ADDENDUM

 Institutes and hospitals where I have worked in Cardiac Surgery

 

Sanjay  Gandhi  Post-Graduate  Institute  Of  Medical Sciences, Lucknow.

The  Sanjay  Gandhi  Post-graduate  institute  of  Medical Sciences, Lucknow, is a premier autonomous Institute of  national importance.   It  is  a  tertiary-level  super-speciality referral center for the state of  Uttar Pradesh  (UP).    Super-speciality training  is  imparted to Senior residents, selected on the basis of an All - India competitive entrance  examination,  leading  to the award of either DM or MCh degrees.  Post-graduate courses are also  offered  for speciality subjects like Transfusion medicine, Immunology, Radiotherapy and so on.

 

The  Department  of  Cardio-vascular  and  Thoracic  Surgery (CVTS),  comprising  five surgeons, has an independent ward of 30 beds, a dedicated well equipped postoperative Intensive Care Unit and Intermediate Care  facility.    It  runs  an  active  Cardiac surgical  programme  covering both acquired and congenital areas. Valvular, coronary and pediatric work constitute  a  third  each of about  350  Open  Heart  surgeries  performed  per  year.   An additional 450 closed cardiac surgical operations are  performed. Cardiology backup is     excellent. Colour-Doppler, Echocardiography,  CT  scan  and  MRI  facilities , PET CT are  available round-the-clock.   An ongoing Interventional Cardiology programme covers MVBD, AVBD, PTCA, Atherectomies and  EPS  with  ablations. Radiology   Pathology   and   Biochemistry  backup  is  available round-the-clock.

 

Each year two general surgical post-graduates are selected  on merit  for  a  three year training in CVTS leading to eligibility for super-speciality  certification  (MCh).    Training  includes emphasis on clinical research, a tight academic schedule, courses in  Molecular  biology,  biostatistics,  Computers and additional outstation postings at other major centres in India.

 

Senior Residents in CVTS perform  independent  post  operative Intensive  care  duties  and  additionally manage emergencies and ward.  They are expected to assist in  all  operative  cases  and perform  routine  cannulation  and  decannulation  for Open heart procedures.  Some simpler procedures are performed  by  residents under supervision.

 

 Bombay Hospital & Medical Research Centre, Mumbai.

There are together 869 beds in  Bombay  Hospital  and  Medical Research Centre of the Bombay Hospital Trust.

There are  thirteen  Operation Theatres.  Facilities exist for treating patients in various Departments.  Viz.  General Surgery, Thoracic Surgery, Obst. &  Gynaecology,  Cardiovascular  Surgery, Neurosurgery,  Orthopaedic  Plastic  Surgery,  General  Medicine, Cardiology, Neurology, Psychiatry, Artificial  Kidney  (Dialysis) Intensive  Coronary   Care   Unit,   Intensive   Care   Unit,  (Adults)  Endocrinology,  Skin,  E.N.T., Ophthalmology,  Dental,  Oncology, Urology,  Nuclear  Medicine  and  Ultrasonic Department and Nerve Muscle Research Wing, C.T.Scan, Therapeutic Drug Monitoring Dept. Urodynamic Laboratory and Neonatology  including  Intensive  Care Unit (Newly Born).

The  Bombay  hospital  has a well equipped Central Laboratory, Blood  Bank,  and  X-ray  Department  (Diagnostic  &  Therapeutic including Cobalt  Therapy).    Physiotherapy & Occupation Therapy Department a Casualty Department and  an Out-patient  Department, Retina  Clinic,  and  Dental  Speciality  Section, and Endoscopic Department.

The  Department of Cardiovascular & thoracic Surgery comprised of 3 units, with 3 operation  theatres functioning from Monday to Saturday. There is a well equipped post operative Intensive  Care Unit  and  Intermediate Care facility comprising of total 25 beds(17 bedded ICU).  The department is  running  an  active  cardiac surgical  programme including both acquired and congenital areas. Morethan 1500  Open heart surgeries are done per year  comprising of Valvular, Coronary  and  Paediatric  work.   An  additional of 450-500 Closed cardiac surgical operations and  Vascular  surgery were performed.   Cardiology back-up was excellent, and round the clock facilities were available for Echocardiograpy, CT Scan  and MRI.   Emergency  cardiovascular  and  thoracic  cases  were also managed by the department.

Every  year,  3  surgical post graduates were selected  on  the basis  of  competitive  entrance exam conducted by the Maharastra University.  These residents  underwent   3 years training  which included clinical research and a tight  academic  schedule  along with  a  pre,  per  and post operative mangement of patients, and ultimately led to eligibility for  Superspeciality  Certification (M.Ch.).

Senior clinical  assistant  in CVTS performed independent  post operative ICU duties and    additionally    managed the ward.   They  are  expected  to perform Open heart surgeries like ASD, Mitral valve replacement,  Aortic  valve  replacement,  Open mitral   valvotomies   along   with  Closed  heart  and  vascular procedures.

