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Dr Rajneesh Malhotra
(Chief Cardiac Surgeon)
Max Super Specaility Hospital
(East Block), Saket
Phone: +91-11-26515050, 9999722781
Fax: +91-11-2651-0050
Email: drrajneeshmalhotra@gmail.com
Ms.Vandana Rawat
(Secretary to Dr. Rajneesh Malhotra)
Phone: +91-9650429068

Dr Rajneesh Malhotra Blog

Heart Surgery: Newer Technologies, Changing the Paradigm

From the times of Simple Heart Ailments and Difficult Surgeries to Difficult Ailments and Simple Surgeries at the dawn of a new Era –

In old days of the Heart surgery was a difficult surgery. To get good access to the vision and hands of the surgeon the incision made was usually big. With the intend to nave clear vision on one hand and to keep incision as small as possible it was desirable from the surgeons to have Eagle’s eye and Ladies fingers. Previously the chest bone was cut and retracted to clear the view of the heart surgeon & his first assistant surgeons own hands use to become limiting factors. The space was small and movement was restricted. Under these limitations surgeons still performed to their maximum ability.

With the development & New inventions, Endoscopes came in. the vision became better/ with a small hole, tube with cameras and operating instruments were send into the body of the patient. Without leaning into the openings for partial views, now everyone in Operation theatre has a magnified view on Screens. Small movements are effective. To further assist the surgeon Robotic surgeries came into existence. The incision became further smaller, Instruments become tinier and precise and vision improved beyond Expectation. During this process the surgeon is shifted away from the patient on the Operation Table.

Surgeon now sits on the console. Surgeons are relieved from hours of standing and leaning over the patient to get into the Operation openings and perform surgery. Everything is computer documented. Every step is planned and then move is taken. Mistakes have reduced tremendously. With 3D vision & 360 degree approach it has become no less than creating a piece of an art on the computer. With one assistant surgeon in the Operation Theater the surgeon with his console can sit miles away from the patient and perform and accurate surgery.

Every time you can’t have a chance to operate on a dying person there and then. Either the dying heart is inoperable or Heart may not be readily available in case of Heart Replacement, or rest to the ailing heart can put back heart into function again. So the issue was to gain time in spite of best surgical Procedures. ECMO (Extra Corporeal Membrane Oxygenation), a machine came to rescue these types of patients.

Heart and Lung Machine could be used for 6-7 hours only and support heat, lung and body but ECMO can be used over 6-7 Weeks and keep the patient alive, awake and active. ECMO is made up of two parts, one is oxygenator and another is pump. Pump is like a heart. It rotates several thousand times a minute to provide ample amount of blood to the body as in normal condition heart does. Oxygenator purifies the blood and works like a lung. Not only cardiac cases but acute respiratory failure cases because of bacterial or viral pneumonitis or HINI infection (Swine Flu) can be put on but on ECMO to support the lungs, till the lung factions improve, then the patient can be taken off from ECMO support. Seventy percent of dying patients survived due to this latest invention. If 37 thousand patients have been saved of 53 thousand dying cases across the globe, then few of them was saved here also defeating 70% mark.

Results with us are much better because this machine can be taken to the patient where he can be in other city hospital or his residence or even on roads in case of severe Road Traffic Accidents. A dedicated ECMO team is created which involves lot may people working round the clock to save. Because every life Counts.

Posted on : October 19, 2013 by Cardiac Doctors in Delhi
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