Cardiac Surgery

Heart surgery corrects several heart problems. Types of heart surgeries include coronary artery bypass graft (CABG)heart surgery application and it can fix problems in the heart valves, arteries, restore blood flow, or replace a diseased heart too.

Heart Problems

• Amyloidosis is a disease in which abnormal build up of proteins (called amyloids) in various organs in the body happens.
• Aortic disease is disorder of the aorta (the main artery that supplies blood from the heart) that can be life threatening and may include aneurysms, tears in the inner lining and penetrating ulcers.
• Arrhythmia is an abnormal heart rhythm considered serious when it causes fluctuation in the heart either to beat too slow or too fast in order to pump blood.
• Cardiomyopathy is the deterioration of the function of heart muscle that often results in heart failure.
• Congenital Heart Disease refers to a defect in the structure of the heart and associated vessels that is present since birth.
• Hypertrophic Cardiomyopathy is a genetic condition wherein muscle of the heart is abnormally large in absence of any apparent reason. When muscle of left ventricle of heart becomes abnormally thicker, it results in obstructed blood flow to the rest of the body.
• Coronary Artery Disease occurs when arteries in the heart grow narrow or blocked causing angina, heart attack, or a congestive heart failure (CHF)
• Heart Failure occurs when heart muscles are unable to pump blood due to various reasons.
• Pericarditis is the inflammation of the pericardium i.e. the thin membrane that surrounds the heart.
• Valvular Heart Disease is any disease involving one or more valves of the heart. This could be an inherited or acquired condition of the Heart.

Heart Surgery Types

Angioplasty (Percutaneous Coronary Interventions [PCI], Balloon Angioplasty and Coronary Artery Balloon Dilation) Often combined with Implantation of a Stent to help prop the artery open and decrease the chance of another blockage. In the procedure, special tubing with an attached deflated balloon is threaded up to the coronary arteries while the balloon is inflated to widen blocked areas where blood flow to the heart muscle has been reduced or cutoff. This procedure is considered less invasive as the body is not cut open. Procedure lasts from 30 minutes to several hours and might require an overnight hospital stay.

Angioplasty, Laser is similar to angioplasty except that the catheter has a laser tip to open the blocked artery.

Atherectomy is similar to angioplasty except that the catheter has a rotating shaver on its tip to cut away plaque from the artery. It increases blood flow through the blocked artery by removing plaque buildup and might also be used in carotid arteries (major arteries of the neck leading to the brain) to remove plaque and reduce risk for stroke.

Minimally Invasive Heart Surgery is an alternative to standard bypass surgery (CABG). Small incisions (“ports”) are made in the chest. Chest arteries or veins from your leg are attached to the heart to “bypass” the clogged coronary artery or arteries. Instruments are routed through the ports to perform the bypasses while the surgeon views these operations on video monitors rather than direct. It relieves chest pain (angina) and reduces risk of heart attack

Radiofrequency Ablation (Catheter Ablation) is used to treat arrhythmia. In this process, a catheter with an electrode at its tip is guided through veins to the heart muscle with real-time, moving X-rays (fluoroscopy) displayed on a video screen and is placed at the exact site inside the heart where cells give off the electrical signals that stimulate the abnormal heart rhythm. A mild, painless radiofrequency energy (similar to microwave heat) is transmitted to the pathway that destroys carefully selected heart muscle cells in a very small area (about 1/5 of an inch).

Atrial Septal Defect (ASD)

An atrial septal defect is a hole in the wall (septum) between the left and right atria. If there is a large hole, oxygen-rich blood from the left atrium flows back into the right atrium and gets pumped back to the lungs again. This causes more work for the heart.

Ventricular septal defects (VSD)

VSD is a hole in the wall separating the two lower chambers of the heart.In normal development, the wall between the chambers closes before the fetus is born, so that by birth, oxygen-rich blood is kept from mixing with the oxygen-poor blood. When the hole does not close, it may cause higher pressure in the heart or reduced oxygen to the body.

Aortic Surgery : to repair or replace aortic aneurysms & the aortic dissections.

Aortic Valve Surgery : repairs or replaces defective aortic valve/s not working in order.

Coronary Angiogram: uses X ray Imaging to see heart’s blood vessels; generally to assess if there’s a restriction in blood flow on its way to heart. It can both diagnose and treat heart and blood vessel conditions.

Stent Placement : A stent is a wire mesh tube to prop open an artery during angioplasty and it stays in the artery permanently. It holds the artery open, improvises blood flow to the heart muscle while it relieves chest pain (angina).

You may require take cardiac medications, including dual antiplatelet therapy to prevent complications .

Arrhythmia Surgery : a surgical procedure that corrects irregular heart rhythms like atrial fibrillation /ventricular tachycardia.

Congenital Heart Surgery application fixes or treats genetic heart defects. Treatment for most cases of CHD consists of either surgery or catheter procedures or a combination of the two depending on the type and severity of the heart defects. These treatments have a good success rate provided babies with CHD are diagnosed early enough and reach the hospital
on time.

