Numerous heart surgeries are performed each day in India. Among them, cardiovascular surgery is the most common kind performed by the surgeons. These surgeries are performed to treat various heart diseases including atherosclerosis, rheumatic heart disease, valvular heart disease and ischemic complications. The surgeries sometimes may need a heart transplant for treating extreme cases. However, the cardiovascular and cardiothoracic surgery is performed on the various vascular parts of the heart and can be divided into 9 broad categories.
Coronary artery bypass grafting
CABG or Coronary Artery bypass grafting is the most common cardiac surgery. People with severe Coronary Heart Disease (CHD) are treated with CABG to improve their blood flow to the heart.
CA CHD patient suffers from artery blockage where a wax-like substance accumulates in the inner wall of the coronary artery. As a result, the arteries become unable to supply oxygen to the heart. Over the period of time, either the blockage can be ruptured or be hardened, causing a permanent problem.
If the stiff wax or the plaque narrows the arteries, the blood reaches the heart with lesser oxygen causing acute chest pain. Even if the plaque ruptures, the blood creates clot on the surface of the organ. Large blocks can add to the complication and completely block the arteries.
CABG is a proven treatment for CHD. For replacing the blocked artery or vein, a healthy one is cut out from any safe body part and replaced with the blocked portion. A new path is thus created for the oxygen filled blood to reach the heart muscle.
The CABG or cardiothoracic surgery can easily be prevented if the patient owns some changes in his life. Medicine, healthy lifestyle and Percutaneous Coronary Intervention (PCI) or coronary angioplasty can alternate the surgery procedure.
The nonsurgical procedure of PCI unblocks the damaged coronary artery. During the treatment procedure, a slender tube named stent is used to treat the weak and narrow artery.
These treatment options are absolutely necessary when the heart is suffering from acute blockage with minimum oxygenated blood supply. In early situations, alternative treatments with preventive measures are quite successful in treating such diseases.
Transmyocardial laser revascularization
Transmyocardial Laser Revascularization is a treatment option for cardiac patients with a minimum chance of being operated. The angina treatment is also for the patients who have had a cardiac surgery already once and cannot take the trauma of having another one yet.
People usually opt for angioplasty, medication or coronary bypass surgery for getting improved result for their heart disease. But in some cases, none of the methods give complete relief to the patients. With no other viable method, the best cardiac surgeon in India avoids taking a risk and opts for this therapeutic treatment.
The already treated patients may show symptoms of having the same problem all over again. In these cases, TMLR or Transmyocardial laser Revascularization is performed by using high powered carbon-di-oxide or alternative lasers to inject a powerful energy pulse into the left ventricle. This procedure vaporizes the ventricular muscle and creates a transmural channel of 1 mm diameter. The treatment procedure may be complicating but it is hugely effective for treating complicated diseases.
The laser energy sources were developed in the 1980s that stimulated investigators to research myocardial acupuncture. Mirhosini and Cayton used the carbon-di-oxide laser in addition to the CABG to treat patients with the hypokinetic condition of the left ventricle. The patients recovered well and thus the practice to use TMLR was introduced to the world of cardiac treatment.
Heart valve repair or replacement (Open Heart Surgery)
A human heart pumps blood to a single direction. Valves open and close with each heartbeat and play a significant role in this blood-flow system. A rhythmic pressure change causes the valves to open up like a flap door to allow the blood to flow in and then shuts close to restrict blood from flowing back.
With a mild damage in the valves, doctors may treat them with medicine. Only if there is severe damage or prospective chance of severe valve damage, the best cardiac surgeon in India takes the method of valve replacement to avoid life-threatening risks. Some complex cases may need more than one repairing or replacement for getting an absolute cure.
Instead of organic valves, these days, mechanical valves are more commonly used in the surgeries. They are made from metal, carbon or reliable plastic sources. As the valves are long lasting, doctors can rely upon them to handle the blood pressure of the patient’s body during the whole lifetime of him or her.
Other than these, biological valves are also extracted from suitable animal or human tissues (allograft and homograft) to be donated to the needful heart. A patient’s own tissue is ideal for the autograft process of valve replacement.
It is advised to admit the patient a day or two prior to the operation. It is mandatory for the patients to get cleaned and disinfected the night before the cardiac surgery. Catheter procedure is safer for patients who have weaker conditions to take the surgery. After the surgery, patients treated with mechanical valves are in utmost need of thinning medicines for the rest of their lives to be safe from any further mishap.
Human heartbeat is usually rhythmic and systematic. Unfortunately for some people, the heartbeat misses its rhythm and either can beat fast or slow or on an irregular beating routine. As many cases of arrhythmia are considered to be harmless they are left untreated by the patients. If you come to know that you have Arrhythmia, your foremost concern is to find out whether it is an abnormal or mere reflex of normal heartbeats.
