is a balance giving both professional satisfaction and reasonable finances,
compared to the other two at two extremes," elucidates Dr Chandra.
Thus, in February 1992, he joined Escorts Heart Institute
and Research Centre, New Delhi as an attending cardiologist. Under the aegis
of Dr Seth and Dr Ravi Kasliwal, he says, his association with Escorts had been
the most fulfilling one. It was also fascinating for him to be a part and contribute
towards the journey of the field of interventional cardiology, which was still
at a nascent stage in the '90s. Responsible for expanding the angiography and
interventions programme of Escort, annually his group used to perform approximately
10,000 cardiac catheterisations/diagnostic angiographies and over 2,500 coronary
interventions ranging from balloon angioplasty, atherectomy, rotablator to stenting.
"We also had an active primary PTCA in acute myocardial infarction programme.
I personally performed 1,000 diagnostic procedures, and 500 of all percutaneous
interventions, including valvuloplasty, each year," he recollects.
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 Born
on 15th March, 1963 at Gorakhpur (UP), Dr Chandra's family was based there
until his 12th standard.
Hailing from a family of doctors (his grandfather
was a doctor in the army and his father a chest physician), Dr Chandra
wanted to become a doctor. The eldest among the three siblings, Dr Chandra
went to study to Carmel School. Though never a topper, he always came
within the first ten. In his childhood, he was into games like basketball
and cricket.
After the 10th standard, he was sent to Lucknow
for intermediate where he studied in boarding of Colvin Taluqdars College.
He enjoyed hostel life immensely. He remembers flouting the rules of not
stepping out of the hostel after 10 pm. "I used to throw our bicycle
over the campus wall to sneak out," says he, with his eyes twinkling
at his mischief.
He remembers no particular reason for choosing cardiology.
"I chose it at a time when it was not that popular," says he.
Family: His wife Namita, who worked as a
paediatrician before, is presently pursuing a course in public health
at National Institute of Health and Family Welfare. Their son Shiva in
the 12th standard and daughter Ishita is the 10th standard study in Sardar
Patel School in Delhi.
Travel: His favourite way of unwinding is
travelling. He has travelled across Asia and America. His favourite destinations
in India are Goa and Nainital.
Music: He loves listening to old Hindi film
music. There is no favourite artist. "Any old melodious song works
for me," says he.
Books: He is an avid reader of inspirational
books and medical fiction. His favourite books are 'Winning' by Jack Welch
and 'The Final Diagnosis' by Arthur Hailey.
Movies: He likes realistic movies. Some
of his favourite movies include 'Ardha Satya', '3 idiots' and 'Wednesday'.
Food: He loves spicy food, especially chicken-based
dishes.
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At the Forefront
Always keen on exploring new vistas, he was actively involved
in the newer devices in coronary intervention programmes, like the introduction
of directional coronary atherectomy in 1992, and rotational atherectomy in 1993.
"In 1994, we acquired the angioscope and the intravascular ultrasound,
and have been using them increasingly to aid decision-making during coronary
interventions. We were the first and only centre in India using the AngioJet
Thrombectomy Device and, in 1998, had become one of the first centres in Asia
to start the Percutaneous Myocardial Laser Revascularisation programme,"
he enthuses.
In 1995, he did an interventional fellowship, at the University
of Rouen, France. He was thrilled when Dr Trehan informed him that Escorts would
pay for his education and travel for the academics without any bond. Until 1995
Dr Chandra worked as a part of Dr Seth's team. "Later I worked independently,
but in close coordination with him. I respect Dr Seth for his interest in research
and exploring cutting edge technology. He encouraged me when I wanted to pave
my own path," he murmurs.
He also immensely enjoyed the teaching portfolio at Escorts. Teaching was not
a part of any programme or curriculum at Escorts, but just his desire to impart
the knowledge and skill of interventions. "I was responsible for supervising
and training all junior colleagues in percutaneous coronary diagnostic and therapeutic
interventions. The senior residents were formally trained by me in haemodynamic
monitoring, right and left heart catheterisation, coronary angioplasty, pericardiocentesis,
and temporary transvenous pacing. I was also responsible for training the senior
residents who are enrolled in the fellowship programme towards obtaining DNB
in Cardiology. A part of this teaching commitment involved organising regular
weekly updates and journal club meetings," says Dr Chandra, who was a visiting
consultant at Indira Gandhi Institute of Cardiology, Patna and Norvic Hospital
and Research Center, Kathmandu, Nepal. His teaching involved extensive travelling
to train cardiologists in cities like Jaipur, Bikaner, Kathmandu, Patna and
Gorakhpur to do complex procedures. "I am so glad that all of them are
doing independent work now," says he, with his lips curving into a smile.
Though he was learning and enjoying his work at Escorts,
it was a painful realisation for Dr Chandra that despite being with Escorts
for over a decade, there was a wafer-thin chance for further vertical growth
as there were many senior cardiologists vying for promotion. Thus in 2004 Dr
Chandra, who was then a senior consultant at Escorts, along with Dr Seth, who
was then head of the interventional cardiology department at Escorts, left the
premier institute to join Max.
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 He
has always been keen on doing his bit for society. He has organised and
conducted nearly 200 free heart check-ups in India and abroad. "In
the last 15 years, these camps were organised in the states of UP, Bihar,
Rajasthan, Himachal and Haryana, where advanced heart care diagnosis and
treatment were not available. In these small towns and villages, 2D Doppler,
Echocardiography, Blood Sugar and other tests were done and free medicines
were distributed to patients," he informs.
With the help of various Governmental organisations
and NGOs, he has delivered more than 250 lectures on preventive heart
care in all sectors of society. He has provided free angiography, angioplasty
and valvuloplasty to underprivileged sections of society at their doorstep.
