Open Heart Surgery: Basic Things One Should Know

 

During a heart transplant surgery, a deteriorating heart is replaced with a healthier donor heart to save the sick patient's life. Most frequently, patients who require a heart transplant are those whose cardiac diseases have not improved enough with medicine or other treatments. 

Everyone feels a little nervous whenever surgery is suggested, mainly when it concerns the heart. A renowned cardiac surgeon with a significant understanding of heart transplants, open heart surgery, and treatments for treating heart failure, Dr. Sujay Shad has offered vital information about Open Heart Surgery in Delhi in this blog.

When is Open Heart Surgery Required?

A CABG (coronary artery bypass graft) procedure may involve open-heart surgery. Individuals with coronary heart problems may require a bypass artery graft. Coronary heart disease develops when the arteries that provide oxygen and blood to the heart muscle narrow and harden. When fatty tissue forms plaques on the coronary artery walls, hardening occurs. Blood flow is hampered by the narrowing arteries caused by this plaque. A heart attack could happen if the heart's blood supply is impacted.

Other reasons may include the following:

• The replacement or repair of heart valves, which allow blood to flow through the heart

• The repair or replacement of damaged or abnormal heart tissue

• The implantation of medical devices to assist the heartbeat normally

• The replacement of a dysfunctional heart with a donor heart (heart transplantation)

What are the Risks Involved?

• Refusal of the Implanted Heart: One of the most alarming risks after a heart transplant is the body rejecting the donor's heart. If the immune system considers the donor heart a foreign object, this could lead to rejection, which could harm the organ. Every patient receiving a heart transplant receives immunosuppressants.

• Problems With the Arteries: The arterial valves in the heart could possibly thicken and harden after the transplant. Due to this, the heart may struggle to pump blood, which could cause a heart attack, cardiac arrest, myocardial infarctions, or early cardiac death.

• Primary Graft Failure: The most frequent cause of death in the first few months after transplant is primary graft failure, in which the donated heart is not functioning. 

Note: Immunosuppressants must be taken by the person for the rest of their life; among other factors, they can significantly damage the kidneys. Immunosuppressive drugs make it more difficult for a person to fight infections—in the first year following the operation. Thus, it is advised to follow the doctor’s advice. 

What Happens Before the Surgery?

• Inform the doctor about all medications one is taking, including over-the-counter pharmaceuticals, vitamins, and herbal remedies. Let them know if one has a herpes outbreak, the flu, a cold, or a fever. The doctor might advise quitting smoking and stopping blood-thinning drugs, such as two weeks before the procedure.

• One can experience alcohol withdrawal if one regularly consumes three or even more drinks each day and stops soon before the procedure. Following open-heart surgery could result in potentially fatal consequences like seizures or tremors. To lower the chance of these issues, the doctor can assist patients with alcohol withdrawal. 

How is the Procedure Carried Out?

A CABG takes three to six hours:

• Anaesthesia is administered to the patient. That guarantees that the patient will be sleeping off and will remain pain-free throughout the entire procedure.

• An 8 to 10 inch cut is made in the chest by the surgeon.

• The surgeon makes a full or partial cut through the breastbone to access the patient's heart. 

• The patient might be attached to a heart-lung bypass device after the heart is visible. The machine pumps blood out from the heart for the surgeon to perform surgery. Some more recent techniques use something other than this device.

• The surgeon creates a new passage around the obstructed artery using a functional vein or artery. The wire is left within the body after the surgeon uses it to seal the breastbone. The first cut has been repaired.

• After surgery, the breastbone is repaired with small plates and screws known as sternal plating.  Sternal plates may normally be necessary for individuals who are at high risk, including those who have undergone several surgeries or are elderly. 

What Happens After the Procedure?

In order to determine whether the system is rejecting the new heart, periodic cardiac biopsies are performed in the first few months after transplantation, when rejection is particularly likely to happen. Over time, less frequent biopsies become necessary. Any signs of resistance, including gaining weight, feeling out of breath, a fever, weariness, and decreased urination, will be examined in terms of one's health.

