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MAHARAJA AGRASEN HOSPITAL

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Cardiology

The Department of CARDIOLOGY has
  •  Dedicated ICU
  •  Dedicated OT
  •  Experienced Anesthesia team
  •  Expert Cardioc  Surgeons and Perfusion Technology team

The Department of Cardic Surgery fully equipped with state of the art facilities to deal with every related medical condition.
 
The Department also has advanced post operative surgical ICU and step down ward along with two operation theatres with state of the art equipment.
 
Cardic Surgery department not only involve themselves in performing Cardic Surgery, but also render regular technical and specialty support to the Cardiology unit, Transplant unit and Pulmonology unit within the hospital.

Services Offered:

Coronary Artery Bypass Surgery (CABG):
As a solution of blocked and narrowed vessel and compromised blood flow to heart due to it ,a graft is obtained from other part of the body and is attached  above and below the blockade so as to divert the blood flow.

On Pump CABG:
It is also known as Open Heart Surgery. Heart’s and lung’s functions are replaced with a machine known as “Heart-Lung Machine”. The process of such replacement of function is known as extracorporeal (outside the body) membrane oxygenation (ECMO). The operator/technician responsible for handling and use of the equipment is known as perfusionist. The heart-lung machine is made up of majorly three parts: a pump (either non-occlusive or occlusive roller pump), a blood oxygenator, and a blood warming device. Through plastic tubing, connection of these three parts with anatomical heart is made. Deoxygenated blood is pumped to oxygenator to remove carbon dioxide from blood. Oxygenated blood is thereafter pumped to respective artery/vein of the body.Schematic block diagram for orientation of position of Heart Lung Machine:

Off-pump CABG:
Beating Heart Surgery Another technique with advantage of lesser patient harm is known as off-pump CAB (OPCAB) as it doesn’t utilize any pump. It doesn’t require heart lung machine. The surgery is performed on beating heart that’s why it is called as “beating heart surgery” – a highly precise, complex and skill demanding procedure. We are proud that our cardiothoracic surgery team has exceptionally excelled in this technique and has shown continued commitment towards patient safety.

Minimally invasive coronary artery bypass:
We also perform MICS-CABG which seems like a boon as according to name itself; it requires a very minimal invasion similar to that made using a key i.e. keyhole. We have great success in patients with Left Ventricular Ejection Fraction (LVEF) even less than 25% i.e. critical heart failure patients.

Valvular Diseases:
Cardiothoracic surgery unit has established a dedicated unit for surgical /interventional procedures for valvular diseases including left atrial appendage ligation and electro cautery maze. The diseased valves could be either repaired or replaced based on its diseased condition’s severity and surgery recommendations.

Septal Defects:
It is a disorder where due to abnormality (majorly hole in septum separating two chambers of ventricles), a portion of blood from one chamber enters to another. Thus, it is sent back for oxygenation even after being oxygenated. This causes increase in load to heart and also causes gradual damage to lungs.

Tetralogy of Fallot:
It is a group of four diseased conditions in the heart, which is a congenital abnormality. It is characterized by the following: a large ventricular septal defect (VSD), pulmonary stenosis, right ventricular hypertrophy and an overriding aorta.As a solution of blocked and narrowed vessel and compromised blood flow to heart due to it ,a graft is obtained from other part of the body and is attached  above and below the blockade so as to divert the blood flow.

Pediatric Cardiac Surgeries:
We have unique expertise in surgical management of paediatric cardiac diseases and/or congenital cardiac diseases with full time availability of paediatric cardiologists, paediatric cardiac surgeon and latest diagnostics technologies including fetal echo.

 

Aortic surgery:
MAH cardiothoracic surgeons treat diseases on ascending aorta, aortic arch, descending aorta including thoracoabdominal repairs, thoracic and abdominal aorta endovascular stent graft procedures which are all performed by a multidisciplinary surgical team.
For ascending thoracic and abdominal aorta aneurysms, a minimally invasive endovascular approach is becoming the preferred method, decreasing morbidity and mortality in these
patients when performed by a skilled team. We use the endovascular approach for thoracic aorta aneurysm surgery.
 

MAZE Procedure for Treatment of Atrial Fibrillation:
Atrial Fibrillation (AF) is an abnormal heart rhythm where the upper chambers of the heart contract in an uncoordinated fashion and start rapid and irregular beating. AF is dangerous because it may cause blood to pool in these chambers. The pooled blood can lead to clumps of blood called blood clots. A stroke can occur if a blood clot travels from the heart and blocks a small artery in the brain.

Maze surgery cures AF by creating a “maze” of new electrical pathways to let electrical impulses travel easily through the heart. Our team recommend Maze surgery if AF cannot be treated with medicines or other treatments. During the procedure, a number of incisions are made on the left and right atrium to form scar tissue, which does not conduct electricity and disrupts the path of abnormal electrical impulses. The scar tissue also prevents erratic electrical signals from recurring. After the incisions are made, the atrium is sewn together to allow it to hold blood and contract to push blood into the ventricle.
 

Hypertrophic cardiomyopathy surgery – septal myectomy:
Septal myectomy is the gold-standard therapy for hypertrophic obstructive cardiomyopathy (HOCM).  The surgery entails removing a portion of the septum that is obstructing the flow of blood from the left ventricle to the aorta. Septal myectomies have been successfully performed for more than 25 years. The alternatives to septal myectomies are treatment with medication (usually beta or calcium blockers) or non-surgical removal of tissue with alcohol ablation. Ordinarily, septal myectomies are performed only after attempts at treatment with medication fail.
 

Heart failure surgery
 

Implantable left ventricular assist device (LVAD):
An LVAD is a kind of artificial heart pump. It is used to treat people with severe heart failure and is sometimes given to people on the waiting list for a heart transplant. Normally, the left ventricle, one of the heart’s four chambers, pumps blood into the aorta (the large artery leaving the heart) and around the body. In the event that someone has severe heart failure, the heart is too weak to pump enough blood around the body. Some patients being considered for a heart transplant may need to have an LVAD implanted if they are unlikely to survive until a suitable donor heart becomes available. The device helps the failing heart and aims to restore normal blood flow.
 

Left Ventricular Reconstruction:
After a heart attack in the left lower chamber of the heart (left ventricle), scar tissue will form in the left chamber.  As the time passes this scar tissue can weaken and thin out to become an aneurysm–an abnormal bulge of tissue. This aneurysm–in conjunction with other heart problems–can cause the heart to enlarge, reducing its ability to pump blood effectively, resulting in heart failure.

 
In a ventricular reconstruction surgery, surgeons remove part of the aneurysm scar tissue to reshape the heart and restore it to its normal, conical shape. Typically, a small patch is sewn into place where the aneurysm once was. With the patch in place, surgeons sew tissue over the patch. Other procedures, such as valve repair or coronary artery bypass may be performed during the ventricular reconstruction operation.

Top Surgery & Procedures

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Valvular Heart Surgery