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    Capitol Hospital
    Pathankot Road (NH-44),
    Near Reru Chowk,
    Jalandhar -144012
    Tel: 84275-84275
    Fax: 0181- 2366667
    Email: info@capitolhospital.com
24/7 HELPLINE 84275-84275

Department of Cardiac Sciences

Department of Cardiac Sciences

The department of cardiac sciences has two state-of-the-art Cath Labs along with an electrophysiology program and a dedicated cardiac operating room.

In view of a marked increase in heart diseases, the Department of Cardiac Sciences in Capitol offers comprehensive treatment for heart problems and works round the clock to care for your heart in the best possible way. With eminent cardiac specialists, dedicated cardiac operation theatres, digitalized Cath-labs and Cardiac ICUs, your heart receives prompt and prime attention.

The department offers a wide range of services ranging from Diagnosis & Clinical Cardiology to Cardio Thoracic & Vascular Surgery, which are as follows:

  • Cardiology
  • Cardio Thoracic Vascular Surgery
Cardiology

CAPITOL aims to provide comprehensive diagnostic and interventional cardiology services and also aims at delivering excellent, cost-effective and evidence-based patient care.

Cardiology Division of the department is equipped with cutting edge technology in the field of:

Coronary Angiography

What is Coronary Angiography?

Coronary angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the arteries in your heart.

How the Test is Performed?

Coronary angiography is usually done along with cardiac catheterization. Before the test starts, you will be given a mild sedative to help you relax. An area of your body, usually the arm or groin, is cleaned and numbed with a local numbing medicine (anesthetic). The cardiologist passes a thin hollow tube, called a catheter, through an artery and carefully moves it up into the heart. X-ray images help the doctor position the catheter. Once the catheter is in place, dye (contrast material) is injected into the catheter. X-ray images are taken to see how the dye moves through the artery. The dye helps highlight any blockages in blood flow. The procedure may last 30 to 60 minutes.

Why the Test is Performed?

Coronary angiography may be done if you have:

  • Angina for the first time
  • Angina that is becoming worse, not going away as fast, occurring more often, or happening at rest (called unstable angina,)
  • Aortic stenosis
  • Atypical chest pain, when other tests are normal
  • Had an abnormal heart stress test
  • To have surgery on your heart and you are at high risk for coronary artery disease
  • Heart failure
  • Recent heart attack

Assessment of Results

  • Normal: There is a normal supply of blood to the heart and no blockages.
  • Abnormal: An abnormal result may mean you have a blocked artery. The test can show how many coronary arteries are blocked, where they are blocked, and the severity of the blockages.
Coronary Angioplasty

What is Coronary Angioplasty?

Coronary angioplasty is a procedure used to open narrow or blocked coronary (heart) arteries. The procedure restores blood flow to the heart muscle.

What are the types of Interventional procedure that are used in Coronary Angioplasty?

There are several types of interventional procedures which your doctor may use when performing angioplasty. They include:

Balloon angioplasty

During this procedure, a specially designed catheter with a small balloon tip is guided to the point of narrowing in the artery. Once in place, the balloon is inflated to compress the fatty matter into the artery wall and stretch the artery open to increase blood flow to the heart.

Stent

A stent is a small metal mesh tube that acts as a scaffold to provide support inside your coronary artery. A balloon catheter, placed over a guide wire, is used to insert the stent into the narrowed coronary artery. Once in place, the balloon tip is inflated and the stent expands to the size of the artery and holds it open. The balloon is then deflated and removed while the stent stays in place permanently. Over a several-week period, your artery heals around the stent. Stents are commonly placed during interventional procedures such as angioplasty to help keep the coronary artery open. Some stents contain medicine and are designed to reduce the risk of reblockage (restenosis). The doctor will determine if this type of stent is appropriate for your type of blockage.

Rotoblation

A special catheter, with an acorn-shaped, diamond-coated tip, is guided to the point of narrowing in your coronary artery. The tip spins around at a high speed and grinds away the plaque on your artery walls. The microscopic particles are washed safely away in your blood stream and filtered out by your liver and spleen. This process is repeated as needed to allow for better blood flow. This procedure is rarely used today because balloon angioplasty and stenting have much better results and are technically easier for the cardiologist to perform.

Atherectomy

The catheter used in this procedure has a hollow cylinder on the tip with an open window on one side and a balloon on the other. When the catheter is inserted into the narrowed artery, the balloon is inflated, pushing the window against the fatty matter. A blade (cutter) within the cylinder rotates and shaves off any fat that protruded into the window. The shavings are caught in a chamber within the catheter and removed. This process is repeated as needed to allow for better blood flow. Like rotoblation, this procedure is rarely used today.

Cutting Balloon

The cutting balloon catheter has a special balloon tip with small blades. When the balloon is inflated, the blades are activated. The small blades score the plaque, then the balloon compresses the fatty matter into the artery wall.

