Cardiothoracic and Cardiovascular Surgery

Treatments & Procedures

Surgical or nonsurgical procedures are often necessary to treat cardiovascular conditions. Some may be scheduled electively while others are performed urgently in response to a cardiovascular event or results from a diagnostic procedure that indicates a Cardiovascular Surgery is imminent. Some of the Cardiovascular procedures and treatments are:

ABDOMINAL AORTIC ANEURYSM REPAIR

This procedure, which involves removal of the blood clot in the aneurysm and repair of the aorta wall, is undertaken when an abdominal aortic aneurysm grows too large or ruptures. In some situations, a stent (wire mesh) is inserted into the aorta to treat the aneurysm.

CARDIOVERSION

It used to correct an abnormal heartbeat. This is accomplished by delivering an electrical charge through electrodes or paddles placed on the chest. This causes a brief interruption in the heartbeat, giving the conduction system a chance to reset itself.

CAROTID ENDARTERECTOMY

This surgical procedure is used to remove atherosclerotic plaques from the carotid artery, which carries blood to the brain. It is often done to reduce the risk of a stroke in patients who have had transient stroke-like symptoms (transient ischemic attack).

CORONARY ANGIOPLASTY

Coronary angioplasty is used to restore blood flow in a blocked coronary artery.

BALLOON ANGIOPLASTY

It is done during a Cardiac Catheterization procedure in which a balloon at the tip of the catheter is quickly inflated and deflated to open the vessel. Often, a stent is inserted into the vessel to keep it from narrowing again in the future. This technique is also applied to arterial blockages elsewhere in the body, most notably the legs, but may be used in the aorta or carotid arteries, as described above.

CORONARY ARTERY BYPASS GRAFTING (CABG) SURGERY

This procedure is used to restore blood flow to the heart, particularly if there are severe or multiple blockages in several coronary arteries. In this procedure, surgeons reroute the blood flow around the blockages by grafting vessels from another part of the body (usually the saphenous vein in the leg) into the coronary circulation. This surgery is traditionally done after patients are placed on a Heart-Lung machine (which takes over the function of those organs) and the heart is stopped. To avoid this elaborate step, some surgeons have recently begun to perform CABG surgery on beating hearts in certain cases.

CORONARY STENTING

This procedure is done in conjunction with Coronary Angioplasty. Once a catheter with a balloon at the tip is inserted into a blocked vessel, a small mesh tube called a stent is placed at the tip of the catheter. The balloon is inflated, opening up the blocked vessel, and also expanding the stent. The stent, which is sometimes medicated with anticoagulant medication (blood thinners), remains in the blood vessel to prevent it from narrowing again in the future.

FEMOROPOPLITEAL BYPASS SURGERY

Similar to a CABG procedure, this surgery is used to bypass a blocked artery in the leg, restoring proper blood flow to the lower leg and foot. Doctors use a vein from another part of the body or an artificial vessel to graft around the blocked artery.

HEART TRANSPLANT

A Heart Transplant is done to replace a diseased and damaged heart with a healthy heart donated by someone who has died. It is usually reserved for patients whose congestive heart failure is severely disabling and life-threatening, and when all other treatments have been exhausted.

PACEMAKER INSERTION

An artificial pacemaker is inserted when the body’s natural pacemaker—the sinoatrial (SA) node—or other parts of the conduction system no longer work properly. The artificial pacemaker maintains the normal heartbeat by automatically sending electrical impulses to the heart when it detects an abnormal rhythm. It is inserted through an incision beneath the collarbone. Wires from the pacemaker are then inserted through a vein to reach the heart.

IMPLANTABLE DEFIBRILLATOR

A treatment for heart failure that uses a three-lead biventricular pacemaker implanted in the chest. The pacemaker sends tiny electrical impulses to the heart muscle to coordinate (resynchronize) the pumping of the chambers of the heart, improving the heart’s pumping efficiency. Both ventricles are paced to contract at the same time. This can reduce the symptoms of heart failure.

BIVENTRICULAR PACEMAKER

A treatment for heart failure that uses a three-lead biventricular pacemaker implanted in the chest. The pacemaker sends tiny electrical impulses to the heart muscle to coordinate (resynchronize) the pumping of the chambers of the heart, improving the heart’s pumping efficiency. Both ventricles are paced to contract at the same time. This can reduce the symptoms of heart failure.


Our Cardiothoracic surgeons provide a full range of cardiothoracic treatments, including:


HEART-LUNG TRANSPLANT

This last-resort procedure is used to remove extremely diseased and damaged lungs and heart and to replace them with healthy organs donated by someone who has died. This is most commonly performed on people with severe pulmonary hypertension.

LEFT VENTRICLE RESTORATION (DOR PROCEDURE)

Our cardiothoracic surgeons can treat heart attacks, Congestive Heart Failure and certain types of aneurysms by reshaping the left ventricle in a procedure named for its creator, Dr. Vincent Dor. It involves removing scarred, dead tissue in this chamber of the heart muscle, improving its ability to pump blood out to the body. This is often done in conjunction with coronary bypass surgery and/or valve repair.

SURGICAL TREATMENT OF AORTIC ANEURYSMS AND DISSECTIONS

The walls of the aorta, the body’s largest blood vessel, can weaken and develop an aneurysm (a dilatation or pouching), which can rupture or lead to a separation—also called a dissection—of the vessel walls. When an aneurysm or dissection is detected in a chest X-ray, an echocardiogram or computed tomography (CT) and magnetic resonance imaging (MRI) scans, surgeons repair the damaged section with a graft (also called a stent) of special woven material. Many of these procedures can be performed using endovascular techniques without surgical incisions.

SURGICAL TREATMENT OF AORTIC ANEURYSMS AND DISSECTIONS

The walls of the aorta, the body’s largest blood vessel, can weaken and develop an aneurysm (a dilatation or pouching), which can rupture or lead to a separation—also called a dissection—of the vessel walls. When an aneurysm or dissection is detected in a chest X-ray, an echocardiogram or computed tomography (CT) and magnetic resonance imaging (MRI) scans, surgeons repair the damaged section with a graft (also called a stent) of special woven material. Many of these procedures can be performed using endovascular techniques without surgical incisions.

CARDIAC SUPPORT DEVICES

Our surgeons sometimes install external devices that can help maintain blood circulation either before or after surgery. The TandemHeart implantable pump also can be used in patients undergoing high-risk percutaneous coronary interventions (angioplasty or coronary stent). This small, semi-portable device can be placed in an artery through the groin or at the time of open heart surgery.

LUNG AND ESOPHAGEAL RESECTION

Both the esophagus and lungs can be affected by either benign or malignant diseases, necessitating surgical removal of the damaged tissue. Many of these procedures can be performed with small incisions that are less painful and can speed recovery time.

EVALUATION AND TREATMENT OF MEDIASTINAL TUMORS

Mediastinal tumors are abnormal tissue growths in the chest cavity between the lungs. These tumors can be benign or malignant (cancer) and they occur across all age groups. Surgical treatment may include thoracotomy, a procedure performed through an incision in the chest, as well as with minimally invasive approaches, including thoracoscopy and mediastinoscopy. We also perform latest treatments for varicose veins and venous ulcers using surgery for varicose veins, endovenous laser therapy, subfascial endoscopic perforator surgery, and endovascular surgeries and open reconstruction of deep veins.

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