Q&A with Dr. Yuriy Pya, Chairman of the Executive Board of University Medical Center, Kazakhstan

Best known internationally for leading the world’s first implantation of a fully artificial heart (CARMAT) in 2017 — a landmark achievement that positioned Kazakhstan among global leaders in cutting-edge transplant medicine — Dr Yuriy Pya stands as one of the world’s foremost cardiac surgeons and a pioneer of advanced heart surgery in Central Asia.

Under his leadership, the UMC Heart Center has achieved a series of national and regional milestones, including Kazakhstan’s first heart transplant (2012), first lung transplant (2016), and first fully implantable left ventricular assist device (2018).

In this exclusive Q&A with HealthTechAsia, Dr Pya discusses innovations in cardiac care — from the integration of AI to international collaborations — and shares his vision for the future of heart surgery.

What is the current scale of the cardiovascular disease burden in Kazakhstan, and how is your team responding through cardiac care initiatives?

Cardiovascular disease remains the leading cause of death not only in Kazakhstan but worldwide. What is particularly concerning is that the disease is becoming ‘younger’—we are seeing more patients in their thirties and forties presenting with serious heart conditions, driven by lifestyle risk factors such as stress, smoking, diabetes, and sedentary habits.

At the Heart Center of the University Medical Center, we constantly strive to improve cardiac care by introducing the latest surgical techniques, technologies, and treatment protocols. Each year, our team performs thousands of complex procedures, including transplants and minimally invasive surgeries, ensuring access to world-class care within Kazakhstan.

Equally important is prevention. We actively promote cardiovascular health through community screenings and public education. Our specialists regularly deliver Basic Life Support trainings to diverse groups—from schoolchildren and university students to employees of banks and participants at large sporting events. This not only saves lives but builds a culture of awareness and preparedness across society.

Looking ahead, we are committed to further expanding prevention and early detection programs, strengthening regional cardiac care, and exploring digital health tools to ensure that people across Kazakhstan—especially in rural areas—receive timely and effective help. Our ultimate goal is to reduce premature mortality from heart disease and improve the quality of life for our citizens.

Could you share recent innovations in cardiac surgery that have significantly improved outcomes or expanded access?

Innovation has always been at the core of our work, because every advancement translates directly into lives saved and improved. The most advanced technologies introduced at our Center are heart transplantation and the use of left ventricular assist devices (LVADs).

Although we have been performing these procedures for more than ten years, they still remain among the most innovative and complex technologies in cardiac care worldwide. They have transformed the treatment of end-stage heart failure, giving patients not only a chance to live longer, but to return to an active, fulfilling life.

In recent years, we have also adopted transcatheter aortic valve implantation (TAVI)—a minimally invasive alternative to open-heart surgery for patients with severe aortic stenosis. TAVI significantly reduces surgical risk, shortens recovery time, and makes advanced care available to patients who previously had limited treatment options.

All these technologies—heart transplantation, LVADs, and TAVI—have greatly improved patient outcomes and survival rates.

Importantly, we are now working to expand access by transferring these advanced techniques to our subsidiary hospital in Shymkent and our partner institution in Almaty. This ensures that patients across Kazakhstan can benefit from the same high standards of care, without the need to travel long distances to Astana.

Your facility is now ranked among the world’s top 22 cardiac surgery clinics. What do you believe sets it apart – from clinical outcomes to patient experience?

Our greatest strength lies in our people. At the Heart Center, an interdisciplinary team of cardiac surgeons, cardiologists, anesthesiologists, perfusionists, nurses, and rehabilitation specialists work as one unit—sharing expertise, analysing outcomes, and learning from every case. This close collaboration enables us to achieve excellent results even in the most complex surgeries.

Equally important is our commitment to education and continuous professional growth.

We constantly upgrade our own knowledge, introduce the latest international practices, and actively train the next generation of specialists. Our Center regularly hosts masterclasses, workshops, and fellowships, sharing experience with colleagues from regional hospitals across Kazakhstan to strengthen the national cardiac care system as a whole.

We also place a strong emphasis on research and innovation. Our scientific work and clinical outcomes have earned recognition from many leading hospitals and medical institutions around the world, opening doors for new collaborations and joint projects.

Another defining factor is our dedication to maintaining the highest standards of safety and quality. We were the first institution in the post-Soviet region to receive Joint Commission International (JCI) accreditation as an academic medical center—an acknowledgment of our integrated approach to care, education, and research.

And finally, we place great attention on the patient experience. Beyond clinical excellence, we strive to create an atmosphere of comfort and calm. Our nurses and staff continually improve their communication and empathy skills to better understand patients, provide reassurance, and ensure that compassion and respect remain at the heart of everything we do.

Are you currently integrating advanced technologies – such as robotics or AI – into cardiac surgery?

In cardiac surgery, the use of robotics and AI is still emerging, but we are actively implementing advanced digital technologies to enhance the precision, safety, and quality of our operations.

