Dr A B Gopalamurugan

QUALIFICATIONS

MBBS, MRCP, MD, FRCP, CCDS, FACC

OTHER ACCREDITATIONS

EHRA accreditation (Interventional EP)
IBHRE (NASPE)
British Society of Echo. Accreditation
Certificate of Completion of Training (CCT) UK

PROFESSIONAL REGISTRATIONS

Indian Medical Council
Registration Number: 65599
Maharashtra Medical Council, Mumbai
Registration Number: 2020/12/6973
General Medical Council, UK
Full Registration
No: 5205723
British Cardiovascular Interventional Society
Member ID: 3746
European Heart Rhythm Association
Member ID: 385011

Following his under-graduation in India, he left India and undertook postgraduate training posts in the UK. He was then awarded an MD degree by University of London for his research at St.Thomas’s Hospital, London funded by the British Heart Foundation. He then trained as a cardiology specialist registrar rotating through North London hospitals and obtained formal accreditation in interventional electrophysiology and device therapy. He trained in paediatric electrophysiology at Great Ormond Street Hospital where he continues to be an honorary consultant. He obtained formal European accreditation in Interventional Cardiology and Electrophysiology. He worked as a consultant cardiologist in the UK for some years delivering a full range of cardiac services. He was one of the very few consultant cardiologists in the UK who performed coronary interventions, catheter ablations for complex arrhythmias and structural interventions. After spending 16 years in London, UK, he moved to India and is currently working as a senior consultant interventional cardiologist based at Chennai, South India where he is delivering state of the art cardiac services with a specific focus on complex cardiac interventions and electrophysiology interventions, percutaneous valves and endovascular interventions.

Dr Gopalamurugan is well known internationally and nationally as the pioneer for cutting edge interventional cardiology and transcatheter valve replacement therapy. He is the founder and course director of the country’s largest course for transcatheter valve therapies (www.indiavalves.in). To date, he has introduced the maximum number of transcatheter valve therapies to India. He has performed 3 of world’s first transcatheter valve therapies too.

RESEARCH IN CARDIOVASCULAR MEDICINE

Dr Gopalamurugan completed his research project and attained the MD degree (2006) from the University of London under the supervision of Prof J M Ritter and Prof P Chowiencyzk at King’s College London. The British Heart Foundation funded this research. In vitro studies have shown that potassium (K+) acts as an endothelial derived hyperpolarizing factor (EDHF) regulating vascular tone. He investigated the role of K+/EDHF in vivo in healthy volunteers. Methods included brachial artery cannulation and local infusion of specific inhibitors of the inwardly rectifying K+ channel. He also explored the effects of K+ intake on arterial tone and blood pressure. He has contributed to the design of this technically and intellectually demanding series of experiments and analysis of results. He received excellent feedback from the University of London who awarded him his MD degree

CARDIOLOGY SERVICES CURRENTLY DELIVERED

Dr Gopalamurugan runs a virtual heart team across India namely HeartTeam India.Through this team based approach, he currently delivers the following cardiology services

Coronary Interventions

  • 24/7 Primary angioplasty for Acute Myocardial Infarction
  • Complex coronary interventions including coronary artery graft PCI, Bifurcation
  • PCI, Alcohol septal ablation for HOCM and unprotected left main stem PCI.
  • He has a wide experience of using FFR, iFR, IVUS and OCT for intra-coronary assessments. 95% of his coronary interventions are intra-coronary imaging guided

Electrophysiology and Device therapy (Adult and Paediatric) Head of Department

  • Full range of interventional EP performing Ablations for SVT, AF, VT and VF. His department currently performs the highest number of VT and AF ablations in South India
  • Implantation of pacemaker, ICD and CRT devices
  • Explantation or extraction of devices. His department is the only department in
  • South India offering percutaneous extractions of cardiac devices.
  • Supervision of device clinics for troubleshooting device related issues

Structural Interventions (Adult and Paediatric) Head of Department

  • Assessment and planning of patients for structural interventions through MDT
  • TAVR
  • Valve-in-valve implantations for dysfunctional bioprosthesis (Mitral, tricuspid, aortic and pulmonary positions)
  • Percutaneous PFO closure, ASD closure and VSD closure
  • Percutaneous Paravalvular leak closure, LAA occlusion
  • Balloon pericardiotomy,
  • Interventional Treatment for Pulmonary Embolism/DVT
  • Percutaneous mitral repair with Mitral Clip device
  • IVC Filter implantation and explantation Paediatric Cardiac Interventions
  • Endovascular Aortic Therapies (EVAR, TEVAR). His department performs one of India’s highest number of Aortic Endovascular therapies