Book an appointment with Dr. Sujay Shad, best bypass surgeon in Delhi, at Sir Ganga Ram Hospital straight away to learn more about heart problems and life-saving heart transplant surgery.

Angina Signs And Symptoms- What To Do To Save A Life

Angina is a syndrome- a set of symptoms including chest pain or discomfort which occurs due to insufficient oxygen-rich blood supply to the heart muscles. It is not a disease but a warning sign of having a risk of heart attack or stroke. It is usually caused by coronary artery disease- a heart disease wherein coronary arteries become narrowed, hence reducing blood flow to the heart. ‘When this happens, the heart may beat faster and harder to receive more blood, causing a noticeable pain in the chest area’ shares Dr. Sujay Shad, an expert and senior heart doctor in Delhi practising at Sir Ganga Ram Hospital

 

Signs of Angina

 

The main symptom of angina is chest pain or discomfort which usually-

 

• feels dull, tight/squeezed, or heavy and it may radiate to the jaw, neck, arms, shoulders, back, or belly
• is triggered by stress or physical exertion
• stops after some resting.

 

The chest discomfort usually starts behind one’s breastbone and some people may not be able to exactly locate the source of pain. Some people feel angina like their indigestion or gas. Due to a lack of oxygen supply to the heart, a person can experience symptoms that are not felt in the chest area, called angina equivalents. These include:

 

• Fatigue or extreme tiredness
• Shortness of breath
• Nausea or Vomiting
• A lot of sweating.

 

Types of angina

 

Angina can be of varying kinds including:

 

1.  Stable Angina (Angina Pectoris): It is a temporary feeling of pain, pressure, fullness, or squeezing sensation at the centre of the chest, lasting for only 5 minutes or less. This feeling may spread to other body parts and may feel like gas or indigestion. The symptoms may show up and disappear in predictable patterns for at least 2 months. It is usually noticed in people having strong emotions like extreme anger, anxiety, or stress; during body exertion like walking up a hill; after having a heavy meal; any time when the heart is made to work harder; in extreme weather conditions (too hot or too cold). Usually, it is the case with patients suffering from coronary artery disease. Proper rest and certain medications can alleviate it. 

  

2.  Unstable Angina: Unlike usual stable angina, the pain feels more intense or worsens, and may last for more than 20 minutes. It may go away and return and may be accompanied by shortness of breath. It can happen to anyone while resting or sleeping or during light physical activity. It is not predictable, may be a sign of a heart attack, and rest or medications may not let it fade away.  

 

3.  Microvascular Angina: It refers to severe chest pain lasting for at least 10 minutes. The patient may even experience shortness of breath, fatigue, sweating, or trouble sleeping. It occurs during physical exertions, periods of strong emotions, and normal daily routines. It is a symptom of coronary microvascular disease. Immediate relief cannot be provided by medications.

 

4.  Prinzmetal (Variant or Vasospastic) Angina: The chest pain is unbearable or the lower chest may feel like having vague pain or pressure. It may spread to the jaw, neck, or left shoulder and may go along with fainting, nausea, dizziness, or cold sweat. It happens in a recurrent pattern when one is sleeping or resting often between 12 a.m. to 8 a.m. It is the least commonly occurring angina which can be relieved by certain medications. It is a symptom of coronary spasms affecting younger people.

 

When to Seek Medical Help?

 

If a person is diagnosed with angina and experiences an attack of chest pain that disappears after a few minutes of resting, he/she must have an urgent appointment with a general physician. The doctor would be able to identify if the pain is caused by a heart problem and refer the patient for certain tests. Chest pain lasting for more than a few minutes must be taken more seriously and the patient must consider it an emergency.

 

By becoming aware of the signs and symptoms of angina, one can take immediate steps for its treatment and perhaps save a life- maybe his/her own life. If one is having unexpected or severe chest pain, it could be a possible sign of an upcoming heart attack. So act promptly, call emergency services, and get to the hospital for medical assistance from a cardiologist to avoid serious health issues.

 

How Angina Can Be Treated?