One of our key initiatives is the Digital Operating Room project, which is transforming how surgeries are performed and analysed across UMC. These next-generation operating rooms are equipped with multiple cameras that capture every stage of the procedure from different angles. The video data is not only stored but also used for training young specialists and for analytical review to improve surgical processes.

AI plays an important role—it analyses each stage of the operation, learns from accumulated data, and provides new insights to enhance surgical accuracy and efficiency. The system also automatically tracks surgical instruments, sponges, and other materials to ensure that every item used during the procedure is accounted for, significantly improving patient safety.

Another project focuses on the digital tracking and management of medical instruments. Developed in-house at UMC, this system monitors every step of an instrument’s life cycle—from storage and sterilisation to delivery and use in the operating room. Integrated AI algorithms analyse utilisation patterns, predict demand, optimise logistics, and prevent errors or losses, creating a fully transparent and safe workflow.

Beyond the operating room, UMC is implementing AI in diagnostic and research projects. As part of a research project, we trained the Cogna Medical Imaging Platform, an advanced system for accurate and rapid diagnosis of lung diseases. The platform was tested on our extensive archive of CT and X-ray images and integrated with our PACS system to enable real-time application in clinical practice.

We are also running a project focused on the early detection of cardiovascular disease. Using data from our laboratory information system along with the patient age, sex, and certain blood test results, we trained an AI model that can now automatically highlight individuals at high risk of heart disease.

All these initiatives reflect our broader vision: to build a digital ecosystem where AI supports doctors in making faster, more accurate decisions—enhancing both patient safety and clinical excellence.

How do you envision the role of AI evolving in surgical practice over the next decade, and what are the most pressing challenges you face in deploying it?

AI is undoubtedly the future of medicine. In cardiac surgery, AI has the potential to transform every stage of care — from early disease detection and surgical planning to postoperative monitoring and long-term follow-up. Machine-learning algorithms can already analyse imaging and clinical data far more rapidly than humans, helping clinicians make faster and more precise decisions.

In the coming decade, I see AI becoming an essential assistant to the surgeon — optimising perfusion parameters, predicting complications in real time, and supporting decision-making during complex procedures. It will also play a growing role in training and simulation, allowing young surgeons to practice on virtual models that replicate real physiological conditions.

However, the integration of AI into surgical practice comes with serious challenges. One is ensuring data quality and interoperability — algorithms are only as good as the data they are trained on. Another is maintaining the balance between technology and human judgment: no algorithm can replace the intuition, responsibility, and compassion of a skilled clinician. We must also address ethical and legal issues, such as patient data protection and accountability for AI-assisted decisions.

At the Heart Center, we are actively exploring digital solutions that enhance surgical precision and patient safety. Our vision is not to replace the surgeon, but to empower the entire medical team with intelligent tools that make care safer, faster, and more personalised.

Can you share examples of international partnerships that have accelerated Kazakhstan’s cardiac care capabilities?

International collaboration has been fundamental to our progress. From the very beginning, we have built strong partnerships with leading institutions in the United States, Israel, and across Europe. These collaborations have enabled our doctors, nurses, and perfusionists to train in world-renowned hospitals, gaining exposure to best practices and the latest innovations in cardiac surgery and perioperative care.

We also work closely with major European centers in research—particularly in areas such as left ventricular assist devices (LVAD) and total artificial heart technology. Our participation in international multicenter clinical trials allows us to contribute to global scientific progress while offering our patients access to advanced therapies that meet the highest international standards.

Another important dimension is our collaboration with global medical-device manufacturers. Many of them recognise our Center as a regional hub of excellence and send physicians from India and other countries to Astana for hands-on training in advanced cardiac technologies.

These partnerships not only accelerate innovation within Kazakhstan but also position our Heart Center as an active contributor to the international cardiac-surgery community—sharing expertise, advancing research, and shaping the future of heart care together.

What lessons can other emerging health systems learn from Kazakhstan’s cardiac care journey?

The most important lesson for any organisation and its leaders is to believe in your team and stay true to your mission, no matter the challenges. When we began this journey, we faced many obstacles—limited resources, lack of experience, and skepticism. But our commitment to improving cardiac care in Kazakhstan kept us moving forward. Persistence and a shared sense of purpose made all the difference.

Another lesson is that whatever you do, you must do it to the highest standard. Quality cannot be compromised. Every protocol, every procedure, and every patient interaction should reflect professionalism and responsibility.

Continuous learning is also essential. Medicine evolves rapidly, and we must evolve with it—through training, international collaboration, and active participation in research. These are the foundations of sustainable progress.

And finally, always put patients first. The UMC Heart Center’s slogan has always been ‘Patient First’, this is not just a motto—it is our guiding principle. Every decision, every innovation, and every effort begins with one question: what is best for the patient?

That philosophy has guided us from the very beginning, and it continues to shape everything we do.