Though cardiology has made huge strides in the last two decades, there continues to be a clear role of surgery by experts in the treatment of heart disease. Know the 3 diseases that require immediate intervention:
CORONARY ARTERY DISEASE
Technological advancements in biomedical engineering have made coronary blockages to be tackled by catheter based interventions, which are relatively more appealing to the patient. Whereas this could hold true for short segmental lesions, long term results of long lesions especially close to the left main bifurcation are inferior to arterial bypass grafts (by surgery). Well conducted randomised trials (SYNTAX, FREEDOM) have proven the benefits of CABG remain for longer periods in diabetic patients.
There is no denying that biomedical technology has helped in making cardiac surgery a progress and the operations that were carried out by making big incisions and stopping the heart to operate have been replaced by “Beating Heart Surgery”(operation continues even when the heart is beating) without the assistance of Heart Lung Machine or its inadvertent complications. Vein grafts (harvested from the leg) have been replaced by arterial grafts from the chest or from the forearm. Latest advancements have reduced the average length of stay in the hospital with less chance of repeated interventions.
VALVULAR HEART DISEASE
Though simple mitral stenosis (the common Rheumatic heart problem) can be adequately treated by catheter based balloon dilatation, the other valve related problems require surgery. Repairs are the first modality offered by the experts. Valve replacements are required for a large majority of patients because of late presentation and extensive calcifications. Anticoagulation (blood thinning) is mandatory for mechanical valves but optional after 3 months when TISSUE valves are implanted. The third generation tissue valves last more than 20 years and ideally suited for the elderly. However, whenever anticoagulation is prescribed, frequent blood tests are mandatory to optimise the dose of the drug.
CONGENITAL HEART DISEASE
As per World Health Organisation estimates, nearly 8 out of 1000 live births are born with Congenital heart defects. Most congenital heart diseases have to be tackled by Open Heart Surgery. Technological advances in perfusion have made corrective surgery safe even in the neonatal period. Young parents of these unfortunate children do not find the resource to fund these operations. Philanthropy by Rotary International and non- Government Organisations like the Health Education And Research Trust make it possible for these poor kids to receive lifesaving cardiac surgery in tertiary care facilities.