Heart Surgery in India (adult and pediatric)

Lack of exercise, sedentary lifestyle and junk food has contributed to a lot of cardiovascular diseases primarily among the people in metropolitan cities. With diabetes and hypertension contributing to heart ailments, there is absolutely no age now for developing a cardiovascular disease. Indian Hospitals have been know worldwide for the advanced critical cardiac healthcare services. The success rates of heart surgery in India has surpassed 99% in most of the Indian hospitals. Procedures like bypass surgery, angioplasty, stents placements and atherectomy are being performed everyday in large numbers both for domestic as well as international patients coming to India for seeking treatments to cardiovascular problems. The approximate cost of bypass surgery in India is $6000 to $9000 in an accredited hospital,  whereas the same heart bypass is going to cost around $23000 to $34000 in Thailand and $100000 in the USA. As a result of low cost heart surgery in India and proven excellence, India is poised to become the world leader in heart surgeries. 

Non-invasive Cardiology

Non-invasive medical techniques are those which generally do not penetrate the body, for example by incision. The motive of a non-invasive procedure is not to invade the healthy organ tissue and are generally a set of diagnostic procedures. Some of the non-invasive diagnostic tests related to cardiovascular techniques are electrocardiography, echocardiography, treadmill tests, tilt table tests etc. 

1) Electrocardiography

Electrocardiography is a interpretation of the electrical activity of the heart over a period of time, as detected by electrodes attached to the surface of the skin and recorded by a device external to the body. The recording produced by this noninvasive procedure is termed an electrocardiogram (also ECG or EKG). ECGs are the key to observe rythm of heart beat, predict the possibility of a heart attack, and to monitor the blood flow to or from the heart. ECG is the most frequently used modality for diagnosing and monitoring the activity of the heart.

2) Echocardiography

Echocardiography is now a widely accepted as a useful technique for diagnosing and managing a range of congenital and acquired heart diseases, in part because it alone can provide spatial information about cardiac structure and function non invasively without the user of radioactive tracers. Echocardiography also offers the advantages of immediate results - unlike newer techniques such as Magnetic Resource Imaging (MRI) and Computerized Tomography (CT). These advantages make echocardiography, the second best and most popular used modality for tracking and diagnosing cardiac disorders afer an Electro Cardio Gram ECG. 

 Minimal Invasive Cardiology

Because of the damage to the tissues of the delicate organs in an invasive cardiac procedure, like the open heart surgery, a new range of techniques performed through very small incisions have been intorduced collectively called the minimally invasive cardiac surgeries. The incisions required by the minimally invasive surgeries are of the order of 2-3 inches as compared to the incisions required by invasive techniques which are of the order of 6-8 inches. A minimally invasive cardiac procedure is generally a robotic assisted surgery in which the surgeon uses a strategically designed computer setup that controls the surgical instruments using thin robotic arms. Some of the advantages of a minimal invasive cardiac surgery over invasive cardiac surgery are smaller incisions and scars, low risk of infection, lesser bleeding and short recovery time. Due to the extensive use of minimal invasive techniques for heart surgery in India, a lot of international patients prefer accredited Indian hospitals. 

Coronary Angiography

Coronary Angiography or arteriography is a medical imaging technique used to visualize the inside, or lumen, of blood vessels and organs of the body, with particular interest in the arteries, veins and the heart chambers. The arteries could be obstructed due to the accumulation of fatty materials like the cholestrol and triglyceride, and thus allowing very less blood to travel through them. Coronary angiography is a test that uses dye and special x rays to show the insides of your coronary arteries. During coronary angiography, special dye is released into the bloodstream. The dye makes the coronary arteries visible on x-ray pictures. This helps doctors see blockages in the arteries. 

Angioplasty

Angioplasty is a medical procedure to open wide the obstructed or blocked arteries of the heart. Arteries are the small muscular tubes transporting blood from the heart to other parts of the body. The arteries could be thickened or completely blocked due to the accumulation of fatty materials like the cholestrol and triglyceride, and thus allowing very less blood to travel through them An empty and collapsed balloon on a guide wire, known as a balloon catheter, is passed into the narrowed locations and then inflated. The balloon forces expansion of the inner white blood cell/clot plaque deposits and the surrounding muscular wall, opening up the blood vessel for improved flow, and the balloon is then deflated and withdrawn. A stent may or may not be inserted at the time of ballooning to ensure the vessel remains open.  