 

Angina can be probably treated with certain medications that are taken for remaining life and also proper rest. Medications may be prescribed for treating attacks, preventing future attacks, and reducing the risk of having strokes or heart attacks. Medications may not be suitable in every patient case. Sometimes, surgery may be needed to save a life. An operation of the heart to improve blood flow to the muscles may be recommended. For instance, if the patient has angina due to coronary artery disease, the cardiac surgeon may fix a blocked artery by coronary artery bypass graft surgery or coronary angioplasty and stent placement.

 

Living with angina

 

If one is diagnosed with angina, then it’s important to have a healthy lifestyle to avoid the risk of heart attacks and strokes. Hence, the patient must:

 

• Have a healthy, well-balanced diet
• Quit smoking
• Limit alcohol intake
• Lose and maintain body weight- if overweight or obese
• Regular exercise- mild to moderate intensity ones are usually safe.

 

If one is experiencing the above mentioned symptoms and want to know more about the ways and treatments that can help one to live healthy, consult now with Dr. Sujay Shad, best cardiologist and heart doctor in Delhi at Sir Ganga Ram Hospital. He is an expert heart surgeon with experience in performing many lifesaving heart surgeries. To know more consult today!

What Is Heart Surgery? A Brief Introduction

 Any procedure involving the heart or the blood arteries that supply it is referred to as a cardiac operation. It is also referred to as heart surgery or cardiovascular surgery. It's a significant process that can enhance heart health and blood flow while giving one a completely new perspective on life. Heart surgery can fix inherited problems (congenital heart disease). Additionally, it can fix problems that surface later in life. The underlying issue or issues that need to be addressed determine the kind of heart surgery one will have. 

Dr. Sujay Shad, the best cardiac surgeon in India, uses his surgical skills and techniques that he has developed over the course of his studies, training, and decades of practice to successfully execute a variety of heart procedures for his patients. However, there are a number of heart diseases and various procedures to treat them are still misinterpreted. This article attempts to clear these out with important insights by the doctor. Continue reading further to know more. 

Symptoms

The symptoms may point to various heart diseases and are not specific. These include: 

• Breathing difficulty

• Irregular heartbeats or a "flip-flop" feeling in the chest

• An increased heartbeat

• Dizziness or weakness

• Nausea

• Sweating

• Vomiting

• Fatigue

• Fainting

• Bloating

• Feeling of suffocation (it may feel like heartburn)

• The ankles or feet may swell rapidly or irregularly, 

• Cyanosis

• Poor weight gain

• Recurrent lung infections

Who is an ideal candidate for Heart Surgery?

• Cardiac surgery is required for people with a variety of heart issues. These include irregular heart rhythms, dysfunctional heart valves, and obstructions in the vessels that provide blood to the heart.

• Heart surgery is typically prepared ahead as part of the treatment strategy. This occurs when the doctor  determines that the best or the only approach to cure the heart condition is through surgery. 

• Sometimes the need for cardiac surgery arises unexpectedly and must be treated as an emergency. This may occur if one experiences a heart attack or is identified as having serious blockages that put one's life in immediate danger. To learn more about heart surgery, book a consultation with Dr. Sujay Shad, one of the best Heart Surgery Doctors in Delhi, at Sir Ganga Ram Hospital. 

Types of Heart Disease

• Aneurysms: A protrusion in the heart muscle or arterial wall is called an aneurysm. The major artery that transports blood from the heart to the parts of the body,  is where this happens. In the abdomen, aortic aneurysms may develop. They rarely develop in the chest.

• Arrhythmias: An abnormal heartbeat is known as an arrhythmia. The heart may be beating too quickly (tachycardia) or slowly enough (bradycardia). The heart could also beat irregularly. An arrhythmia can damage the heart over time and cause major issues.

• Congenital Heart Disease: Congenital cardiac disease can take many different forms and affect infants, children, and adults. 

