Cardiac Surgery

DESUN can justifiably claim to have one of the finest cardiac surgery teams in India. Led by the renowned Doctor, the member team of senior surgeons and anaesthetists have pioneered several new surgical techniques over the last few years.

Out of a total number of critical care beds, are devoted to cardio-thoracic surgery patients. Of the total number of operating theatres, are dedicated to cardiac care for undertaking surgeries ranging from valve replacements to correction of congenital defects. Surgical expertise is backed by sophisticated post-operative care, ensuring that DESUN is one of the best centers for high-risk cardiac surgeries.

Highly dedicated steel modular operating theatres are fully equipped with the latest state-of-the-art instruments for the convenience of the surgeons.

The aim is just not to prolong life but to ensure that all normal activities can be quickly resumed

HEART BYPASS SURGERY (CABS) –
CORONARY ARTERY BYPASS SURGERY, is a surgery by which the surgeon re-routes or “bypasses” the blood around blocked arteries by means of a new artery (taken from the body itself) to improve the blood flow to the heart. An improved and latest method being done currently is Beating Heart Bypass Surgery.

Open-heart surgery generally refers to operations performed on the heart that require a patient being placed on the heart-lung bypass machine.

The heart-lung bypass machine takes over the function of the heart and lungs to provide oxygenated blood to the body. The heart can be stopped with a solution called "cardioplegia" that is a cold, high potassium solution which also protects the heart muscle while it is stopped. Cold saline irrigation over the heart is also used to protect the heart while it is stopped and without its own blood supply.

The heart itself can then be opened and repair can be accomplished in a bloodless, still environment. In some situations, the heart can be operated upon while still beating with the patient being supported on the heart-lung bypass machine.

To get access to the heart, the surgeon has to open the chest. To do so, he or she has to go through the breast bone (sternum). This is referred to as the sternotomy. The skin incision is generally smaller in size than the length of the breast bone, since the skin margins can be stretched to some extent. For repeat incisions ( a redo-sternotomy) often the length is a little longer than the previous scar.

For many parents, the concept of a sternotomy raises much concern. However, sternotomy is one of the safest and more comfortable incisions performed during surgery. Performing a sternotomy is nothing but an artificial fracture; at the end of the operation the two edges of the breast bone are put back together with steel wires. This does not lead to any deformities of the chest wall, even as a child grows. At the same time, performing a sternotomy does not prevent the progression of already existing chest wall deformities (e.g. "pigeon chest").

Pain is sensed by the nerve endings in the affected tissues. In the bone, pain arises from movement at the site of a fracture. Infants don't have much chest wall muscle mass to move the sternal edges and develop pain. For that reason, not surprisingly, most infants are discharged home on just ibuprofen and Tylenol.

After the chest is opened, a part (or all) of the thymus gland is removed. The thymus gland is involved in the immune system; however, its removal has not been shown to lead to any immune compromise. The removal of the thymus is necessary to allow exposure of the heart, which sits in a thin, leather like sac called the pericardium. To get access to the heart, this sac has to be opened, at which time the surgeon can remove a small portion of the pericardium for later. Often the removed piece is treated with a chemical called gluteraldehyde to increase the stiffness of the pericardium, making it easier to manipulate during surgery.

The removed pericardial piece is used during the operation as patch material for a variety of holes or defects within the heart. The removed piece of pericardium does not need to be replaced. At times however, a piece of a synthetic material called Gore-Tex membrane is used to replace the used pericardium. Typically this is done when the surgeon anticipates a repeat operation in the future and wishes to protect against injury to the heart during redo-sternotomy.