Education and Research

  • Train junior cardiologists in the area of complex cardiac interventions
  • Teach cardiac support staff on the concept of multidisciplinary team working and cardiac skills (Heart Team)
  • He is currently developing patient flow and registry towards a centre of excellence for percutaneous valves in South India
  • A B Gopalamurugan et al, “First-in-man proof of feasibility: PCI, TAVR and TEVAR of Aortic Arch with a hybrid approach through a Trans-caval (Cavo-aortic) access in the same procedure”, European Heart Journal, Volume 42, Issue 4, 21 January 2021, Page 357
  • A B Gopalamuruga et al. Transcatheter aortic valve implantation: Patient selection and technical considerations for the growing heart teams of India. Indian Heart Journal Interventions 2018;1:9-17
  • A B Gopalamurugan et al, “India’s First Transcatheter Mitral Valve Implantation: Mitral valve-in-valve for dysfunctional mitral bioprosthesis”, Indian Heart Journal CVCR, 10.1016/j.ihjccr. 2017.11.005
  • A B Gopalamurugan et al, “India’s first single side access EVAR device implantation: A hope for patients with poor vascular access”, Indian Heart Journal CVCR, Volume 1, Issue 2, May–September 2017, Pages 92-95
  • A B Gopalamurugan et a, “India’s First Successful ECMO Assisted TAVI: A Strategy for ‘High Risk’ TAVI patients”, Indian Heart Journal CVCR, Volume 1, Issue 1, January–April 2017, Pages 4-6
  • A B Gopalamurugan et al, “India’s First Percutaneous Tricuspid Valve Implantation: Valvein-Valve is a Treatment Option for Bioprosthetic Valve Dysfunction”, Indian Heart Journa CVCR, Volume 1, Issue 2, May–September 2017, Pages 61-63
  • A B Gopalamurugan et al, "TAVI for Aortic Regurgitation – India’s First Case with Corevalve Evolut R”, Indian Heart Journal, doi:10.1016/j.ihj.2016.03.022
  • Ganeshababu, G., Webber, M., Providencia, R., Kumar, S., Gopalamurugan, A B et al, (2016), Ventricular Arrhythmia Burden in Patients With Heart Failure and Cardiac Resynchronization Devices: The Importance of Renal Function. Journal of Cardiovascular Electrophysiology, 27: 1328-1336
  • Kumar V R, Subramaniam SB, Gopalamurugan A B, Bapu K R. Endovascular pulmonary artery inflatable balloon-induced hypotension: A novel technique for clipping giant intracranial aneurysms. Neurology India 2017;65:566-9
  • L Leung, A B Gopalamurugan et al, "The use of EKOS-catheter-directed thrombolysis in the management of extensive thromboembolism”, British Journal of Cardiology, Br J Cardiol 2015;22:(3) doi:10.5837/bjc.2015.024
  • Reinthaler M, Stähli BE, Gopalamurugan A et al, “Post-procedural arterial hypertension: implications for clinical outcome after transcatheter aortic valve implantation”, Journal of Heart Valve Disease. 2014 Nov;23(6):675-82
  • A B Gopalamurugan et al, "Is CRT Pro-arrhythmic? A Comparative Analysis of The Occurrence of Ventricular Arrhythmias Between Patients Implanted With CRTs and ICDs", Frontiers in Physiology, 2014 Sep 17;5:334, doi: 10.3389
  • A B Gopalamurugan et al, ‘Aortic Valve Regurgitation after Heterotopic Heart Transplantation: Percutaneous Treatment with TAVI’, Journal of Heart and Lung Transplantation, doi:10.1016/j.healun.2014.04.011
  • Ahsan SY, Saberwal B, Lambiase PD, Koo CY, Lee S, Gopalamurugan AB et al, A simple infection-control protocol to reduce serious cardiac device infections. Europace. 2014 Oct;16(10):1482-9. doi: 10.1093
  • A B Gopalamurugan et al, ‘Percutaneous valve-in-valve implantations: importance of knowing the effective internal diameter of bioprosthetic valves’ Heart, doi:10.1136/ heartjnl-2013-304274
  • A B Gopalamurugan et al, ‘Percutaneous Transvenous Mitral Valve Implantation’, Journal of American College of Cardiology, 2013;61(7):e143-e143
  • S. Y. Ahsan; B Saberwal; P. D. Lambiase; S. Chaubey; O. R. Segal; A. B. Gopalamurugan et al, ‘An 8-year single-centre experience of cardiac resynchronisation therapy: procedural success, early and late complications, and left ventricular lead performance’, Europace 2013; doi: 10.1093
  • A B Gopalamurugan et al, “An unusual left ventriculography of a patient presenting with ‘panic attacks’”, European Heart Journal, (2012) 33 (24): 3087.
  • Ahsan SY, Fittall MW, Gopalamurugan AB et al, ‘Left ventricular Pacing should be considered when Biventricular pacing worsens Heart Failure’, Journal of Interventional Cardiac Electrophysiology, 2012 Jan; 33(1): 37-41
  • A B Gopalamurugan et al, ‘Bilateral endophthalmitis and ARDS complicating group G streptococcal endocarditis’ The Lancet, Volume 366, Issue 9502, Pages 2062-2062.
