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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.


Monday, 29 February 2016

Launch of ECMO Service at Ivy Hospital Amritsar






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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..
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