Assessment of Results

Normal:

There is a normal supply of blood to the heart and no blockages.

Abnormal:

An abnormal result may mean you have a blocked artery. The test can show how many coronary arteries are blocked, where they are blocked, and the severity of the blockages.

Pacemaker Implantation

What is Pacemaker?

Pacemaker implantation is a procedure to put a small battery-operated device called a pacemaker into your chest. The pacemaker sends regular electrical pulses which help keep your heart beating regularly.

What is the need for a Pacemaker?

The heart is essentially a pump, made of muscle, which is controlled by electrical signals. These signals can become disrupted for several reasons, which can lead to a number of potentially dangerous heart conditions, such as:

An implantable cardioverter defibrillator (ICD) is a device similar to a pacemaker. This sends a larger electrical shock to the heart that essentially reboots the heart to get it pumping again. Some modern devices contain both a pacemaker and an ICD.

  • damage to part of the heart called the sinus node – which can cause an abnormally slow heartbeat (bradycardia), an abnormally fast heartbeat (supraventricular tachycardia), or sometimes a combination of both
  • heart block – where your heart beats irregularly because the electrical signals that control your heartbeat are not transmitted properly
  • cardiac arrest – when the heart stops beating altogether

ICDs are often used a preventative treatment for people who are thought to be at risk of cardiac arrest at some point in the future. If the ICD senses that the heart is beating at a potentially dangerous abnormal rate, it will deliver an electrical shock to the heart. This can often help return the heart to a normal rhythm.

What happens after pacemaker implantation?

You should be able to get back to normal physical activities very soon after surgery. As a precaution, it is normally recommended that you avoid strenuous activities for around three to four weeks after having your pacemaker fitted. After this, you should be able to do most activities and sports. You will be able to feel the pacemaker, but you will soon get used to it. At first, it may seem a bit heavy and may feel uncomfortable when you lie in certain positions.

Electrophysiology

What is electrophysiology study of heart?

An electrophysiology (EP) study is a test that records the electrical activity and the electrical pathways of your heart. This test is used to help determine the cause of your heart rhythm disturbance and the best treatment for you.

Why is electrophysiology required?

You may need an EP study:

Sometimes an EP study is conducted before implantable cardioverter/defibrillator (ICD) placement to determine which device is best and afterwards to monitor treatment success.

  • To determine the cause of an abnormal heart rhythm.
  • To locate the site of origin of an abnormal heart rhythm.
  • To decide the best treatment for an abnormal heart rhythm

What happens after Electrophysiology study?

After the EP study, the doctor will remove the catheters from your groin and apply pressure to the site to prevent bleeding. You will be on bed rest for about one to two hours.

Cardio Thoracic Vascular Surgery (CTVS)
Heart Bypass

Heart Bypass Surgery (CABG)

Coronary artery bypass grafting (CABG) or Heart Bypass is a type of surgery that improves blood flow to the heart. Surgeons use CABG to treat people who have severe coronary heart disease (CHD). Since Longer life expectancy has led to an increased incidence of cardiovascular disease and consequently to an increasing number of primary and secondary coronary artery bypass grafting (CABG) operations in the elderly. A secondary Bypass surgery is called a Redo Bypass Surgery. Redo Bypass is a relatively difficult procedure and requires an extensive experience by the heart surgeon an extensive to perform the heart bypass surgery.

Why is it required?

CHD is a disease in which high cholesterol levels would lead to formation of a waxy substance called plaque inside the coronary arteries. These arteries supply oxygen-rich blood to your heart. Over time, plaque can harden or rupture (break open). Hardened plaque narrows the coronary arteries and reduces the flow of oxygen-rich blood to the heart. This can cause chest pain or discomfort called Angina.

If the plaque ruptures, a blood clot can form on its surface. A large blood clot can mostly or completely block blood flow through a coronary artery. This is the most common cause of a heart attack. Over time, ruptured plaque also hardens and narrows the coronary arteries.

A Redo-CABG is required in cases where the Coronary arteries narrow down again due to the existing CHD leading to the formation of plaque again in the Coronary arteries.

What is done during CABG/Redo CABG?

During CABG/Redo CABG, a healthy artery or vein from the body is connected, or grafted, to the blocked coronary artery by the surgeon. The heart surgeon ensures that the grafted artery or vein bypasses (that is, goes around) the blocked portion of the coronary artery. This creates a new path for oxygen-rich blood to flow to the heart muscle.

The Goals of CABG/Redo CABG include:

  • Improving your quality of life and reducing angina and other CHD symptoms
  • Allowing you to resume a more active lifestyle
  • Improving the pumping action of your heart if it has been damaged by a heart attack
  • Lowering the risk of a heart attack (in some patients, such as those who have diabetes)
  • Improving your chance of survival
Valve Repair/ Replacement

Heart Valve Repair/Replacement

A heart valve replacement/repair is a surgical procedure that is performed to replace a valve that is not functioning correctly. The heart has four valves that direct blood flow through the heart in one direction. Pressure changes on either side of each valve cause flaps to open and close with each heartbeat to regulate blood flow.