  • A B Gopalamurugan et al, ‘Left ventricular non-compaction diagnosed by real time threedimensional echocardiography’, Heart, 2005; 91:1274.
  • A B Gopalamurugan et al, ‘Migrating Pacemaker causing an Inframammary Abscess’, European Journal of Internal Medicine, a case report, Sept 2003, Vol 14, supplement 1, S105.
  • V S Kumar, A B Gopalamurugan et al, ‘Discitis after Permanent Pacemaker Insertion’,European Journal of Internal Medicine, Sept 2003, Vol 14, supplement 1, S97.
  • A B Gopalamurugan et al, ‘An elderly man with Pancytopenia’, CME Journal of Geriatric Medicine, 2003; 5(3): 122-123.
  • H Nabwera, A B Gopalamurugan et al, ‘An unusual case of hip pain’, CME Journal of Geriatric Medicine, 2002; 4(3): 125-126
  • First in man/First in the world case of transvenous mitral valve implantation: He planned and performed the first in man transvenous mitral valve implantation in a patient with dysfunctional mitral bioprosthesis followed by hospital discharge in 48 hours with excellent follow-up data at one year. This case was published in an international cardiology journal (Journal of American College of Cardiology, 2013;61(7):e143-e143).
  • First in man/First in the world percutaneous treatment with TAVI after heterotopic heart transplantation: Patients may develop native aortic valve regurgitation leading to heart failure after heterotopic heart transplantation. No definitive treatment has been established for this complex group of patients. He performed the first in man case which involved percutaneous treatment of patent’s native aortic valve regurgitation followed by hospital discharge in 48 hours with excellent follow-up data at one year. This case was published in an international cardiac transplantation journal (Journal of Heart and Lung Transplantation, doi:10.1016/j.healun.2014.04.011).
  • First in the world TAVI for Aortic Regurgitation with a highly mobile mass attached to the aortic valve was performed on 28th November 2015. TAVI with mobile mass attached to aortic valve is a contraindication for the procedure. But this procedure that was executed on 28th November showed feasibility and safety using dedicated pre-procedural planning and special techniques for the first time. This case was published in the Indian Heart Journal in February 2016.
  • First in man/First in the world case of PCI, TAVR and TEVAR of Aortic Arch with a hybrid approach through a Trans-caval (Cavo-aortic) access in the same procedure in Feb 2020 - He planned and reformed the highly complex interventional and has been accepted for publication in Eurpoen Heart Journal
  • First in India Dedicated Percutaneous Valve Program: Dr Gopalamurugan started India’s first dedicated department for percutaneous cardiac valve therapy in April 2015 whereby this department was created to deliver all percutaneous valve therapies available including TAVI, Percutaneous Pulmonary Valve Implantation (PPVI), Mitral Clip and Valvein-valves for dysfunctional bioprosthesis. This dedicated department has its own heart team, a robust patient pathway for patients and research programme for newer technologies with world class infrastructure for such specialised therapies.
  • First TAVI in India with Medtronic Evolut R system and the First TAVI in India for Aortic Regurgitation was performed by Dr Gopalamurugan successfully in November 2015. This allowed introducing this technique for aortic regurgitation cases and also demonstrated the use of a recapturable and repositionable TAVI prosthesis. This case was attended by senior officials of the company in india and was video recorded and subsequently published in the Indian Heart Journal.
  • First in India live case recording of epicardial Ventricular Tachycardia ablation in a patient with Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) was performed by Dr Gopalamurugan in October 2015. The patient underwent successful Ventricular tachycardia ablation and was discharged home the next day. The case was recorded live with 3 cameras to demonstrate the efficacy, feasibility and complexity involved to train other physicians in India.
  • First in India 17 vector pacing system for Cardiac Resynchronisation Therapy (CRT) for end state heart failure was implanted successfully by him in June 2015 treating a patient bed ridden with end stage heart failure and discharging patient fully mobile and independent.
  • First Transcatheter Aortic Valve Implantation (TAVI) for Aortic Stenosis in South India: He performed the first TAVI in south India in June 2015 for a patient with aortic stenosis successfully.
