Cardiothoracic and Vascular Surgery Procedure

First of its kind innovative technology for Aortic valve surgery, at Sakra World Hospital

Every year thousands of people in India alone, require aortic valve surgery which can not only be expensive but also require the use of an artificial valve, which demands strict diet restrictions and life-long monthly blood tests. 

But innovative technology and the revolutionary Ozaki procedure, has changed that. With this new technique, the person gets a valve, tailor-made for him, from his body’s own tissues, literally, at no additional cost, and would have the freedom to eat anything he or she wanted. The patient also could avoid the life-long monthly blood tests, and enjoy the same quality of life that people with more expensive and more fastidious valve prosthesis have.

“This special technique was introduced by Dr. Ozaki 15 years ago and has seen the tremendous response in Japan and the world.  In a conventional valve replacement surgery, an artificial valve, made of either metallic elements, or sourced from an animal like a cow or a pig is used.  In the Ozaki procedure, the valve is made upon the patient’s own pericardium, a sac surrounding the heart.  It takes 20 minutes to prepare the new valve from the tissues.  The entire surgery takes over four hours, half an hour more than conventional surgery” explained Dr. Adil Sadiq, Senior Consultant & Head – Adult Cardiac Surgery, Sakra World Hospital. 

The aortic valve controls the flow of blood from the heart to the rest of the body. In the Ozaki aortic valve reconstruction procedure, after removing the diseased valve,   specialized equipment is used to make precise measurements of the heart. Then the patient’s own pericardium is used to fashion specifically sized leaflets using specialized templates, and the leaflets are then sewn precisely into place, to reconstruct a new normally functioning valve.

Dr Adil Sadiq, Head of the Department of Cardiothoracic Surgery, Sakra World Hospital, Bangalore, has been at the forefront of pioneering this technique in India, and his team leads the only center in the country to be able to provide patients with this option. Initially conceptualized by Dr. Ozaki, in Japan, this technique has found many takers, including the world-famous Cleveland Clinic, USA, and the Great Ormond Street Hospital, UK.

Dr. Adil Sadiq
Senior Consultant & Head - Adult Cardiac Surgery
MS (Gen.Surgery), MCh (CVTS), FACS (USA), FMICS (USA)
Department - Institute of Cardiac Sciences

Successful Knee Replacement Surgery on a High-Risk Cardiac Patient

Dr Jagdish from Bhopal, aged 70 years, was suffering from pain in both his knees for the past 6 years and in the last 3 years the pain aggravated to unbearable levels. Being a doctor himself, he feared undergoing the knee replacement surgery and kept postponing the surgery. Having previously undergone a cardiac bypass (open heart) surgery and an angioplasty, he was all the more terrified trying to take a decision on knee replacement.  When the pain became unbearable, he made up his mind to undergo the surgery.

Both his knees needed to be replaced and therefore he wondered if it had to be done in two different sittings or in one go. Although every doctor he met recommended two separate sittings, he decided otherwise. The rationale behind the decision was in fact simple; two sittings would mean double rehabilitation. The advantage of a single sitting is that the post-surgery recovery period is significantly reduced and also avoids the psychological distress of getting admitted twice.

He met many specialists and hospitals across the country to settle with the most adept hands to replace his knees. After through research, he finalized on Dr. Chandrashekar P of Sakra World Hospital, who is a pioneer in “MINIMALLY INVASIVE COMPUTER ASSISTED KNEE REPLACEMENT”.

After a through clinical analysis, Dr Chandrashekar referred him to a cardiologist for their opinion on his heart’s condition. Taking a look at his reports and consulting with the cardiologist, Dr Chandrashekar P. said with a broad smile, “Don’t worry doctor saheb. We’ll replace both knees at once.”

Dr. Jagdish is now completely recovered and happy that he took this life changing decision. “If in future my wife has to under a knee surgery, it would be only under the care of Dr. Chandrashekar” Says Dr. Jagdish jokingly.

Life Changing Cardiac LIS

Gone are the days when a dreaded heart operation entailed cracking open your breastbone, and ensuing recovery took months.  Minimally invasive Cardiac surgery has changed all that.

Pioneering current day practice is Cardiac Least Invasive Surgery, or simply Cardiac LIS- the most advanced form of minimally invasive cardiac surgery, where not just the incision size small, but also the pain, blood loss, hospital stay and requirement for strong antibiotics, the least! All these added benefits lead to a recovery period, almost seven times faster compared to conventional heart surgery, and return to home as-early-as three days.

The ‘Key-hole’ access to the heart is facilitated by video-endoscopes, specialized instrumentation, three-dimensional projections, minimal tissue disruption and negligent blood loss. The cornerstone of success is a specially trained surgeon, skilled in robotic and least invasive surgery, andthe harmony that he shares with his equally skilled support team of doctors, nurses and technicians.

Housing the only Biplane Hybrid Catheterization Lab in the country, Sakra World Hospital, Bangalore, has the most advanced operating suite for all Cardiac LIS procedures, including multi-vessel Beating Heart Bypass surgery, Aortic valve replacements, Mitral and Tricuspid valve repairs or replacements, Closure of holes in the heart, Single-sitting combined angioplasty and surgical procedures.