There are 4 Heart Valves:

  • Aortic Valve
  • Mitral Valve
  • Tricuspid Valve
  • Pulmonary Valve

Why is it required?

A heart valve repair/replacement is required when the valve or valves are beyond repair due to the extent of damage caused by the following:

Damaged valves due to:

  • Rheumatic Fever
  • Bacterial Infection
  • Calcific Degeneration

Degeneration from the normal ageing process

Abnormally formed valves due to birth defect

Two types of defects occur due to these diseases:

Stenosis- the valve does not open completely, forcing the blood to flow through a narrowed opening

Regurgitation- the valve does not completely close and the blood flows backwards through the valve

What is done during Valve Repair/Replacement surgery?

The Valve Surgery is done under General Anaethesia using a Heart-Lung Machine. The heart is accessed by opening up the rib cage through the Sternum. Whole of the blood is directed through the Heart-Lung Machine to maintain Oxygenation and perfusion of the whole body. The Valve is reached by cutting the heart and is repaired/replaced either by Mechanical Valve or a Biological Valve.

Mechanical Valve

It is made from materials such as plastic, carbon, or metal. Mechanical valves are strong, and they last a long time. Because blood tends to stick to mechanical valves and create blood clots, patients with these valves will need to take blood-thinning medicines (called anticoagulants) for the rest of their lives.

Biological Valve

They are made from animal tissue or taken from the human tissue of a donated heart. Sometimes, a patient's own tissue can be used for valve replacement. Patients with biological valves usually do not need to take blood-thinning medicines. These valves are not as strong as mechanical valves, though, and they may need to be replaced every 10 years or so. These valves are used most often in elderly patients.

The goals of a Valve surgery include:

The cutting balloon catheter has a special balloon tip with small blades. When the balloon is inflated, the blades are activated. The small blades score the plaque, then the balloon compresses the fatty matter into the artery wall.

  • Lengthen and improve the quality of life.
  • Maintain an adequate supply of oxygen-rich blood flowing through your heart.
  • Reduce the possibility of damaging your heart and blood vessels
  • Lowering the risk of a heart attack (in some patients, such as those who have diabetes)
  • Give you the best possible option for returning a healthy and active life
Congenital Heart Defects

Congenital Heart Defect Surgery

Congenital heart defect corrective surgery fixes or treats a heart defect that a child is born with. A baby born with one or more heart defects has congenital heart disease. Surgery is needed if the defect is dangerous to the child’s health or well-being. n most cases, no obvious cause of congenital heart disease is identified. However, there are some things known to increase the risk of the condition, including:

  • Down's Syndrome: a genetic disorder that affects a baby's normal physical development and causes learning difficulties
  • Infections: such as Rubella or German measels during pregnancy
  • Poorly controlled Type I or Type II Diabetes

The treatment for congenital heart disease usually depends on the defect you or your child has. Mild defects, such as holes in the heart, often don't need to be treated, as they may improve on their own and may not cause any further problems. If the defect is significant and is causing problems, surgery is usually required. Modern surgical techniques can often restore most or all of the heart's normal function.

Types of congenital heart defects

There are many types of congenital heart disease. Some of the more common defects include:

  • Septal defects such as Atrial Septal Defect and Ventricular Septal Defect
  • Coarctation of the Aorta
  • Pulmonary Valve Stenosis
  • Transposition of great arteries

Treating the congenital heart defects

Mild defects don't usually need to be treated, although regular check-ups are required to monitor the child's health. Severe defects usually require surgery and long term surveillance of the heart after the surgery.

The treatment of ventricular and atrial septal defects depends very much on the size of the hole. If your child has a larger ventricular septal defect, surgery is usually recommended to close the hole. If there is a large atrial septal defect, this can be closed with an umbrella device inserted with a catheter. If the defect is too big or not suitable for the umbrella, surgery may be needed to close the hole. Unlike open heart surgery, the catheter procedure does not cause any scarring and is associated with just a small bruise in the groin and recovery is very quick.

The treatment for Coarctation Of Aorta depends on the severity of the defect. In case of a serious defect, surgery to restore the flow of blood through the aorta is usually recommended. However, if your child has developed the less serious form of coarctation of the aorta in later life, the main goal of treatment will be to control their high blood pressure. This will usually involve using a combination of diet, exercise and, in some cases, medication.

In case of a Pulmonary Valve Stenosis, a valvuloplasty or valvotomy may be recommended depending upon the defect.

The goals of the surgery include:

  • Improving your quality of life
  • Improving your chance of survival
  • Resotre the blood flow to and from the heart
  • Correction of the disorder
  • Minimize the problems arising because of the defect
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