• Coronary Artery Disease: Some congenital cardiac abnormalities require immediate postpartum treatment. CAD is caused by atherosclerosis, which is a steady accumulation of plaque in the arteries. The heart receives oxygenated blood through three coronary arteries. Their function gets disrupted due to this. It's harmful to have excessive plaque in the coronary arteries. Without adequate blood, the heart cannot receive enough oxygen and nourishment, called  myocardial ischemia. The plaque has the potential to rupture as well, which would cause a blood clot to develop.

• Heart Failure: Heart failure is a common comorbidity for other cardiovascular diseases. These include excessive blood pressure and coronary artery disease. 

• Heart Valve Disease: Any one of the four heart valves can develop heart valve disease (tricuspid, pulmonary, mitral or aortic). However, it occurs most frequently in the aortic valve.   

Different types of Heart Surgeries

• Coronary Artery Bypass Grafting (CABG): To reroute blood flow to the heart, CABG uses a healthy blood artery from another part of the body. Typically, arteries from the arms or chest or veins from the legs are used.

• Heart Valve replacement or repair: A valve that regulates the blood flow can now open wider or close more firmly thanks to this procedure.

• Aneurysm repair surgery: A graft which is an artificial artery, composed of a particular kind of fabric, replaces the damaged section of the aorta. 

• Septal myectomy: The septum is slightly split during the procedure. This promotes increased blood flow from the left ventricle to the aorta and lessens symptoms. 

• Atrial fibrillation: The scar tissue is created in the heart. It suppresses the aberrant electrical signals that lead to AFib. Then, the heart can resume its regular rhythm. 

• Insertion of a device: pacemaker, ICD, LVD, TAH, etc.  are the devices that help the heart to work efficiently. 

• Heart Transplant Surgery: A heart transplant is a last-resort option for those with end-stage heart failure. It involves swapping the heart out for a donor heart.

What happens before the surgery?

• Describing the symptoms and how long they have been present.

• Discussing both the personal and the medical backgrounds of one's biological family.

• Blood tests to determine cholesterol and other vital statistics.

• The care team will explain exactly how to get ready and what to expect if one needs surgery.

• Diagnostic tests will also be performed by the team. These examinations provide a thorough picture of one's heart and any issues. 

• Computed tomography of the heart (cardiac CT)

• Magnetic resonance imaging of the heart (heart MRI)

• A chest X-ray

• Cardiovascular imaging

• Echocardiogram (echo) (echo)

• (ECG/EKG) Electrocardiogram

• Test for stress

What happens during the surgery?

Depending on the kind of operation one is  having, different factors can be involved. It also depends on the approach the surgeon employs to carry out the procedure. Different techniques are used by surgeons to operate on the heart. These include minimally invasive cardiac surgery, off-pump bypass, and open heart surgery. 

What happens after the surgery? 

Following heart surgery, one will be transferred to the ICU.  The procedure one underwent and how the body reacts to it, will determine how long one needs to stay in the hospital. Recovery  varies for every person. The medical staff will closely monitor to make sure that recovery is going smoothly. Additionally, they are ready to recognize and address any issues that may arise.

A skilled heart surgeon is strongly advised to choose which course of action is best for each individual. The optimal treatment approach would depend on a person's age, other medical disorders like diabetes, kidney disease, aortic calcification, past medical history, etc., according to the doctor. To know heart surgery cost in Delhi, consult Dr. Sujay Shad at Sir Ganga Ram Hospital.

Open Heart Surgery: Basic Things One Should Know

 During a heart transplant surgery, a deteriorating heart is replaced with a healthier donor heart to save the sick patient's life. Most frequently, patients who require a heart transplant are those whose cardiac diseases have not improved enough with medicine or other treatments. 

Everyone feels a little nervous whenever surgery is suggested, mainly when it concerns the heart. A renowned cardiac surgeon with a significant understanding of heart transplants, open heart surgery, and treatments for treating heart failure, Dr. Sujay Shad has offered vital information about Open Heart Surgery in Delhi in this blog.

When is Open Heart Surgery Required?