Cardiac LIS has its limitations. Just like it cannot be done at all hospitals or by all surgeons, it is not applicable universally. Still almost 70% of all conventional cardiac operations can be done by the Cardiac LIS technique.

Twenty years ago, everybody was skeptical about a laparoscopic abdominal operation, when today it has become the rule. Cardiac LIS is at that same crossroad. It is the future of cardiac surgery, being performed in our hospital today!

Blog by

Dr. Adil Sadiq
Senior Consultant & Head - Adult Cardiothoracic Surgery,
Sakra World Hospital, Bangalore

Heart Attacks A heart stopping tale

We’ve all heard it, feared it and panicked over it whenever there was even a little pain in our left arm, but heart attacks aren’t the end of the world. In fact, when treated with proper caution and care, heart attacks can be fully recovered from. We at Sakra World Hospital always encourage our patients to make well informed choices. To understand how to shed blind fear of heart attacks, we must try to understand what a heart attack is, its causes, emergency treatment and the rehabilitation. Read on to get to the heart of the matter.

What is a heart attack?

In simple words, a heart attack occurs when the blood flow to your heart is suddenly reduced or cut off. During a heart attack, your heart muscles don't get the oxygen they need & without it, the heart muscles get damaged or destroyed.

What causes a heart attack?

A gradual buildup of cholesterol and a fatty material called plaque in your artery walls usually causes a heart attack. A heart attack occurs when the plaque breaks off your artery wall which then results in a blood clot forming around the broken-off plaque, blocking the artery.

What are the symptoms?

Men and women have different symptoms, but both may have pain, pressure, or discomfort in the chest. Other symptoms include shortness of breath, sweating, fainting, and nausea. Men are more likely to break out in a cold sweat and feel pain move down the left arm during a heart attack.

Women are more likely than men to have back or neck pain, heartburn, shortness of breath, nausea, vomiting, and indigestion. They may also feel extremely tired, light-headed, or dizzy. Flu-like symptoms and sleep problems may also occur 2 weeks before a heart attack.

What should I do in case of a heart attack?

If you or someone you’re with is experiencing the symptoms of a heart attack, the chances of survival are much higher with emergency medical treatment within 90 minutes. Sakra World Hospital has a dedicated cardiac team that is well trained and equipped with the latest technology to treat you in case of a heart attack.

While waiting for emergency treatment, the person with heart attack symptoms should chew and swallow an aspirin to lower the risk of a blood clot (unless they're allergic). If the person is unconscious, hands-only CPR can double his/her chances of survival.

Am I at risk?

Smoking can raise your risk of a heart attack. So can having a high blood pressure, high cholesterol levels, diabetes, and being obese. Your odds of having a heart attack go up with age, and men have a greater risk than women. A family history of heart disease could also increase your risk.

Other things that can raise your risk of a heart attack are a lack of exercise, depression, and stress.

Can I prevent heart attacks?

If you smoke, stop. It will immediately cut your chances of a heart attack by a third. Get exercise and eat plenty of fruits, veggies, and whole grains to keep your arteries healthy.

Will a heart attack treatment affect my daily life too?

If you're in the hospital for a heart attack, you may come home in just a few days. You can resume your normal activities after a few weeks. The Sakra World Hospital offers various cardiac rehab therapies that can help you recover. You'll get a fitness program that's made just for you, and learn how to keep up a heart-healthy lifestyle. Our counselors are always here for your support if you're depressed or worried about getting a second heart attack.

A healthy lifestyle and an active physique go a long way when it comes to heart health. However, a lot of other factors like hereditary risks and diabetes can make your heart health deteriorate. To prevent any such unseen factors from taking a toll on your heart, book a heart check up with our highly experienced cardiac team at bit.ly/cardiacsciences. Our team of specialized doctors ensures that you’re heart stays healthy and you stay happy.

Least Invasive Heart Surgery

Technology has always made healthcare easier and more accessible to the masses. Keeping up with the trend of innovation in healthcare, the latest advent in cardiac surgery is the Least Invasive Surgery. In conventional open-heart surgery, the surgeon makes an incision in the chest and then spreads the ribs to expose the heart. This type of incision is called a sternotomy. However, in least invasive heart surgery, the surgeon makes a smaller incision in the chest. The aortic valve is located near the front of the chest. Surgeons may do this least invasive surgery in different ways. These variations include different ways to:

• Bypass the heart with a heart-lung machine

• Protect the heart during surgery

• Make the incision in the chest to access the heart

Despite these variations, in all other ways the technique for replacing the aortic valve is the same in least invasive surgery as in conventional valve surgery.

What are the potential benefits of least invasive valve replacement surgery?

