Arteries get blocked by multiple reasons. The commonest reasons are advancing age, genetic history, smoking, diabetes, B.P, Cholesterol, Stress, physical inactivity ..

Genetically we Indians have small arteries as compared to Caucasians, this factor cannot be changed. India is Diabetic capital of world,most of the diabetics get blocks in various arteries.Changing dietary habits, increasing stress,lack of physical activity,all the above are the causes of high number of heart diseases in India.

The opening of the blocks in the arteries with the balloon and subsequently keeping it open using a metallic coil is called Stenting. Stenting is generally advisable for single block.

Bypass surgery, once done, gives relief of symptoms and prevents further heart attack for longer period of time up to 20 years or more . Where as in Stents, the artery can get blocked in few years and in the case of diabetic patients ,stents get blocked even faster. Bypass is the technique of making new channels from patients own body, hence it is very physiological and longer lasting. Also, bypass surgery is economical as compared to stents especially in India. Once a bypass is done, the cost of medicines is reduced for the rest of the life.

Bypass surgery can be done by two methods. Conventional, using the heart lung machine and Beating heart surgery.

Traditional way of doing Bypass surgery is by using Heart-lung machine. During surgery, Human heart is connected to the heart-lung machine,this machine does function of heart and lungs while surgeon repairs the Heart. Heart is temporarily stopped and restarted at the end of the operation.

With advances in bypass surgery, this operation is done without using heart-lung machine.A devise called Octupus is used to stabilize part of the heart to be operated and the repair is carried out. It becomes like a normal operation like any other procedure like hysterectomy or appendectomy where no machines are used. Also, in beating heart surgery, the heart is never stopped, hence, outcome is very predictable.

Elective bypass surgery is like any other operation. It is completely safe. Risk to life is less than 1% with modern medicine

The duration of surgery is about 4 to 6 hrs.

The duration of stay in hospital is 7 to 8 days from the time of admission to discharge. Generally admitted a day before surgery and discharged after 7 days.

Surgical wounds generally heal in 10 to 15 days. Home rest is advised for 4 – 6 weeks. Person can resume work in one month’s time. After one month, intake of medicines is reduced drastically and subsequent recovery is even faster. Person becomes completely normal in two months time.

Person should take care of diet, diabetes, blood pressure, cholesterol, quit smoking and increase physical activity. With these minimal life style modifications, the result of operation will last for many years.

Key hole surgery is done by making multiple small holes in the body and heart operation is carried out. It is suitable only for few heart operations to get cosmetic benefits. It is advisable in younger patients. It is expensive, technically difficult, longer surgery. Surgical repair could be sub optimal because of poor access and may need to covert to conventional technique in case of complications. Bypass surgery which is generally done in elderly patients. It is ideal to carry out by conventional method because total correction is done in short period of time

It is a surgery done by Robot, controlled by human. It is an expensive, long duration surgery and not commonly available all around the world.

It is very important to choose a right surgeon for the operation. Surgeon must do a complete and precise repair. It is once in a lifetime operation as heart can not be repaired multiple times without a risk. Meet your surgeon discuss all the issues. Do not get carried away with big corporate hospitals and the discount offered, after all it is the skilled surgeon who is important not the hospital who is going to perform the operation on your heart.

There are four valves in the Heart. Aortic, mitral, Pulmonary, Tricuspid. These valves can get affected by many disease processes. Function of these valves is to allow forward blood flow. If valves get affected then forward flow of blood becomes less and a person becomes breathless, weak, develops swelling over the body

Once medications fail then surgery is recommended to prevent Heart Failure. The valves can be repaired or replaced.

The valves can be made up of bio prosthetic material ,they are called Biological Valves. The Valves made up of metallic material are called Mechanical Valves.

Choice of Valve must be discussed with a doctor as the choice depends on patient profile.

Yes. After Heart Valve replacement with a Mechanical Valve a bloody thinner is required for lifelong. With biological Valve blood thinners are required only for a few months.

Mechanical Valves are permanent. Biological Valves may need to be changed after 10-15 years.

Two commonly encountered venous problems are, varicose veins and deep vein Thrombosis

Varicose veins

Varicose veins mean engorged, tortuous veins in legs, which are well seen in standing position as blue or purple streaks. It is seen in almost 20 % of the general population, predominantly females.

It is caused by faulty valves in veins, which could be developmental problem. Prolong standing, pregnancy, obesity are other known factors which leads to this condition.

This condition does not have any symptoms but it leads to complications over period of time. It causes pain, discoloration and ulceration around ankle, bleeding from around ankle or vein thrombosis

There is no medical treatment for this condition. It is treated with compression stockings in early stages. Later stages, treated with open surgery or Laser therapy as definitive therapy. Both are equally effective. Laser surgery is less painful and leads to quicker recovery.

Early surgery will prevent late complications and gives better quality of life

Deep vein thrombosis

It means formation of blood clot in the deep veins of legs generally.

It produces pain, swelling, of legs. Generally caused by injury to veins, prolong recumbency, after pregnancy or major operation, cancers, varicose veins.

It is a serious problem because the clot can fragment from leg and can go to the heart producing serious complication called as pulmonary embolism which is a life threatening condition.

This condition is treated with heparin injections for a few days followed by oral tablets of anticoagulation treatment for months.