A CABG (coronary artery bypass graft) procedure may involve open-heart surgery. Individuals with coronary heart problems may require a bypass artery graft. Coronary heart disease develops when the arteries that provide oxygen and blood to the heart muscle narrow and harden. When fatty tissue forms plaques on the coronary artery walls, hardening occurs. Blood flow is hampered by the narrowing arteries caused by this plaque. A heart attack could happen if the heart's blood supply is impacted.

Other reasons may include the following:

• The replacement or repair of heart valves, which allow blood to flow through the heart

• The repair or replacement of damaged or abnormal heart tissue

• The implantation of medical devices to assist the heartbeat normally

• The replacement of a dysfunctional heart with a donor heart (heart transplantation)

What are the Risks Involved?

• Refusal of the Implanted Heart: One of the most alarming risks after a heart transplant is the body rejecting the donor's heart. If the immune system considers the donor heart a foreign object, this could lead to rejection, which could harm the organ. Every patient receiving a heart transplant receives immunosuppressants.

• Problems With the Arteries: The arterial valves in the heart could possibly thicken and harden after the transplant. Due to this, the heart may struggle to pump blood, which could cause a heart attack, cardiac arrest, myocardial infarctions, or early cardiac death.

• Primary Graft Failure: The most frequent cause of death in the first few months after transplant is primary graft failure, in which the donated heart is not functioning. 

Note: Immunosuppressants must be taken by the person for the rest of their life; among other factors, they can significantly damage the kidneys. Immunosuppressive drugs make it more difficult for a person to fight infections—in the first year following the operation. Thus, it is advised to follow the doctor’s advice. 

What Happens Before the Surgery?

• Inform the doctor about all medications one is taking, including over-the-counter pharmaceuticals, vitamins, and herbal remedies. Let them know if one has a herpes outbreak, the flu, a cold, or a fever. The doctor might advise quitting smoking and stopping blood-thinning drugs, such as two weeks before the procedure.

• One can experience alcohol withdrawal if one regularly consumes three or even more drinks each day and stops soon before the procedure. Following open-heart surgery could result in potentially fatal consequences like seizures or tremors. To lower the chance of these issues, the doctor can assist patients with alcohol withdrawal. 

How is the Procedure Carried Out?

A CABG takes three to six hours:

• Anaesthesia is administered to the patient. That guarantees that the patient will be sleeping off and will remain pain-free throughout the entire procedure.

• An 8 to 10 inch cut is made in the chest by the surgeon.

• The surgeon makes a full or partial cut through the breastbone to access the patient's heart. 

• The patient might be attached to a heart-lung bypass device after the heart is visible. The machine pumps blood out from the heart for the surgeon to perform surgery. Some more recent techniques use something other than this device.

• The surgeon creates a new passage around the obstructed artery using a functional vein or artery. The wire is left within the body after the surgeon uses it to seal the breastbone. The first cut has been repaired.

• After surgery, the breastbone is repaired with small plates and screws known as sternal plating.  Sternal plates may normally be necessary for individuals who are at high risk, including those who have undergone several surgeries or are elderly. 

What Happens After the Procedure?

In order to determine whether the system is rejecting the new heart, periodic cardiac biopsies are performed in the first few months after transplantation, when rejection is particularly likely to happen. Over time, less frequent biopsies become necessary. Any signs of resistance, including gaining weight, feeling out of breath, a fever, weariness, and decreased urination, will be examined in terms of one's health.

Book an appointment with Dr. Sujay Shad, best bypass surgeon in Delhi, at Sir Ganga Ram Hospital straight away to learn more about heart problems and life-saving heart transplant surgery.

Heart Transplant Surgery- What One Need To Know

 A deteriorating heart is substituted by a healthier donated heart during a heart transplant procedure to save the life of the diseased patient. People who need a heart transplant are typically those whose heart conditions haven't progressed enough with medication or other procedures. Even though a heart transplantation is a big procedure, the chances of survival are strong with the right aftercare and proper surgical management.

Everyone is a little apprehensive about surgery whenever it is mentioned, especially when it involves the heart. Renowned heart surgeon, Dr. Sujay Shad, has extensive knowledge about heart transplant and open heart surgery in Delhi and procedures concerned with heart failure, and in this blog he has shared more information related to heart failure and transplant treatment.

