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Cardiac Surgery

Carotid Artery Disease

Carotid artery disease occurs when the major arteries in your neck become narrowed or blocked. These arteries, called the carotid arteries, supply your brain with blood. Your carotid arteries extend from your aorta in your chest to the brain inside your skull.

Your arteries are normally smooth and unobstructed on the inside, but as you age, a substance called plaque can build up in the walls of your arteries. Plaque is made up of cholesterol, calcium, and fibrous tissue. As more plaque builds up, your arteries narrow and stiffen. This process is called atherosclerosis, or hardening of the arteries.

Carotid artery disease may not cause symptoms in its early stages. Unfortunately, the first sign of carotid artery disease could be a stroke or a transient ischemic attack.

Lifestyle changes to lower your risk include:
  • Stop smoking
  • Control diabetes
  • Control blood pressure
  • Be physically active
  • Eat a low-saturated-fat, low-cholesterol diet

Your treatment will depend on the severity of your condition, and whether or not you are having symptoms from the carotid artery disease, as well as your general health. As a first step, your physician may recommend medications and the lifestyle changes.

Carotid Artery Stenting is a non-surgical procedure that can be used to dilate (widen) narrowed or blocked carotid arteries. A tiny coil (stent) is expanded inside the blocked artery and is left in place to keep the artery open. Carotid artery stent procedures are performed with special devices (embolic protection devices) to prevent plaque from entering the circulation of the brain during the stent procedure.

Structural heart disease most often refers to cardiac defects which are congenital in nature (birth defects), but may also include abnormalities of the valves and vessels of the heart wall that develop with wear and tear on the heart, or through other disease processes. The three most common congenital heart diseases are atrial septal defect (ASD), patent foramen ovale (PFO), and coarctation of the aorta.

An ASD is a hole in the wall (septum) which separates the top two chambers of the heart. A PFO is similar to an ASD; it is a flap-like hole in the wall that separates the upper two chambers of the heart, a coarctation of the aorta is a narrowing of the vessel, in the upper chest that carries the blood from the heart, to every other part of the body to supply oxygen and other nutrients.

What are Symptoms of Structural Heart Disease?

    In PFOs
  • Transient Ischemic Attack (TIA or mini-stroke)
  • Migraine headaches
  • Low oxygen levels in rare patients.
  • “Bends” in divers
    In ASDs
  • Heart palpitations
  • Exercise intolerance
  • Stroke

There are treatments in the cath lab treatment for ASDs, PFOs and coarctations. For both ASDs and PFOs there is a catheter based procedure that utilized specific closure devices. Stenting is used to treat patients coarctations.


Valvular Heart Disease

Heart valves are flaps, or leaflets, of tissue that ensure that blood entering or leaving the heart moves in the proper direction with no backflow. The heart has a total of four valves, the mitral, triscupid, aortic and pulmonary valve. Valvular disease can affect any of these four valves, and can interfere with the normal flow of blood through the heart

Valvular stenosis, or a narrowing of the valve requires the heart to pump harder, which can strain the heart and reduce blood flow to the body. The tissues forming the valve leaflets become stiffer, narrowing the valve opening and reducing the amount of blood that can flow through it. If the narrowing is mild, the overall functioning of the heart may not be reduced. However, the valve can become so narrow (stenotic) that heart function is reduced, and the rest of the body may not receive adequate blood flow. Valvular regurgitation (incompetent, insufficient, or leaky) valve does not close completely, letting blood move backward through the valve. This backward flow is referred to as “regurgitant flow.”

There are many types of valve disease .Valve disease can be congenital (present at birth) or may be acquired later in life. Acquired valve disease includes problems that develop with valves that were once normal. These may involve changes in the structure of your valve or infection, such as rheumatic fever which causes a the heart valve leaflets to become inflamed, and may cause the leaflets to stick together and become scarred, rigid, thickened and shortened. Other causes of valve disease include: coronary artery disease, heart attacks, cardiomyopathy (heart muscle disease), syphilis, hypertension, aortic aneurysms, connective tissue diseases, and less commonly, tumors some types of drugs and radiation.

If the valve disease is more serious, the symptoms can include:
  • Breathlessness during exertion
  • Waking up at night short of breath
  • Palpitations (irregular, fluttery heartbeat)
  • Angina (chest pain) because the blood vessels supplying the heart muscle are not getting enough blood
  • Swelling of the ankles or feet
  • Tiredness
  • Dizziness or fainting

Treatment depends on what is wrong with the valve and how serious the problem is. If the disease is minimal, medical therapy may be prescribed to relieve the symptoms.

Balloon Valvuloplasty is a procedure in which the narrowed heart valve is stretched open. A small incision is made in the skin and a catheter is inserted into an artery in the leg, where a balloon-tipped catheter is advanced into the heart and across the narrowed valve. When in place, the balloon is expanded to open the valve, resulting in improved blood flow across the diseased valve.

Percutaneous mitral valve repair (MVR) is a new treatment being investigated to determine the effectiveness of a percutaneous approach for treating mitral valve regurgitation. The procedure is performed in the cardiac catheterization laboratory with the aid of echocardiography. During this procedure, a very small, specially made metal clip device is delivered through a catheter inserted into the femoral vein (in the groin) and advanced to the heart. Guided by echocardiography, the cardiologist attaches the clip to the flaps of the mitral valve. Placement of the clip is adjusted until optimal improvement in blood flow and pressures through the valve are observed. Then, the clip is released, and the catheter is withdrawn. The clip holds the valve flaps in position, which limits the leakage.

Our Cardiothoracic Surgery department delivers outstanding level of surgical care to patients suffering from heart diseases. The department is a leader in performing complicated heart surgeries, such as the Coronary Artery Bypass Grafting (CABG, or Heart Bypass Surgery), Valvuloplasty and other complex procedures. It has an exceptional record of high safety and success rate for complex heart surgeries. It is led by renowned surgeons and highly skilled staff, and supported by a state-of-the-art facility with ultra modern equipment. The department provides around the clock services to patients requiring surgical care.

Our Cardiothoracic Department is equipped with the latest equipment and facilities

Operation Theatres
  • We have four dedicated operation theatres, for the Cardio-Thoracic department. Our operating theatres are fully equipped and prepared for all types of heart surgeries, including Beating Heart Surgery (Bypass Off Pump), Open Heart Surgery (Bypass On Pump), Valvular and Cogenital Surgery, Pulmonary and other complex procedures.
  • Filtration of air in the operating theatres is critical for preventing infections. Our theatres have Micro-V and Hepa filters to ensure sanitary air supply during the procedures. The air is changed every 2 minutes and a positive pressure is maintained to prevent outside air from coming in.
  • All materials of our operating theatres, including floor and wall materials, are non-porous to prevent growth of any bacteria or infectious materials. These washable materials are kept sterile by top quality of sterilization and disinfection processes. The operating rooms are built to allow every nook and corner to be kept easily sterile.
  • Our operating theatres are furnished with the latest equipments

We provide exceptional high quality post operative care in our well-equipped and dedicated Intensive Cardiac Care Units (ICUs) for the Cardiothoracic. We have one of the lowest incidences of post operative infections in the nation. We maintain a 1:1 nurse to patient ratio to ensure positive outcomes and caring service.