dr pankaj goel: August 2015

Profile

Dr Pankaj Goel, is currently working as a Director and Head of the Cardio-thoracic and Vascular (Heart, Lung and Vascular Surgery) unit at the Ivy Hospital, Amritsar.

After completing his MCh in cardio-thoracic and vascular surgery from GB Pant Hospital, Delhi University in 1998, Dr Goel worked at Madras Medical Mission, Chennai for three years. Here he obtained training in complex paediatric cases. Thereafter he went to Australia (Royal Perth Hospital) for further training and experience.

Dr Goel joined the Fortis Escorts Hospital, Amritsar in 2003. Since 2008 , in his capacity as HOD at the same hospital he has done pioneering work and established cardio-thoracic and vascular surgery in the city.

The Goel's unit now routinely performs all types of cardiac, thoracic and vascular surgeries with results comparable to the best centres in the world. Dr Goel is responsible for many firsts in the region.

Dr Goel has several research papers published in indexed journals. He has authored a book on cardiac surgery. He has an original technique for harvesting saphenous vein to his credit.

In 2009, Dr Goel was elected member of the prestigious Society of Thoracic Surgeons , USA. He is also a member of the Indian Association of Cardio-thoracic surgery and CTS Net.

At Ivy Hospital, Dr Goel routinely performs all types of Cardiac, thoracic (including thoracoscopic) and vascular procedures.

Sunday 30 August 2015

Case of the Month- Peripheral Arterial Disease- Surgical Management.

Peripheral Arterial Disease (PAD)- As the name suggests,is the disease of the peripheral arteries i.e tubes that supply blood to the arms and the legs. The disease process leads to narrowing of the arteries and this restricts the good flow to the limbs producing symptoms.
Symptoms- pain on walking , relieved on resting (intermittent claudication), rest pain, cold and pale limbs and sores on limbs that do not heal.
A variety of disease can clog the arteries. The common ones are

Atherosclerosis (cholesterol deposition)
Buergers disease (related to smoking)
Bood vessel inflamation(arteritis)
Injury.

If neglected PAD can lead to gangrene requiring amputation.

Case Report-

A 47 year old gentleman presented with progressive discomfort on walking for last 3 years. He was a heavy smoker and off late the pain was persisting even at rest. On examination he had no peripheral pulses. CT angiogram (figure1) showed severe PAD with blocked superficial femoral artery(artery to lower limb) on both sides. The patient was operated and a bypass was constructed using special synthetic tubes(grafts). These bypasses connect the arteries above and below the block thus restoring blood supply(figure2).
The patient was discharge in two days and is able to walk nearly 3km everyday.

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Comment-
PAD is common associated with heart disease and diabetes. Smoking is another risk factor. PVD if neglected can lead to gangrene and amputation. Medical, Surgical and endovasular (stent) are treatment options depending on specific case.