What is Cardiac Science?
Cardiac science is a specialty department that deals with heart diseases. There are super specialisations that include Cardiac surgery, Interventional Cardiology, Paediatric Cardiology, Cardiac Arrhythmia, Stem Cell therapy & Eelectrophysiology.
What is Cardiothoracic Surgery ?
Cardiothoracic surgery involves the treatment of diseases affecting organs inside the chest (thorax), including treatment of conditions of the heart (heart disease) and lungs (lung disease). The Center of Cardiothoracic Surgery, is a Center of Excellence, which attracts thousands of patients, including international patients and performs virtually every type of heart surgery. Good Centers perform over 0.5 million surgeries an year which makes these centers one of the most experienced heart care centers in South East Asia. The cardio surgical units perform a wide range of surgeries - from neonatal open heart surgeries to aneurysm surgeries to heart transplants, with excellent results.
CABG (Coronary Artery Bypass Graft)
A form of heart surgery that redirects blood around clogged arteries to increase blood flow and oxygen to the heart. The cardiac surgeons have great expertise and experience with CABG surgeries. Panel hospitals that we have are versatile and handle critically ill patients with severe left ventricular dysfunction or diffusely diseased vessels. As heart - lung machine avoided, there are patients who received treatment for CABG even when there are associated morbidities such as renal disease, compromised lung function or other coexisting diseases. These experts have performed total arterial revascularization of the heart off-pump with varying configurations of arterial conduits such as left/right internal mammary arteries, radial arteries, and gastro-epiploic arteries individualized to patient's requirements.
Beating Heart Surgery
Coronary Bypass Surgeries are performed using contemporary techniques including the off-pump bypass. Over 99.6% of the surgeries are "off-pump" or "beating heart" surgeries.
Minimally Invasive Coronary Artery Surgery
Conventional CABG or coronary Bypass surgery is performed by splitting or cutting through the breastbone or sternum. MICAS or MICS CABG is a safe and complete operation that has revolutionised the way coronary surgery is performed. MICS CABG or MICAS stands for Minimally Invasive Coronary Artery Surgery. It is a relatively new and advanced technique of performing coronary bypass for coronary artery disease. In this technique the heart is approached through the side of the left chest via a small 4cm incision.
Extensive and challenging thoracic procedures (lung, esophagus, etc.) are undertaken by our panel thoracic surgeons with the best results.
India started doing heart transplantation since 1995. As a testimony to this excellence was the trust shown by an American patient last year who underwent a Heart Transplant at one of our panel hospital and is doing well.
Heart Valve Surgery
Specialized surgery which is performed for the treatment of abnormalities like Mitral Regurgitation (MR).
Emergency Cardiac Surgery
Surgeries for treatment of complications caused by the dilatation of the aorta (aortic aneurysm), problems caused by irregular heart beat (arrhythmias - such as atrial fibrillation), heart failure, Marfan syndrome - a genetic disorder that causes cardiovascular abnormalities and other less common conditions are performed extensively.
The Keyhole Angioplasty, is considered an alternative to the conventional bypass surgery, as it is less time consuming, takes less than an hour. The major advantage of the procedure is that it is non-surgical in nature, which means lesser hospital stay and quicker recovery. This procedure is supported by the use of advanced techniques, new generation drug eluting stents and adjunctive Imaging Technology of IVUS (Intravascular Ultrasound), giving a virtual view of the inside of the arteries which makes this procedure simple.
Fractional Flow Reserve (FFR)
Fractional Flow Reserve (FFR) is used to determine if a cardiac patient really needs a stent or bypass surgery or can be kept only on medicines avoiding any procedure.
OCT Technique – Optical Coherence TomographyOCT – Optical Coherence Tomography is a light based catheter which acquires on an image (photo) inside the heart blood vessel. OCT is a recently-developed, catheter-based Intravascular Imaging Technology that provides micron-scale resolution.
The Interventional Cardiology Centres are manned by senior Cardiologists trained in India and abroad. Coronary stenting is routine and performed by most of the interventional cardiologists. Patients with high risk and multi vessel involvement are also treated.Primary angioplasty, an approach of opening blocked coronary artery during acute myocardial infarction, in place of thrombolysis is practised in suitable cases. Our panel cardiologists have performed over 85000 angiographies and over 50000 coronary angioplasties since the establishment of Interventional Cardiology Centres. Non-coronary intervention deals with a variety of cardiovascular abnormalities. Subclavian, iliac, femoral and carotid artery balloon angioplasty and stenting are being performed. Vascular dissection and aneurysm repair are also conducted with covered stents.