In association with Indira Gandhi Institute of Cardiology, Patna, he has
performed over than 500 angioplasties and balloon valvuloplasties free
of cost to the people of Bihar. In association with Medical College Gorakhpur,
he performed free mitral valvuloplasty free of cost for a large number
of suffering people at their doorstep and thereby initiated the programme
where this procedure was done for the first time.
From 1994 in Jaipur and then in 2004 in Bikaner,
he initiated the advanced heart care treatment in the medical colleges
and thus far has performed hundreds of procedures free of cost in these
hospitals for the poorer section of the population. He did the first balloon
valvuloplasty and first dual chamber pacemaker implantation in Nepal.
Even in war-ravaged Afghanistan, he did free heart check-up camps at Kabul
and Mazar-e-Sharief, where more than 5,000 patients have already been
treated and underwent free colour Doppler, Echocardiography, and free
drugs were distributed. Apart from this, he has trained more than 15 doctors
from Afghanistan, free of cost, and arranged for their stay in India.
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Joys & Woes at Max
He joined Max Heart & Vascular Institute, Saket as Director
of Cardiac Cath Lab and Interventional Cardiology. However, those were the initial
years for Max and it turned out to be a big challenge for Dr Chandra. "Working
in one of the most popular heart hospitals was grossly different from working
for a brand new hospital. Max had no standing or credibility at that time. Along
with Dr Seth and my former colleagues, I sat down and discussed the nitty-gritty
and started working on almost a war footing to create this new brand in heart
care," he informs.
Then with a wide grin, he exclaims, "To our joy, things
worked out. Within six months, we were rolling and started doing excellent numbers
in just one year. We enjoyed the triumph for the next few years as our competitors
faced major setbacks at the same time which helped us." It was here that
he started using new devices like Rotarex (2006), Kensey Nash DPD (2006-07),
Impella device (2007) and orbital arthrectomy (2008), which was the first in
man study for the first time in India. "Out of these, Impella was the most
enriching experience," says Dr Chandra, who has also been involved in trials
for biodegradable polymer stent study, Beacon and Maximus study, the Neovasc
study with coronary sinus reducer and many others.
Soon, besides managing the interventional cardiology department
of Max, Saket, he was involved with the group's hospitals in Patparjung and
Pitampura. However, the bubbles of joy started bursting around the end of 2008.
"There were many organisational changes in Max which I was unhappy about,"
he says, tersely. After some prodding, he reveals, in a somber tone, "The
management wanted to change the cardiac hospital to a multi speciality hospital.
It changed its views on bottom lines and egos came in the way with doctors.
Subsequently, most of us quietly moved out, one by one." After a pregnant
pause and a long sigh, he segues, "Anyway, the experience at Max gave me
a lot of new opportunities in life to do what I wanted. Also, I wanted to work
in a bigger set-up, where I would be able to lead, so I had to move out."
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 Asked
to elaborate on some difficult cases, he first mentions a case that happened
15 years ago at Escorts. "I remember, a boy who was waiting in the
hospital for a valve surgery and suddenly he became very serious in the
ward. We rushed to the ward and immediately decided that if we do a immediate
ballooning, only then he will survive and no way would he survive for
his surgery, if we don't do anything immediately," says he. The challenge
was that this was done when this procedure was not done as an emergency
and also this patient was in Dr Trehan's surgical list. "Once Dr
Trehan agreed, we rushed him to the cath lab and did his ballooning urgently
with almost 100 per cent risk explained to the patient's family. The procedure
was finished as desired and he was discharged in a few days and still
living after 15 years of his emergency ballooning," says he.
Another case he remembers is that of a 27-year-old
computer engineer who had a massive heart attack and had a cardiac arrest
outside hospital. This happened in 2005, when Dr Chandra was with Max.
He was brought in a comatose condition and we did not know whether his
brain was working or dead. "We discussed with his parents that his
chances of survival are 10 per cent, but if we do an emergency angioplasty
and stenting, he may have a 50 per cent chance. Even if he survives, he
may remain a vegetable all his life. His parents told me that his wife
was about to deliver a child in a few days; we immediately decided to
take all chances and thought that we may give a child his father. We did
his angioplasty and he opened his eyes five days later to everybody's
joy and an unborn son got a father," he informs.
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A New Beginning at Medanta
The melancholic look quickly turns jubilant, when asked to
state the strength of his department at Medanta. "This department works
with the best of technology and equipment and has a desire to offer the latest
breakthrough technologies available in the world. We have one of the top leaders
and brains in all specialities and it is important to have such support to treat
complicated cases. I think that is the main differentiator from other standalone
heart hospitals where I worked earlier," he waxes eloquent.
The department has started a new technique of FFR which helps avoid unnecessary
angioplasty and bypass. "There are only four hospitals in India using FFR
and thus far, we have done the largest number of such cases," enumerates
Dr Chandra, who had been involved with 30 clinical trials and is currently the
principal investigator of 12 trials.
Under his aegis, a team has been formed to start the latest
technology of percutaneous aortic valve implantation in association with European
cardiologists in patients where surgery is not an option and who would die without
treatment. "Our robotic cath lab, which is known as a hybrid cath lab suite,
is the place where valve implantations are performed, and it is the only one
in Asia," he informs, adding, "The most important is that we do interventions
with compassion and personal touch."
His goal in Medanta is to take on more complex and high-risk
cases, and establish the department as a leading name in interventional cardiology.
And what is his personal ambition? "If I grow, the department also grows,"
he quips, pithily.
As a simple man, his ambitions are also simple. His wish in the coming years
is to do `more procedures', do more patient-friendly procedures and get more
recognition as a cardiologist. Way to go!
rita.dutta@expressindia.com
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