Reputed hospitals offering cardiothoracic surgery in India are apt with diagnosing clinically significant problems related to arrhythmia and treating them in a proper way.
Arrhythmia researchers are dedicated to investigating the progress of the treatment policy. Some people are neglected from getting support from the people they are associated to, as they do not show any symptoms for seeing visible symptoms.
It is hard for the doctors to understand the acute problem as there is no functionality problem in the patient’s heart. If your family members do not understand what you are going through, it is your responsibility to educate them about the conditions and seek support from them during the cardiothoracic surgery.
Source of Heart Beat
The electrical impulse spread by the monocytes creates coordinated and regular heartbeats. Arrhythmias are mal-organization of myocardial contractions. The abnormal conduction and generation of these impulses cause the heart disorder. At the joint of the vena cava and high lateral right atrium is a clustered cell initiating electrical impulse generation for normal heart beating. These pacemaker cells discharge electrical stimulation for adjacent cells leading to an active function of the heart muscles. The transmission of impulses happens through atria to the vascular node via intermodal conduction tracts with unspecialized myocytes. Thus, the cardiac output remains normal in any atrial rate.
The cardiac surgery to repair the large artery that carries blood named aorta of a human heart is known as Aneurysm repair. The aneurysm procedure is performed in the radiology department or catheterization lab by the best cardiac surgeon in India. The patient lies on the padded operation table with general, epidural or spinal anesthesia.
The aneurysm location, type, and result in the blood pressure influences the symptoms of the disease pressing against the surrounding blood vessels, nerves, and organs. As a result, croaky voice generation, shortness of breath, pain in left arm and shoulder and backache may be experienced.
The treatment of the heart disease depends mainly on the effect of an aneurysm on the patient’s overall health. The type A aneurysm is observed in the upper chest region which is medically significant. But the lower chest or stomach surrounding aneurysm is not much life threatening and thus does not need emergency attention. cardiothoracic surgery on patients is done to stop from out bursting when they tend to grow, become more 5 centimeters in diameter or start showing excessive symptoms.
Artificial heart valve surgery
Mechanical heart valves are used as prosthetics specially designed to substitute the function of the diseased human heart. Originally the human heart consists of four major valves named pulmonic, tricuspid, mitral and aortic. They serve to maintain the unrestricted forward flow of blood through the organ to the whole body. Congenital and acquired disease process cause malfunction of the heart valves resulting in either stenosis (forward flow) or regurgitation (backward flow).
Modern mechanical valves have the life of approximately 5000 years satisfying the entire human life need. But, newest versions of the mechanical heart valves require lifelong treatment and precaution along with intake of blood thinners to make them work in an unhampered atmosphere.
The first ever artificially created heart valve was used to house a silicone elastomer ball in a metal cage, which was commonly referred to as caged-ball. As the blood pressure surpasses the outside pressure of the organ, the mechanical ball is pushed to allow blood flow without any hurdles.
Effect on Children and Pregnant Woman
Heart valve replacement intrigues problem, especially in a child’s health. Factors like the type of artificial valve, the ramification of the choice of a valve, constraints and types influence greatly the post surgery health effect on children. Long term effect of the anticoagulation medication on the children and pregnant women are surveyed before any operative procedure takes place.
Generally, diseases like degeneration, inflammation and abnormal rate of embryologic development cause these kinds of heart valve diseases and require the attention of the best cardiac surgeon in India.
The age size, natural and medical history, pathological background, factors related to cardiac chambers and great vessels are minutely checked before the decision of this cardiac surgery is taken. At first, the natural valve is intended to be reconstructed and preserved, as it is not easy to obtain the ideal size of a prosthetic valve for implantation. As the growth of a child is more than the adults, the valve is easily transformed into a small hypoynamically restrictive one. Adding to the risks, the prosthetic valve can initiate infection in the child’s body.
The three commonly used prosthetic valve types are bioprosthetic, allograft and mechanical. However, during the surgery, a child suffers from management issues such as thromboembolism, endocarditis, reduced blood coagulation, and undue bleeding. Numerous women having prosthetic heart valves are gaining more reproductive years. Those who have adequately efficient valves and are in Class I & Class II of American Heart Association are more likely to have a successful pregnancy and fetal outcome as compared to those in Class III & Class IV. Women of class III and IV complication status should not conceive until they upgrade their health status. The risk of their pregnancies includes cardiac output maintenance, teratogenic effect, and stroke volume. Here, nurses have a leading role in supporting and counseling the children. They can keep the parents informed about the kid’s health benefit of having the cardiac surgery done in the teens.