 

Sri Venkateswara Institute Of Medical Sciences, Tirupati

 

The department was started way back in November 1993, when this super-specialty hospital came into existence, under the banner of Tirumala Tirupati Devasthanams. I became the part of the Department in April 1995.  Our mission has been to provide the most advanced technology to the poor and needy, extending as a life line to every patient through innovative ways of management including the surgical procedures with positive results.  This is flanged by a continued dedicated follow-up in a patients friendly approach.

The last few decades have seen medical science, including cardiac science advance like never before in the history of mankind. On the other hand, modern life has brought about an increase in the life style diseases. At present, patients would be presenting with multi-system involvement and co-morbid conditions like chronic obstructive airway diseases, Diabetes mellitus, hypertension, and many more which may make this group of patients unfit to undertake major surgeries. Here we use the concept of minimally invasive procedures or hybrid procedures to decrease the mortality, this involves a combination of medical /surgical skills and technology.

The staff in the Department of Cardiovascular and Thoracic Surgery have a patient centric approach to clinical practice and aim to bring advance form of medical health care to our patients, through high quality facilities ensuring the best outcome to patient care. We value all our staff and team work is what determines our future. There is an open communication between the patients and relatives and this results in effective and timely action which benefits our patient.

The Department of  Cardiovascular  and  Thoracic  Surgery (CVTS)  has an independent bed strength of  60    beds which are dedicated to preoperative  ward,  a well  equipped  postoperative intensive care unit and intermediate care facility. It runs  an  active  cardiovascular  and  thoracic vascular  surgical  program  which  entertains both routine and emergency procedures. Cardiac work comprises of  both  congenital and acquired  areas  including  valvular, coronary and congenital work except transplantations. Approximately 500 OHS  procedures are  performed  each  year, in addition to these a good number of closed cardiac surgical procedures, thoracic and  vascular  cases (including  aortic  aneurysm)  are  being  done.  There is a good cardiological back-up with facilities available round  the  clock for    invasive    hemodynamic    monitoring,   echocardiography. Cardiology department is well equipped with  an  echocardiography machine   having   biplane  transoesophageal  probe,  along  with facilities for color  flow  mapping,  several  computerized  ECG machines, a computerized tread mill machine and two siemens cath lab, CT Spiral, 28 slice CT and MRI are other facilities available in the department of Radiology  of  this Institute.   Department   of   Nuclear  medicine  is  armed  with sophisticated Gamma Camera with  spect  system  and  radioisotope dose calibrator. Recently, the PET CT also has been added to the armatarium of advanced investigations. Besides the Institute is backed up with the Biotechnology and Bioinformatics department which are involved with the basic research on stem cells. This institute has several research projects which are being conducted in collaboration with Indian Council of Medical Research and the University Grants Commission

 

The Department runs:

  • a three years M.Ch. course in Cardiovascular and thoracic surgery which is recognized by the Medical Council of India,
  • a four years B.Sc in cardiopulmonary perfusion technology
  • a one years course in post basic specialized CVT nursing.
  • Besides the department Faculty are also involved with the teaching and training of the students of the seventh semester of the Bachelors of Physiotherapy and Bachelors of Nursing course.
  • Training of the Masters of Physiotherapy and Nursing
  • Guiding the Ph.D for the Physiotherapy and the Nursing students.
  • The Department of Cardiovascular and Thoracic Surgery provides surgical solution to a wide spectrum of heart, vascular and lung ailments. The cardiac procedure involves the following:
  • Palliative and intra-cardiac surgeries for congenital heart diseases.
  • Valve reconstruction as well as replacement for valvular heart diseases.
  • Coronary artery bypass grafting /revascularization surgery through the beating heart technique as well as on cardiopulmonary bypass.
  • Repair of aortic aneurysms arising from the ascending aorta till bifurcation of the aorta.
  • Repair of all forms of peripheral arterial aneurysms including the A-V fistula aneurysms in the chronic renal failure patients.
  • Surgery for aorto- iliac diseases, femoro-popliteal diseases  and the other peripheral arterial occlusive diseases.
  • Surgery for  varicose veins

  • With the increasing incidence of the pleural and the pulmonary diseases, there has been an increase in their interventions. Thoracic surgery involves the surgery which are done through the open technique as well as with the use of the video assisted thoracoscope where ever indicated.
  • Chest wall tumors with chest wall reconstructions
  • Decortication for Empyema thoracis irrespective of the etiology
  • Lobectomy / pneumonectomy for all forms of lung diseases whether infective or malignant.
  • Extended thymectomy for Myasthenia Gravis
  • Surgery for mediastinal tumors both benign and malignant.
  • Tracheal reconstruction
  •  Ever since the inception of the Department of Cardiovascular and Thoracic department the major achievements have been the versatility of the operative procedures being done here. Most of the cases which visit our outpatient department are very sick and have either had a surgery done earlier or the ones which have been denied surgery at the peer institutions.

 

DR.ABHA CHANDRA

SENIOR PROFESSOR & HOD

DEPARTMENT OF CARDIO VASCULAR & THORACIC SURGERY

SRI VENKATESWARA INSTITUTE OF MEDICAL SCIENCES

TIRUPATI

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