Dr Anbarasu Mohanraj - Heart Surgery

Women and Heart Attacks The recent episode of Sushmita Sen having a heart attack and an emergency Stenting to her blocked Coronary Artery has brought an age old discussion to the centre stage. HEART ATTACKS IN YOUNG AND MIDDLE AGED WOMEN When we were in Medical school, we were taught that women were immune to  Ischaemic Heart diseases due to the protection offered by hormones. This is no longer true. We as Heart specialists not infrequently see young and middle aged women coming in with heart attacks and blockage of coronary arteries.  A study by Indian Cardiologists from Jaipur states that between year 2000 and 2017, the annual mortality due to heart attacks rose from 8.5 lakh to 15.4 lakh, with the number of women dying rising from 3.2 to 6.2 lakh. The rise among men did not reflect such an alarming rate of rise.  Reasons for such alarming rise are Obesity, Diabetes, life style and oral infections. The incidence of central obesity among women is quite high in the previo...

Heart Healthy Diet The commonest anxiety among heart patients is what sort of diet to be followed. The internet is flooded with lots of information, both authentic and unauthentic. To add to the menace is the info from forwarded Social Media messages which our general public believe with so much of authenticity. Indians are a predominant vegetarian society, I don't mean the vegetarians lone, even the so call Non-vegetarians consume less than 250 grams of meat in a week sparing a few families. The issue is further complicated by the fact that Indian diet - be it South or North Indian diet, is carbohydrate rich diet. What should be the ideal diet composition? A balanced Diet should have about 45-55% carbohydrates, 10-35% proteins, 20-35% fats and enough micronutrients and vitamins. An average Indian diet has 60-70% carbohydrates. The problem with a Carbohydrate rich diet is that it makes people obese, central obesity with a high incidence of Diabetes and in fact Insulin resistant Dia...

  Aortic Dissection Aortic Dissection is a life threatening emergency condition where a tear happens within the layers of the great blood vessels which arises from the heart - The Aorta. If not properly diagnosed within the first few hours, the patient usually succumbs to the disease. The risk to life (mortality rate) is 21% in 24 hrs, 38% in 48 hrs, 62% in 7 days and 74% in 14 days . That means, if a proper diagnosis is not established and treated properly, 1in 5 patient doesn't survive in the first 24 hours, one in three patients succumbs in two days, 2 out of 3 patients within one week. Once an Aortic Dissection occurs, its like a ticking time-bomb. The symptoms of an Acute Aortic Dissection is severe chest pain spreading to the back. The severity of the chest pain is more than a Heart Attack (Myocardia Infarction). Some patients may develop associated breathing difficulty. The onset of symptoms may be severe and quite progressive. Some people may develop abdominal pai...

  Heart Valve Repair - F.A.Qs What is the common surgerical treatment for Valvular Heart Disease? The treatment for Valvular Heart diseases starts with Medical treatment once a diagnosis is made. When the disease becomes critical, your doctors advice surgical treatment of the problem. Valves can be dilated with balloons called Balloon Valvotomy if the valvular heart disease is straightforward. If there is severe disease, your Heart Team may decide on surgical intervention. Traditionally Valvular Heart disease was treated with Surgical Replacement of the valve. This involves removing your own native valve and replacing it with a synthetic valve. What are the recent developments in Surgery for Valvular Heart Disease? Valve Repair and Percutaneous Replacement are the recent advances. In Valve Repair, your surgeon makes use of the tissues in your own valve which is diseased and repairs the valve to a perfect condition. Though technically challenging, valve repair yields excellent long ...

Coronary Bypass Operation - F.A.Qs  How risky is it to undergo a Coronary Artery Bypass Surgery ?(CABG).  The risk of Coronary Bypass Operation is very minimal. In a patient with Good Heart Function and no major associated risks like Kidney or Brain issues, the risk of Bypass surgery is less than half a percentage (0.5%)  In case the patient has a poor Heart Function because of a previous Myocardial Infarction (Heart Attack) or if patients have very poor diabetic control or associated Renal issues with high Sr Creatinine or a previous Neurological problems, then the risk of Bypass Operation goes up and the Surgical team will explain the risks involved with the surgery. What is the normal course of events during a Bypass operation? Patients are usually admitted the day before the Operation. The Surgical team, Anaesthetist and the Nursing teams brief you about the risks involved in the surgery and the outcomes. Please have a ligh...

 Mitral Valve Repair and not Valve Replacement When it comes to Heart Valve Surgery, the common belief is that heart valves are usually replaced. The replacement of heart valve is done with artificial valves. It's either a Mechanical valve (aka) Metal valve or Biological valve (aka) Tissue valve. The  advantage of a Mechanical valve is that, it's durability is quite good. But patients with a Mechanical valve implanted in them need to be on lifelong blood thinning tablets like Acitrom or Warfarin. Managing these blood thinning tablets is quite tough and needs very close monitoring.    PT & INT test is to be done at least once in a month and the bleeding and blood clot formations due to these drugs is very high, especially in a country like ours where the uniform access to quality health care is difficult.  The survival of patients with heart valve replaced is quite poor due to the anti-coagulation related complications and n...