Use of estrogens-based contraceptives, IUD, and early pregnancy during the teenage can cause valve disorder in near future. Females already with heart valve disorder are advised to use diaphragms, condoms, and spermicide to avoid unattainable pregnancy.
Coronary artery bypass surgery or commonly known heart bypass surgery is a cardiovascular surgery performed in extensive number each year. The surgery aims to replenish any damaged arteries in the patient’s heart.
The doctors providing cardiothoracic treatment in India only opt for this surgery when the arteries are majorly blocked or damaged. If coronary arteries are damaged or blocked, they cannot supply oxygenated blood to the heart’s muscle. Thus, the heart cannot function properly. According to CDC or the Centers for Disease Control, cardiac surgeons in India perform innumerable surgeries each year.
Doctors recommend balloon angioplasty as an alternative to heart bypass surgery. During the treatment, the clogged artery is widened through the threading of a tube and inflation of a small balloon in the organ. After the works of the tools are done, they are removed from the body but leave behind a stent or a small metal scaffold that resists the artery to contract back to the previous size.
The cardiothoracic surgery diverts the blood flow around the certain blocked arteries in patient’s heart. Post surgery, the new pathway has improved blood flow in the heart muscle.
In order to perform the surgery, a healthy vein is extracted from some other portion of the body like chest, arm or leg and is reconnected to the arteries of the heart so that blood flows past the blocked or partially damaged area.
The heart disease can cause a heart attack if neglected for a longer period. It is the reason for resisting blood to flow and also creates unnecessary clots in the organ. The cardiothoracic surgery is proven for giving most of the patients an effective health upgrade.
The best cardiac surgeons in India dealing with vascular complications have experience in performing Atherectomy for treating peripheral vascular occlusive disease. The continued research and analysis advances the treatment and reduces the life-risk of the patients.
The surgery procedure involves the surgeons to insert a specialized catheter into the damaged artery for removing the accumulated atherosclerotic plaque from the blood vessel. The front end of the catheter contains a sharp blade that grinds a bit or laser filaments. A collection tool allows the surgeon to remove the plaque deposited along the wall of the vessel and sucks out any remnant debris.
Atherectomy cuts plaque from the artery wall instead of pushing them into the vessel wall. The surgery can be done to perform vascular bypass graft and treat veins and arteries as well.
Atherectomy is a general percutaneous revascularization for reanalyzing the damaged vascular path through puncturing the skin with needles. The most common insertion access point is close to the groin through the common femoral artery. The other relevant places for performing the tube insertion are the radial artery, brachial artery, dorsalis pedis and popliteal arteries.
The interventionists use the devices keeping in mind certain factors like the type of lesion being treated, the familiarity of the physician with the device and the risk factor of using the device on the patient’s body.
Tissue engineering, a part of regenerative medicine, is a biomedical reconstructive stream to repair and improve the tissues of the biological organ. Efforts to benefit the key stream of medical treatment are currently ongoing through extensive research. In addition to that, technology leveraging from different molecular medicine, biomaterials, nanotechnology, biochemistry and genetics is prime for development in the regeneration field and cell expansion targets. In the area of cardiac surgery application, skeleton myoblasts are easily isolated and influence the organ with high proliferation rate. They are efficiently defined to be hypoxia-resistant.
Natural hydrogel mimic the natural ECM in terms of microstructure and backbone and thus are well-accepted by the hosts. But still, they suffer from batch variation, poor tenability, and more degradation rates. The tunable, reproducible and amenable synthetic hydrogels are regulatory early from the manufacturing protocols. Degradation rates are controlled by the chemical modification resulting in cellular attachment site integration. Besides these, the semi-synthetic hydrogels consist features from both the classes. In fact, they allow any matter to couple the synthetic component or modify natural and purified biopolymer.
During the cardiomyoplasty surgery, the best cardiac surgeons in India cautiously take out a skeleton muscle from the abdominal or back area and place it on the diseased heart. Post surgery, the muscle works as a pacemaker to improve the organ’s pumping motion.
Various cardiac surgery methods for supplementing the organ’s functionality are gaining more advancement each day with the constant research support. Each procedure is unique and effective depending upon the surgeons’ expertise. All the procedures include the impeccable part of using the skeleton muscle to make the ailing heart regain the previous functionality. The newly created pumping chamber has specialized burst pacing to result in effective contraction and provide support in circulation.
The cardiothoracic surgery is positive for the patient and the families to get their life back. In the recent times, as there is a minimum chance of donated hearts, skeleton muscle implantation is a proven alternative for a heart transplant.