Non-Surgical Closure of Heart Defects
Patients with a hole in their heart, whether an Atrial Septal Defect, a small Ventricular Septal Defect or a Patent Ductus Arteriosus can be closed effectively by Button or Amplatzer’s device or coils.
Minimally Invasive Cardiac Surgery
Doctors in our panel use minimally invasive techniques to perform multiple graft heart bypass surgery without cutting through a single bone. The new procedure is less painful and leads to faster healing, compared to conventional bypass. It is the first time in India that multiple grafts have been put at the back side of the heart through minimally invasive coronary surgery. Many non-operative procedures are also done to avoid skin incisions ("key-hole"). These include non-surgical closure of atrial septal defects, ventricular septal defects and patent ductus arteriosus and balloon valvuloplasty of the pulmonary, aortic and mitral valves.
ClearWay RX - Rapid Exchange Therapeutic Perfusion Catheter
The ClearWay™ RX - Rapid Exchange Therapeutic Perfusion Catheter helps save larger area of heart muscle in heart attacks. Cardiac interventionists now know that it is not sufficient to remove the big clot that produces a heart attack; ensuring that the small vessels supply blood to the heart muscle is just as crucial.
Dedicated Bifurcation Stent technology for Complex Bifurcation Angioplasty
Bifurcation lesion means there is a blockage in a site where the blood vessel divides into two and is more challenging to treat. Two branches of the blood vessel have narrowing. If a balloon angioplasty is performed in one, there are chances of the other branch closing. Conventionally one or two stents are placed and there are chances of recurrence in the side branch.
Bioresorsable Vascular Scaffold (BVS)
The new Bioresorbable Vascular Scaffold (BVS), a non metallic mesh tube that is used to treat a narrowed artery, is similar to a stent, but slowly dissolves once the blocked artery can function naturally again and stays open on its own. Similar to a small mesh tube , BVS is designed to help open up a blocked artery in the heart and restore blood flow to the heart muscle . BVS gradually dissolves once the artery can stay open on its own, potentially allowing the blood vessel to function naturally again.
Bioresorbable Vascular Scaffold is similar in appearance to a stent, but is a non-metallic,non-permanent, mesh implant which gets absorbed gradually, dissolves over time and allows the artery to function naturally again, similar to the way a cast supports a broken arm and is then removed. This new scaffold disappears over 12- 24 months and supports the vessel until it has the ability and strength to stay open on its own.
A decade ago, most of the patients with 100% blocked arteries were either managed medically or sent for surgery with long recovery times before they got back to their work. Today all these blocks can be cleared with latest advancements in angioplasty using advanced technologies that can be performed successfully in a few hours.
The CrossBoss Catheter is the latest technology introduced in India for the treatment of 100% blocked arteries. This catheter is made of a stainless steel braid and has a rounded tip that can be rotated in any direction. This facilitates the crossing of the 100% block, either through the tough lesions or can travel behind the blocked segment and exit beyond the lesion. At this point the next novel device called StingRay Balloon is used to get back into the actual passage of the blood vessel, using specialised wires.
Highlights of CrossBoss Catheter:
- Minimally invasive
- Faster recovery
- Reduced hospital stay
- Minimal blood loss
Along with minimal scarring and quicker recovery time, these newly introduced devices will add a new dimension to the treatment of chronic total occlusions (100% blocked arteries). This technology enhances the methods used by Japanese Cardiologists to open these blocked arteries and improves the clinical outcomes. For Cardiologists who are specialists in Chronic Total Occlusion (100% blocked arteries), this device is a great tool to have and will improve outcomes significantly. More such devices are expected in the future to treat such complex problems. This procedure requires a highly skilled intervention cardiologist with expertise along with excellent critical care staff in a tertiary care hospital set up.
What is Paediatric Cardiology ?
The speciality that addresses heart conditions in babies [including unborn babies], children and teenagers is called Pediatric Cardiology. Treatment is provided for Structural, functional, and rhythm-related problems of the heart and a high degree of success is achieved. The Pediatric cardiologists and Pediatric cardiac surgeons of our panel Hospitals, who are trained in the top centres in the country and world, add their immense expertise and experience to this superspecialty.
Our Centres for Pediatric cardiac surgery at our hospitals perform the following:
- Atrial Septal Defect repair - A defect between the heart's two upper chambers called the atria.
- Ventricular Septal Defect repair - A defect between the heart's two lower chambers called the ventricles.
