Cardiothoracic Surgery in Chennai


Cardiothoracic surgery is a medical field that involves surgical treatment in the thorax it includes the heart, lungs esophagus and other organs in the chest.

Cardiothoracic Surgery Services Include:

Closed And Open Heart Surgeries

When a person is diagnosed with heart disease then he is advised for surgery which may be open or closed heart surgery that may depend on the complication. Closed heart surgery is an invasive method in which the heart is not opened directly and no heart-lung bypass machine is required This reduces the chances of complication and it is the first step to any further procedures that deal with the heart.

Closed heart surgeries are performed by opening the chest in front or through the ribs. This surgery deals with arteries that carry blood from and to the heart rather than dealing with the chambers itself. Palliative heart surgeries are often performed on young children which is carried out in different stages. Some examples of closed heart surgeries are ligation of patent ductus arteriosus, repair of coarctation of the aorta, and the placement of pulmonary artery bands and Blalock-Taussig shunts.

Every surgery is done by anesthetizing the patients and post-surgical care such as regular monitoring of patients by keeping them in ICU, providing intravenous medication to combat pain if any and checking heartbeat and blood pressure at regular intervals.

Open heart surgery is highly invasive as the name suggests. It involves the opening of the chest and heart to operate on its chambers, muscles and arteries. One of the most carried-out open heart surgery is coronary artery bypass grafting. It involves the grafting of a healthy artery or vein to carry blood that becomes impossible with the blocked artery Hence the newly attached artery brings fresh blood bypassing the old blocked one. Now a days open heart surgery has become a traditional method because of the advancement in this protocol. It involves just a small cut or incision which is unlike the traditional method of wide opening. Open heart surgery is carried out with the help of a heart-lung machine.

Open heart surgeries are usually adopted for the following:

  • Coronary heart disease occurs due to the narrowing and hardening of blood vessels that provide blood and oxygen to the heart.
  • In replacement or repair of heart valves through which blood flows from one chamber to another.

Beating heart surgery:

Beating heart surgery is nothing but performing an open heart without the heart-liver machine while the heart is pumping, thus not stopping it during the surgery. Our surgeons use a tissue stabilization system to mobilize the heart when required. This surgery is carried out when the arteries cannot provide enough blood to the heart. In such case, physicians mostly recommend for coronary artery bypass graft (CABG) surgery.

Valve repair and replacement:

The Human heart consists of four valves namely the tricuspid, bicuspid, mitral and aortic. These play a key role in the flow of blood from and into the heart. The well-known 'lub' and 'dub' sound of the heart is due to the closure of these heart valves. They are vital in maintaining the one-way blood flow. Thus any defect in any of these valves is a serious criterion to be addressed immediately. Every repair and replacement is done through open heart surgery.

In the repairing process, the physician adopts certain procedures. Some of them are listed below:

Commissurotomy: is a technique to narrow the valves whose leaflets are thickened and get stuck while closing. The surgeon cuts the joints where the leaflets meet to open the valve.

Valvuloplasty: is a process in which the leaflets are strengthened to close tightly. It is an added support to the valve. A ring like device is attached around the outside of valve opening.

Reshaping: is done to cut a portion of leaflets and when it is sewn again, the valve functions properly

Decalcification: to remove excess amount of calcium stored in the leaflet which when removed restores its function.

Repair: is a structural support to replace or shorten the cords which in turn supports the valves to close properly.

Patching: is covering tears and holes in the leaflets with tissue patching If a valve is completely damaged in which repair is not possible, replacement is the best way for it. Replacement is also done when there is a valve disease that may be life-threatening. It is often done to mitral and aortic valves.

Repair of complex congenital heart defects:

Congenital heart disease is nothing but some defect in the heart right from birth. The defect can be in the walls, the valves or in the flow of blood to the heart. Doctors usually identify such defects either during pregnancy or immediately after birth. Some of the defects include:

  • Rapid breathing
  • Fatigue
  • Poor blood circulation
  • Poor blood circulation
  • Cyanosis (a bluish to skin, lips and fingernails)

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

Pulmonary stenosis is a defect in which the pulmonary valve through which the blood from the right ventricle of the heart reaches the lungs get hard and narrowed. In such case, ventricle is pressured itself to pump more blood which results in swelling of the right ventricle.

Aortic stenosis is a defect in the aortic valve which allows the flow of blood from the left ventricle to the aorta, the largest artery which carries oxygen rich blood from the heart to different parts of the body When this valve is thickened, the blood to various parts of the body becomes insufficient thereby less oxygenated blood to the body.

Coarctation of the aorta is a defect in which the aorta is constricted which carries blood to the lower parts of the body:

There are other defects apart from this. 'Hole in the heart' is one of the major congenital heart problems. During birth the opening in the wall of the heart allows blood to flow from right and left chambers itself instead of pumping to other parts of the body. It causes the heart to swell and enlarge. Some the problems of a 'hole in the heart' are Atrial septal defect is a hole between the atria. The blood from left atrium should flow to the left ventricle and then to aorta to the whole part of the body. But in this case, due to the hole blood flows from left atrium flows into the right atrium which becomes fatal in later stages.

Ventricular septal defect is a hole in the ventricle. Blood from lungs is returned to the heart into the left ventricle to enter into aorta and then to rest of the body. In this case, blood flows from left ventricle to right ventricle. The complications are more in such cases.

Congenital heart diseases are diagnosed through different methods.

  • Cardiac catheterization, to check blood pressure inside the heart and get images of the chambers of the heart.
  • Chest X-ray to show the size and shape of the heart and lungs and other bone conditions.
  • Echocardiogram to show the size and pumping action of the heart along its valves.
  • Electrocardiogram to record the electrical activity of the heart.

Minimally Invasive Bypass Surgery:

It is nothing but a bypass surgery which is performed with several small incisions instead of traditional method of wide opening the chest. This type of surgery may help patients who were neglected from older methods of heart surgery due to age. It has a wide range of advantages like less blood loss, less post-surgery discomforts, fast healing and lower infection rate, less trauma, little scars, etc., minimally invasive bypass surgery gives the physician a clear image of other parts of the heart than the traditional methods.