Towards a regional and national cardiothoracic biobank in India: translating a Dutch model to address a poorly characterised disease burden.

Cardiothoracic disease in India presents earlier and against a different biological background than in the high-income populations from which most evidence and guidelines derive. Coronary disease occurs about a decade earlier in South Asians; rheumatic heart disease remains endemic, with India carrying a quarter to a half of the global burden; and acute type A aortic dissection presents in the mid-to-late forties, with a higher reported proportion of connective-tissue disease than Western registries. The biological substrate of these conditions in Indian patients is largely uncharacterised, and South Asian populations are underrepresented in the datasets driving precision cardiovascular medicine. We argue that a prospectively designed, ethically governed cardiothoracic biobank, collecting surgical tissue, blood and longitudinal clinical data at operation, is foundational national research infrastructure, and we describe what it can deliver, a transferable Dutch model (the IHLCN biobank), an ethical governance and data-transfer framework, and a phased regional-to-national path.