Bypass Surgery also known as Coronary Artery Bypass Graft (CABG) Surgery is a procedure used in which the blocked portion of the coronary artery is bypassed with another piece of blood vessel — and using them to reroute the blood around the clogged artery to supply blood flow to your heart muscle. It relieves chest pain (angina) and reduces risk of heart attack.

Transmyocardial Revascularization (TMR) relieves severe angina(chest pain) in patients where bypass surgery or angioplasty is ruled out. In few cases, TMR is clubbed with bypass surgery. An incision through the breastbone is used for the bypass.

Left Ventricular Assisting Device (LVAD) aids in the pumping function of the blood.

Left Ventricular Remodeling/Surgical Ventricular Restoration provides the heart with precise normal shape after a heart attack, enabling it to pump blood more efficiently.

Myectomy/Myotomy removes a portion of the enlarged heart-wall.
Heart transplant is very rarely chosen option to treat advanced heart failure when the heart can’t pump enough oxygenated blood. It is removal of a diseased heart and replaces it with a healthy human heart in appropriately selected patients.

Planning Heart Surgery

• Once you are recommended heart surgery, surgery schedule shall be worked out.
• An appointment is made.
• Cardiothoracic Surgeon is consulted.
• Type of surgery, risks, benefits are mutually discussed.
• Surgery date with patient and family is agreed depending on the urgency and availability

Pre-operative work up

• A pre-operative work up with your initial surgical consult on a day before surgery.
• Pre Surgery Instructions are provided including planning post surgery care.
• Also discussed, if any other medications you take, need stop or continue before surgery.

On the day of Surgery

“Nothing by Mouth” means not allowed to eat or drink anything unless told on pre-op day. You will get instructions as to which medications you should take on the morning of surgery.

Pre Surgery Preparation comprise of vital signs, shaving, starting intravenous line, and medications, settling down with Anaesthesiologist.

Heart Surgery Duration
Usually, the surgery may take 3 to 6 hours or slightly over depending on the procedure.

Will I require blood transfusion during surgery?

Most of patients would not require blood transfusion during surgery unless very necessary. Discuss the need of transfusion with your surgeon before the procedure.

Heart Surgery After Care
After surgery, patient is transferred to the Intensive Care Unit (ICU), closely monitored by doctors, nurses, and staff. The patient will be asleep due to anesthesia and sedations given during surgery.

Breathing tube would be mostly removed within six hours depending on various factors like vital signs, lab work, lung function, chest x-ray, smoking history and other history of respiratory diseases like Asthma, COPD , Emphysema.

Incentive Spirometer

After the breathing tube is removed, an Incentive Spirometer helps you take deeper breaths and reduces your risk for pneumonia post surgery. This exercise is to be repeated ten times each hour you are awake, while in the hospital under nurse supervision.

Pain Medications
Including Pills, Intravenous medication, Pumps are given during surgery while the patient recovers. Post-operative pain is result of injury to your skin, muscles, bones, and nerves during the heart surgery operation and is kept under control.

Restrictions

• Not to lift objects heavier <5 to10 pounds.
• No bending, pushing, pulling and stretching for 6 to 8 weeks.
• To hold a pillow firmly against your upper chest while coughing or inhaling deep breaths.
• Not to place pressure on your arms to support upper body.
• Avoid extreme reaching using your arms. Do not twist your upper chest.
• Do not place both hands behind your head.
• No driving for 4 to 6 weeks, until cleared by surgeon.
• Walk 3 to 4 times daily after surgery.
• Physical Therapist will determine if you require use walker.

Why India?

India is becoming the most preferred healthcare destination globally.

Heart Surgery in India is popular among medical tourists from both developing &amp; developed countries. While patients from developed countries find heart surgery cost in India highly affordable and no
waiting time to its added advantage, those from developing & underdeveloped countries find the most advanced technology within their budget very attractive.

Over 500 Heart Surgery hospitals in India are spread across all major different states and cities while a majority of them are accredited by Joint Commission International (JCI) and National Accreditation Board for Hospitals and Healthcare Providers (NABH). Advanced Open heart surgery is conducted for the treatment of patients suffering from a congenital disease, ischemic heart disease, rheumatic heart disease, valvular heart disease, aneurysm of the blood vessels, and atherosclerosis. These are among few of the most significant types of heart surgeries conducted in India by team of best heart surgeons.

The superlative medical treatment provided by the skilled doctors in world-class infrastructure at nearly one third the cost compared to Western Europe, North America and some Southeast Asian countries adds up to India’s credentials .

Heart Surgery in India is performed through cutting- edge clinical solutions, research, extraordinary patient care and infrastructure of world-class standards. Heart Surgery is a complex surgical exercise and needs highly skilled consultants, ingenious technical staff and advanced technology working with perfect harmony, enormous dedication and team work. India offers a one stop solution for all those seeking critical procedures such as Heart Surgery.