- Coarctation of Aorta repair - a birth defect that results in the narrowing of part of the aorta (the major artery leading out of the heart).
- Patent Ductus Arteriosus closure - an abnormal circulation of blood between two of the major arteries of the heart - the aorta and the pulmonary artery.
- Tetralogy of Fallot treatment - a common cause of "blue babies".
The occurrence of irregular heartbeat is called Cardiac Arrhythmia. This is a serious condition that can however be treated. When the electrical impulses in the heart, that actually coordinate the heartbeats, cease to function properly, the heart starts beating too fast, too slow or irregularly. This is called a cardiac arrhythmia.
Types of Arrhythmias: The types of arrhythmia include Paroxysmal Supra-Ventricular Tachycardia [PSVT], Atrial flutter, Atrial Fibrillation, Ventricular Tachycardia, Ventricular Fibrillation.
Causes of Arrhythmias: Some of the common causes for Cardiac arrhythmia are: Hypertension, Ischemic heart disease, Valvular heart disease, Cardiomyopathies, Sinus node disease, Tumors, Pericarditis, COPD (Chronic Obstructive Pulmonary Disease), Thyroid Disease, Alcohol abuse, Vagal stimulation, Smoking, stressful modern life styles etc.
Diagnosis: Doctors diagnose arrhythmias by ordering specific tests, depending on the type of the arrhythmia that is suspected. The doctor may also order:
- Electrocardiogram / Echocardiogram.
- 24 hour electrocardiogram using a device called Holter monitor.
- Electrophysiology Studies (EP Diagnostic Studies). These help to locate the origin of the rhythm disorder better and determine the best treatment.
Treatment of arrhythmia: Arrhythmia treatments are multipronged. They could include medication, medical procedures, and surgery. Treatment is required for cardiac arrhythmias only if the arrhythmia causes serious symptoms, such as dizziness, chest pain, or fainting or if it increases risk for heart failure, stroke or sudden cardiac arrest.
Stem Cell Therapy & Transplants
Stem cells from the bone marrow aspirate are currently utilised by our cardiologists to perform Transmyocardial Revascularisation
Tranmyocardial Revascularisation [TMR], is a lesser known option for treatment of coronary artery Among the wide range of options that are available or under development for the treatment of coronary artery disease. In TMR, a laser is use to drill multiple (15-40) millimeter sized channels through the myocardium in order to increase blood flow for patients with angina who may not be good candidates for Coronary bypass surgery. TMR is indeed unique because it also uses autologous stem cells, to provide clinical benefit for these patients.
An Electrophysiologist is a trained cardiac specialist who would be performing an EP Study. This is a specialized procedure in which one or more thin, flexible wires, called catheters are inserted into a blood vessel (usually the groin) and guided into the heart. Each catheter has two or more electrodes to measure the heart's electrical signals as they travel from one chamber to another.
EP study or Electrophysiological study is mainly performed to diagnose cardiac rhythm abnormality, to help determine the best treatment, and to pinpoint the exact site where therapy may be useful.
Do you need a second opinion?
Since treatments are continuously improving, we think that it is important for you to be advised by the best doctor in the field, who has experience with your type of Cardiac disorder. A second opinion is where you meet with more than one doctor to confirm your diagnosis and also, to understand your treatment options.
Second opinions are quite common and most people follow this practise, as it may help to feel more comfortable about your health and the future decisions you make.
Asking for a second opinion is common practice. It may help you feel more comfortable with the health care decisions you make. There are various ways in which a second opinion can give you information. It can:
- Confirm your diagnosis
- Give an accurate location for your disorder
- Tell you whether other parts of your body are being affected
- Put you in touch with experts in associated fields of Cardiology who can inform you of other details
- Also give you other treatment options, in case the doctor disagrees with your prior diagnosis and treatment
How can MedisenseHealth.com help you? How do we get the best Cardiology hospital/ best Cardiologist for you?
We at MedisenseHealth, can help you by finding the top doctors specializing in Cardiology & cardiothoracic surgery. We have a group of 40 hospitals on-board with us. Out of these hospitals, we have 8 specialized Cardiology centres. All you have to do is follow the links provided, or call our health care support and we will be able to schedule you for a second opinion with the best doctors in the field. We do require that you give us complete details regarding your ailment. This includes all your medical records—including test results, such as blood work or imaging tests. Using these as our guide, we then narrow down the field of doctors so that, we are able to provide you with the best health care opinion. Click here to find Doctors for your Second Opinion .