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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.


Friday 28 October 2016

Patient Testimonials


Wednesday 27 July 2016

First Anniversary at Ivy Hospital, Amritsar.

Completion of a successful and fulfilling year at Ivy, Amritsar. We are now the preferred care provider (adult cardio vascular surgery) in the region. Thanks to highly skilled and motivated team.

Saturday 7 May 2016

Chondrosarcoma of the Sternum- Radical Excision and Sternal Reconstruction using customised composite prosthesis.


Case Report- A 60 year old gentleman came with the history of gradually increasing swelling in the upper midline chest for last 6 months. He had been investigated elsewhere and a fine needle aspiration was done. The diagnosis was chondrosarcoma of the manubrium sterni. The CT scan images were also suggestive of the diagnosis. The tomor appeared to be locallu containe with no involvement of the mediastinal structures.
We advised the patient surgery and did a PET scan to rule out any secondaries. The PET scan was negative for tumor spread.





CT Image showing tumor with destruction of both tables of sternum (arrow)

PET Scan negative for any metastasis.


 Surgery- A wide excision with a 5cm margin was planned. This meant removing nearly half of sternum, 1-3 ribs and medial end of clavicles. This would result in a large defect requiring reconstuction.
                                                     
                                             Wide gap in the chest wall after radical excision.


Resected sternum with 1-3 ribsand clavicles (medial ends).


A median sternotomy incision was used and adequate resection carried out. The defect was repaired with a customised composite prosthesis made in the OR using double polypropylene mesh and acrylic bone cement. The prosthesis was covered with bilateral pec major flaps sutured in the midline.

Customised Composite prosthesis for sternal reconstruction using polypropylene mesh and acrylic bone cement

Composite prosthesis being sutured in place to fill defect





The patient was extubated on table and made an uneventful recovery and discharged on the 3rd postoperative day. 
Histopathology Report- Chondrosarcoma Grade II.




Comment-
Primary sternal tomors are rare and account for 1% of bone neoplasms. Chondrosarcoma is the commnest primart sternal tumor. It is resistant to chemotherapy and radiotherapy and curative resection is the only hope. Survival after curative resection is good if the tumor has not metastasised. Surgery involves radical resection with reconstruction of the anterior chest wall with various techniques.



Saturday 26 March 2016

Total Arterial Bypass and On Table Extubation makes Heart Bypass Surgery more safe and reliable.





Life After Heart Valve Surgery- Symposium organised on 18th March.

Organised a symposium on life after heart valve surgery. More than 50 patients who have undergone heart valve surgery by me attended. They shared their experiences, challenges and how their life has changed after surgery.





Sunday 21 February 2016

Mechanical Complications of Myocardial Infarction I - Post Myocardial Infarction VSR

Post MI VSR
The 30 day mortality after heart attack ranges from 2-10%. Mechanical complications after MI i.e ventricular septal rupture, acute papillary muscle rupture and free wall rupture, remain a significant cause of death after heart attack.
Post MI VSR occurs due to gangrene of interventricular septum (Figure1,) leading to rupture and acute left to right shunting. This leads to cardiogenic shock and rapidly progressive liver and kidney failure. If not operated nearly 85% patients die in the next 4-6 weeks. This complication occurs in 1-6% of patients and is responsible for 15-30% of deaths after heart attack.
The diagnosis should be suspected in any patient with acute MI and cardiogenic shock. A holosystolic murmur is heard over praecordium. The diagnosis is confirmed on echocardiography (Figure2).


Specimen showing post MI VSR

Echo showing VSR with shunt across defect.
The treatment of this condition is urgent surgery. IABP is initiated in preparation of surgery. The purpose of the surgery is to debride necrotic septum and close the defect  with a synthetic patch. It creates a water-tight partition and abolishes the left to right shunt. If the patient is stable enough to allow coronary angiography, it is done pre-op and coronary bypasses are also done simultaneously.

Certain selected cases can be closed using devices thus avoiding surgery.
Despite the technical advancements, the surgical mortality remains as high as 25-30% . Patients who recover have a good survival and quality of life..