  • First Aortic Arch Hybrid repair as an alternative for Frozen Elephant Trunk operation: Along with the Heart Team surgeon, he performed India’s first Hybrid Aortic Arch repair in March 2016 in a patient with aortic dissection. This case and its successful outcome was published in 14 Newspapers in South India.
  • First in India use of short term ECMO to retrieve a heart failure patient from the community (May 2016): Dr Gopalamurugan connected a critically sick patient in the community to an artificial heart and lung machine under local anaesthesia, shifted him to a tertiary centre along with those support machines where definite surgical terminate was performed on the patient and the patient walked home eventually. This allowed awareness of using such technologies in the community as apposed to using them in the hospital which had been the norm.
  • First in Asia dedicated Aortic Arch Endovascular Graft treatment for aortic Arch Disease (June 2016) : Along with the heart team, Dr Gopalamurugan performed Asia’s first Nexus graft procedure to treat aortic arch disease with endovascular technique.
  • First national forum for patients and physicians in India to spread awareness of Transcatheter Heart Valve Therapy namely www.indiavalves.in was created by Dr Gopalamurugan in August 2016
  • First in India Transcatheter Mitral valve Implantation. Dr Gopalamurugan and colleagues planned and performed the first mitral valve implantation without open heart surgery in 2017. This case has been published in Indian Heart Journal
  • First in India Transcatheter Tricuspid Valve Implantation. Dr Gopalamurugan and colleagues performed India’s first tricuspid valve implantation without open surgery in 2016 which was published in Indian Heart Journal
  • First in Asia Transjugular Trans-septal Mitral Valve Implantation, Dr Gopalamurugan and colleagues demonstrated this novel procedure as a live case for the first time in Asia and that a mitral valve could be implanted from trans jugular approach successfully. His case was visualised by 100s of Interventional Cardiologists at a conference in January 2018 in India
  • First in India Transcatheter Mitral Valve Implantation (TMVR) for Mitral Annular Calcification (MAC). The first successful case was planned and performed by Dr Gopalamurugan and colleagues in Hyderabad in June 2018
  • Maharashtra’s first Transcatheter Mitral Valve Replacement - Dr Gopalamurgan and colleagues performed the first successful transcatheter mitral value implantation in the state of Maharashtra in 2018 at KGD Memorial Hospital at Nagpur
  • Maharashtra’s first First Transcatheter Tricuspid Valve Replacement - Dr Gopalamurugan and colleagues performed the first successful transcatheter tricuspid valve replacement with a Bi-caval system in the state of Maharashtra at Hinduja Hospital, Mumbai in 2017
  • First in India Transcatheter Aortic Valve Implantation through a subclavian route fully percutaneously - Dr Gopalamurugan performed a fully percutaneous TAVR ever in the country at Breach Candy Hospital, Mumbai in March 2020
  • First in the World ‘Guinness World Record’ in the field of TAVR created by Dr A B Gopalamurugan and team on World Heart Day 29th September 2020 in the midst of the covid pandemic. 20 TAVR procedures were performed simultaneously across the world in 20 different centres across the globe and all 20 TAVRs were performed in less than 1 hour which was watched live by the entire medical fraternity of the Globe. All patients had a successful TAVR procedure.
  • First in India Bentall Procedure with a dedicated Bentall prosthesis Resilia Konect (Edwards Life Sciences) performed by Dr A B Gopalamurugan and team on 5th April 2021. The patient continues to do very well with excellent clinical outcomes

Achievements

FIRST IN INDIA TRANSCATHETER TRICUSPID VALVE IMPLANTATION

Dr Gopalamurugan performed India’s first tricuspid valve implantation without open surgery in 2016 which was published in Indian Heart Journal

FIRST TRANSCATHETER AORTIC VALVE IMPLANTATION (TAVI) FOR AORTIC STENOSIS IN SOUTH INDIA

He performed the first TAVI in south India in June 2015 for a patient with aortic stenosis successfully.

FIRST IN INDIA TRANSCATHETER MITRAL VALVE IMPLANTATION

Dr Gopalamurugan planned and performed the first mitral valve implantation without open heart surgery in 2017. This case has been published in Indian Heart Journal

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