Less invasive surgery has several benefits over conventional valve replacement surgery. These benefits include:

• Less blood loss during surgery

• Reduced need for blood transfusions

• Reduced chance of irregular heartbeat during surgery

• Possibility of removing the breathing tube sooner after surgery

• Less pain during recovery from surgery

• Shorter hospital stay

• A smaller scar

• Lower risk of infection

• Easier treatment in cases of infection

• Quicker recovery and return to previous level of activity

• Lower overall risk of complications, including death

Should I consider least invasive heart surgery?

While most surgeons worldwide are still working towards perfecting the least invasive surgery, here at Sakra World Hospital, our highly experienced cardiac experts provide you with all the information as well as support that you require during the procedure.

The cardiac experts at the Sakra world hospital such as senior cardiothoracic & vascular surgeon Dr. Adil Sadiq who is one of the few masters in this revolutionary procedure, ensure patients a better result and quicker recovery. For the first time in India, patients experience the precision of a least invasive surgery has added to ease through angioplasty procedures with the fastest recovery possible. Make the most of the least invasive surgery with Sakra experts. To know more visit bit.ly/cardiacsciences to make your heart a happy one.

Heart attacks can strike the young too- healthy lifestyle for a healthy heart

Mr. A, a 35 year old software professional had been looking forward to a holiday with his family. It would be a much wanted break from his stressful schedule. Work had been hectic and he was doing 14 hour shifts and taking work home. He had always smoked but it only got worse in the last few months. An active sportsman during his college days, he had virtually stopped exercising and has been noticeably putting on weight. His friends were making fun of his “beer belly”. Weekends were for partying with friends to beat the stress. Lunch was mostly at the office cafeteria. Of late he felt tired easily and short on stamina. He had been planning to get his annual health check up; it had been pending for the last 2 years. The last time his doctor had warned him that his sugars and lipids were creeping up and he had to pay attention.  That morning he started feeling a nagging heaviness in his chest and a hollow discomfort in the arm. He also had little cold sweat and felt nauseous.

He thought it may be because of the food he had the previous night might caused him acidity. His wife however was worried .She knew he needed urgent attention. She brought him to the Emergency Room at Sakra World Hospital, which was 10 minutes drive from home. After a quick physical evaluation, the doctors at the ER did an ECG and found that he was having a heart attack. They were glad that the family had arrived without wasting time because early treatment would mean less damage to the heart and quicker recovery and return to normal life. The doctors assured the family that, though heart attacks are dreadful, with a quick opening of the occluded artery of the heart by doing an angioplasty, risk would be substantially reduced.

Mr .A was taken to the Cath-lab within 20 minutes of arrival and an angiogram was done through his wrist artery (Radial access – lest discomfort compared to the conventional groin artery approach) . His right coronary artery was found totally blocked in its mid part and that was cleared with angioplasty and stent. He had immediate relief of chest pain and the cardiologists were satisfied to see the prompt recovery on the ECG. He spent 2 days in the hospital including one day in the CCU and was discharged .The pre-discharge ECHO (Scan of the heart) showed that the damage was very minimal. He had a near normal Ejection fraction of 55%. EF below 35 % would have put him at risk of heart failure.His wife’s presence of mind and getting him to the right place at the time made a big difference.

Time in treatment is one of the biggest determinants of outcomes in heart attacks as in any life-threatening medical emergencies. Reaching a fully equipped hospital at the shortest possible time is important rather than to go through multiple levels of care in between. Hospitals equipped with a cath lab with 24x7 availabilities of cardiologists, supported by a team of trained nurses and technicians available round the clock can provide the best care for heart attacks. A fully equipped ER run by highly trained Emergency specialists and Nurses helps achieve prompt response to any life threatening emergency.

He has now promised himself that he will create a proper work life balance and have a healthy family time. He has since stopped smoking and reduced alcohol intake. A diet rich in veggies and fruits, healthy nuts like almonds and walnuts, using healthy oils like olive oil, rice bran oil and sunflower oil has replaced fast foods. Rice based diet has been replaced with whole wheat, all bran and oats. He is now walking regularly, at least 45 minutes on most days of the week. Yoga has given him relaxation and peace. He has been advised to strictly follow the medications to avoid recurrences of his heart problem.

Mr.A has taken this episode as a course correction in his life to put him on the path of healthy living. He has taken it upon himself to guide his children to an early adoption of healthy lifestyle .He is amongst the millions of young Indians who because of rapid urbanization and increasing affluence are suffering the consequences of excess without moderation in consumption and no parallel increase in attention to lifestyle .Lifestyle disorders like diabetes, hypertension, high cholesterol and obesity are on the rise and these in turn increases the risk of heart diseases and stroke. Preventive interventions are always more cost effective. These interventions focus on modifiable risk factors like diabetes, hypertension, high cholesterol, smoking, obesity and sedentary lifestyle.

There are other risk factors that are not modifiable, such as advancing age, male sex and family history of Coronary disease. Though heart attacks are said to be less common amongst women, they still constitute a major cause of morbidity and mortality in women. Additionally women are more prone to delayed diagnosis because of absence of classical symptoms of heart attacks. Also women with heart attacks tend to have more complications than men.Heart attacks, though amongst the deadliest of the diseases, are probably also the easiest to prevent.