Cardiac Surgery - Adult
The Cardiac Surgery Department at Narayana Health specializes in all kinds of cardiac surgery and is world-renowned for dealing with complex heart problems. We have with us renowned cardiac specialists who perform amongst the world's largest number of heart surgeries and interventional treatment. Innovative techniques and multiple specialists give patients (adult and children including newborns), the advantage of superior therapies and preventive care for disorders of the heart and vascular system (blood vessels).
The expertise of our cardiac surgeons extends to surgery for heart failure, Aneurysms & Pulmonary Embolisms, Coronary Artery Bypass Grafting as well as Ross and Homograft Procedures. Narayana Health has carved a niche in addressing Complex Valve Repair surgeries too. The success rate in cardiac surgeries is among the highest in India and comparable with the best healthcare institutions anywhere in the world.
Aortic valve surgery includes aortic valve repair, or valve replacement treatment, to fix a faulty aortic valve. The aorta distributes blood throughout the body, the aortic valve lets blood flow from the left lower chamber to the left ventricles to the aorta.
Narayana Health has the facility to perform any type of aorta surgery - open and percutaneous.
The aortic valve replacement is an open-heart surgery, operated to remove damaged valves and replace it with a new valve made from animal tissue or synthetic materials. The aortic valve replacement is necessary to be replaced in patients whose valves become narrow ( aortic stenosis) or the valve is leaky (aortic regurgitation). This type of heart surgery is risky and only a few health institutions have a high success rate in India. Narayana’s health Cardiology department has highly specialized and experienced aortic valve surgeons to give another life for thousands of patients through aortic valve replacement treatment.
A particularly unique procedure performed at NH is Pulmonary Endarterectomy (PEA). It is a complex surgery to remove blood clots from the pulmonary arteries in the lungs (chronic pulmonary embolism, a condition which is particularly prevalent in India). This procedure has significant benefits and the results are superior to other treatments; many patients no longer suffer from shortness of breath, have a better quality of life and enjoy longer life expectancies. Narayana Health’s hospitals are among the few in the country performing this potentially life-changing procedure and having performed over 500 surgeries, is among the most experienced.
Left Ventricular Assisted Device (LVAD)
Due to a cardiac seizure, the heart becomes weak and can't maintain adequate blood flow to meet an individual’s body requirement. Usually, the affected patient can barely walk, talk or even lie down flat. Patients who have reached the terminal stages are recommended to undergo an LVAD implantation. Narayana Health was among the first to offer this implant in the country. Once implanted it takes over the entire blood pumping function of the heart and the patient gets a new lease of life, along with a few lifestyle restrictions. It can be used either as a "Bridge to transplant”, that is, to keep the patient well until a heart is available for transplantation. It can also be used as "Destination therapy", making it a permanent solution for patients who are not suitable for transplants.
Post Heart Surgery Procedure: What to expect?
The patient is immediately transferred to the ICU following the operation with a breathing tube still in place. The anaesthesia would still be in effect, so the patient will wake up in the ICU after the surgery.
In the ICU, the following will be under constant medical supervision:
· Vital signs
· Chest tube drainage
· Breathing status
· Lab test results
· Pain level, etc
Once the vital signs are stable and the initial intake evaluation is completed by the nurses, the patient’s family and friends will be allowed to visit depending on the hospital’s ICU policy for visitors.
After the patients have regained their consciousness, the patients are extubated (removal of the breathing tube). Once they are extubated, the patients are asked to participate in breathing exercises. Early activities are encouraged as well to reduce surgical complications, such as pneumonia, blood clots in the legs and muscle weakness. The patients are then transferred from the ICU to another unit in the hospital if the surgery team feels that they are ready.
The next few days are focused on helping the patient to recover in the hospital. The goal is to move forward with the progress steadily until the patient is strong enough to be discharged from the hospital. During the recovery, daily labs tests, chest X-rays, removing the drainage tubes, monitoring the vital signs, glucose, breathing status are carried out.
The surgeon will determine when the patient is ready to be discharged from the hospital. This is done when:
· The patient can manage the pain with pain pills without needing IV medications.
· They can walk to the bathroom without assistance.
· They can breathe well without supplemental oxygen.
· They are stable on their current medication routine.
· The lab results are stable and the chest X-ray is satisfactory.
· The vital signs are within a normal range.
· Every patient’s condition is different, so not everyone can go straight home after being discharged from the hospital. Sometimes, transitional care or inpatient rehabilitation may be required.
Complications that can arise after open-heart surgery:
Open heart surgery is a type of heart surgery where the chest is cut open and surgery is performed to repair or replace heart valves, which bypass blood to travel through the heart, repair damaged areas of the heart, implant medical devices on the heart or replace the faulty heart with a donated heart. Risks for open-heart surgery include-
- Heart attack or stroke
- Chest wound infection
- Lung or kidney failure
- Chest pain or fever
- Irregular heartbeat
- Memory loss or fuzziness
- Blood clot or blood loss
- Breathing difficulty
Narayana’s Health cardiology department integrates with gastroenterology and hepatology, oncology, pulmonary medicine, anesthesiology, endovascular surgery, critical care unit, pathology and radiology experts to provide full care to the open-heart surgery patients.
Cardiac Surgery FAQ's
Few types of cardiac surgeries include
- Avoid consumption of caffeine especially during the evenings
- Take medication half an hour before you go to bed
- Arrange pillows to avoid any kind of muscle strain
- Coronary Artery Bypass Grafting: During a CABG, a healthy artery or vein from the body is linked to the blocked coronary artery forming a new path for blood to flow to the heart muscle.
- Heart valve repair or replacement: Blood to the heart flows through the heart’s valves that have an individual set of flaps called leaflets. Surgery help fix leaflets that don’t close tightly.
- Arrhythmia treatment: If the heart rate is abnormal then, doctors suggest surgeries to implant a pacemaker or an implantable cardioverter-defibrillator (ICD)
- Heart transplant: A surgery to replace a diseased heart with a healthy heart from a deceased donor.
- Blood clots leading to a heart attack or stroke
- Excessive bleeding
- Infection triggered by diabetes or obesity
- Kidney failure
- Breathing problem
- Unclear memory
- Aspirin: Aspirin reduces blood clotting thus sustaining blood flow through a tapered artery
- Thrombolytics: These drugs dissolve any blood clot that’s blocking the blood flow to your heart
- Nitroglycerin: Nitroglycerin treats chest pain and enables improved blood flow by enlarging the blood vessels.
- Statins: Statins help regulate blood cholesterol