Open Heart Surgery

Open heart surgery is any surgery where the chest is opened and surgery is done on the heart muscle, valves, arteries, or other parts of the heart (such as the aorta). The term "open" means that the chest is "cut" open. It comes under invasive cardiology meaning that the heart tissues are cut or an incision is made to enter the organ. A lot of overseas patients come here for open heart surgery in India as it is one of the most frequent and complex procedure performed with high success rates in India. 

Valve Replacement Surgery

Valve replacement surgery is the replacement of one or more of the heart valves with either an artificial heart valve or a bioprosthesis (homograft from human tissue or xenograft e.g. from pig). It is an alternative to valve repair. Valvular heart disease accounts for nearly 10 to 20 percent of the all the cardiac procedures in the United States. Around two-thirds of all the heart valve operations under heart surgery in India are for aortic valve replacements, most often for aortic stenosis.

There are four procedures under heart valve replacement techniques :-

• Aortic valve replacement
• Mitral valve replacement
• Tricuspid valve replacement
• Pulmonary valve replacement

Aortic Valve Replacement

Aortic valve replacement is a procedure in which a patient's failing aortic valve is replaced with an alternate healthy valve. The aortic valve can be affected by a range of diseases; the valve can either become leaky (aortic insufficiency / regurgitation) or partially blocked (aortic stenosis). Current aortic valve replacement approaches include open heart surgery, minimally invasive cardiac surgery (MICS) and minimally invasive, catheter-based (percutaneous) aortic valve replacement. 

Coronary Artery Bypass Graft

Coronary artery bypass graft surgery (CABG) , and colloquially heart bypass or bypass surgery is a surgical procedure performed to relieve angina and reduce the risk of death from coronary artery disease. Arteries or veins from elsewhere in the patient's body are grafted to the coronary arteries to bypass atherosclerotic narrowings and improve the blood supply to the coronary circulation supplying the myocardium (heart muscle). The grafts used could come from the arteries and veins of the patient, from the chest, leg or arm. The purpose of the graft is to create a new passage for the oxygen-rich blood to flow to the heart. Coronary artery bypass graft surgery remains one of the most frequently performed operations in the United States , with an expenditire in excess of 50 billion dolars anually.  Coronary artery bypass graft surgery provides exccellent immediate-term results in the management of stable Coronary Artery disease. CABG is one of the most successfully performed heart surgery in India. 

Aortic Valvuloplasty

Aortic valvuloplasty is the repair of a stenotic aortic valve using a balloon catheter inside the valve. The balloon is placed into the aortic valve that has become stiff from calcium buildup. The balloon is then inflated in an effort to increase the opening size of the valve and improving blood flow. 

Baloon Pulmonary Valvotomy

Balloon valvuloplasty has been used for congenital valvular pulmonary stenosis (PS) in pediatric patients as a conventional treatment. It's a procedure to treat mitral valve stenosis in some of the patients. A catheter, which is a very fine and flexible tube is inserted through an artery and then threaded into the heart. When the catheter reaches the obstructed mitral valve , the baloon at the top of the catheter is inflated quickly. The inflated baloon streches the valve opening and allows more blood to flow through the heart. 

Cardiac Pacemaker installation

In a person with cardiosvascular diseases, sometimes the right and the left ventricles are not in sync while pumping blood. As a result sometimes the left ventricles is not able to pump enough blood to the body and thus inducing symptoms of heart failure like shortness of breath, an increased heartbeat, fatigue and dry cough. A pacemaker is a medical device that uses electrical impulses, delivered by electrodes contacting the heart muscles, to regulate the beating of the heart. The primary purpose of a pacemaker is to maintain an adequate heart rate, either because the heart's natural pacemaker is not fast enough, or there is a block in the heart's electrical conduction system. It keeps the ventricles, right and left, pump the blood together by sending small electrical impulses. 

Pediatric heart surgery

Heart surgery in children is done to repair heart defects a child is born with (congenital heart defects) and heart diseases a child gets after birth that need surgery.

Open-heart surgery is when the surgeon uses a heart-lung bypass machine.

• An incision is made through the breastbone (sternum) while the child is under general anesthesia (the child is unconscious and does not feel pain).
• Tubes are used to re-route the blood through a special pump called a heart-lung bypass machine. This machine adds oxygen to the blood and keeps the blood warm and moving through the rest of the body while the surgeon is repairing the heart.
• Using the machine allows the heart to be stopped. Stopping the heart makes it possible to repair the heart muscle itself, the heart valves, or the blood vessels outside the heart. After the repair is done, the machine is removed, and the heart is started again. The breastbone and the skin incision are closed up.

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