 

Why is heart transplant surgery performed?

 

When other methods of treating cardiac issues have failed and heart failure has occurred, heart transplants are done to save the patient's life. 

People may Suffer From Heart Failure Due to:

• A deterioration of the heart's muscle (cardiomyopathy)

• Cardiovascular disease

• Heart valve dysfunction

• An inherited heart condition (congenital heart defect)

• Ventricular arrhythmias that are dangerously recurrent and are not under control with conventional therapies

• A prior heart transplant that failed.

Congenital heart defects or cardiomyopathy are the two main causes of heart failure in children. In certain cases, patients with specific diseases may undergo a heart transplant along with another organ transplant (multiorgan transplant). 

• Kidney and heart: Some patients with both kidney and heart failure may be candidates for this surgery.

• Liver and heart: For those with specific liver and cardiovascular issues, this treatment might be an option. 

• Lung and heart: Rarely, if a heart transplantation or lung transplant alone cannot cure a patient's serious lung and heart issues, a specialist may recommend this operation.

How is the Surgery done?

Wait for the donor heart:

One will be added to a waiting list by the transplant center, it is determined that one is an excellent contender for a heart transplant. As there are more patients in need of hearts than there are donors, the wait may be lengthy. The doctors may advise having a Ventricular Assist Device (VAD) inserted to maintain the heart whilst patients wait for a donor organ if medical therapy is unable to support the vital organs.

Just before the procedure:

The donor organ must be used for a heart transplant within 4 hours of the organ's removal. As a result, hospitals within a specified interval of the donation hospital are provided hearts first, followed by a center nearby. The medical team will perform a final evaluation once one gets to the hospital to determine whether the donor heart is a good match for the patient.

During the procedure:

Open-heart surgery for heart transplants lasts for several hours. If one has had previous cardiac operations, the procedure will be more difficult and take longer. To maintain oxygen-rich blood moving throughout the body, patients are attached to a heart bypass machine. The chest will be cut open. The surgeon splits the chest bone and cracks apart the rib cage. The damaged heart is subsequently removed, who then stitches the donated heart into position. The main blood vessels are then joined unto the donor heart.

After the procedure:

One's health will be checked for any indications of resistance, such as weight gain, feeling short of breath, fever, exhaustion, and decreased urination. One will undergo repeated cardiac biopsies in the initial few months following transplantation, while rejection is most likely to take place, to ascertain whether the body is resisting the new heart. Over time, fewer biopsies are required on a regular basis.

If one is feeling any discomfort that can lead to heart problems or heart failure, one can book an appointment at Sir Ganga Ram Hospital, best heart hospital in India to get examined and treated by the best bypass surgeon in Delhi, Dr. Sujay Shad. 

 

Risks-

Every surgery is associated with some kind of risk. Hence It is important to underwent the surgery from an expert for best outcomes and obtain lower risks after surgery:

• Rejection of the transplanted heart: The body discarding the donor heart is one of the most concerning dangers following a heart transplant. The immune system can attempt to reject the donor heart if it perceives it as a foreign entity, which could harm the organ. Immunosuppressants are given to every heart transplant patient. 

• Primary graft failure: The donor heart is not functional in this condition, which is the most common reason for death in the initial months following transplant. 

• Issues with one’s arteries: It's possible that following the transplant, the artery walls in the heart may thicken and stiffen. As a result, the heart may have trouble pumping blood through it, which may result in a cardiac arrest, heart failure, myocardial infarctions, or sudden death.

• Side effect of medicines: One will  need to take immunosuppressants for the rest of their life, and they can severely damage the kidneys, among other things.

• Infection: Immunosuppressive medications make it harder for one to fight infections. In the first year after the surgery.

• Cancer: Its risk can also be increased by immunosuppressants. These drugs can increase the risk of developing several cancers, including Hodgkin's and skin cancer.

To know more about heart issues and life saving heart transplant surgery, book a visit now with Dr. Sujay Shad, best heart doctor in India at Sir Ganga Ram Hospital.