हार्ट के वाल्व का मुश्किल ऑपरेशन
#हार्टवल्वोप्रेशन
The Man with a big heart!
While appreciated by the society at large, we cardiac surgeons are weary of a person with a big heart! Like this gentleman of 32 yrs with a heart valve leakage for several years. His heart had increased to nearly double the size of normal, he was bedridden with jaundice and swelling all over body. According to surgery guidelines he would have a minimal chance of surviving the operation. His only option was valve replacement or a heart transplant. Denied surgery by many, citing high risk ,he was left to languish. With good intention in our heart we took the challenge. His village came to his help collected funds we did our little bit. With his grace he is back on his feet. Should be able to lead a full productive life. His wife and two children are happy. He has proved the scientific guidelines wrong!
#heartsurgery #heartvalvesurgery #openheartsurgery #

Patient experience after Beating Heart Quadruple Bypass.

Race Against Time- Vascular Repair after Trauma

A 28 year old sustained injury to Rt. Knee following anime accident. Examination revealed no pulses in his limb. He also had severe pain and loss of movement. CT angiography revealed a totally cut off blood supply to the leg. He was taken up for emergency surgery and vessel repaired using saphenous vein graft. His limb was salvaged.
#vascularsurgery
#poplitealarteryrepair

Cover Story Urban Melange Magazine July 2018.

Bypass Surgery on Right Sided Heart- Rare Surgery for the first time in Punjab

https://m.facebook.com/story.php?story_fbid=1074419382689184&id=100003633976950

Bypass Surgery in Right sided heart. A rare surgery performed for the first time in Punjab.

Bypass Surgery on a Right Sided heart- Rare heart Surgery performed Successfully at Ivy Hospital amritsar.

In a press conference organised by Ivy Hospital Amritsar, Dr pankaj Goel Director and Chief Cardiac Surgeon claimed to have successfully performed beating heart bypass surgery in a young lady with dextrocardia and situs inversus. In this rare birth defect, the heart and other organs like liver and spleen are situated in a mirror image position. The heart is situated in the right side instead of left. This anomaly occurs in 0.01% of population. Dr Goel elaborated that only 28 cases have been reported worldwide of bypass surgery being performed in such patients. In his 20 yrs experience this is the first instance he added.

The operation becomes challenging due to the change of orientation and most cases have been performed on CPB. Dr Goel performed this case on beating heart despite the technical challenges.

Speaking to media persons, patients husband said that they are thankful to Dr Goel and his team . His wife has made good recovery and is discharged on 5^th day. He said that they had been to several hospitals but surgery was refused. In fact they were told that nothing could be done for her.

Dr Goel complimented the team and management for providing the support to perform such challenging cases at nearly half the cost as compared to Delhi. The Ivy Hospital management complimented Dr Goel and his team for providing world class health-care in the city.

Normal                                                 Situs Inversus

Leriche Syndrome- Treatment by thoraco bi-femoral grafting.

A 32 year old gentleman was referred to us with pain in calf and blackening of toes of his right foot for a week. He gave history of weakness in both lower limbs and erectile dysfunction for past 2 weeks. On examination he had absent femoral arterial pulses bilaterally. The pre-operative CT angiogram showed complete occlusion of juxta renal abdominal aorta with filling of iliac vessels via collaterals.(figure1). The symptoms and angiogram findings are classical features of Leriche syndrome. He had an absent right brachial pulse with occlusion of rt. axillary artery on angiogram. Since the patient was anon smoker the findings were suggestive of aorto arteritis as etiology.

Figure 1.-Pre-operative CT - complete occlusion of juxta reanl aorta (arrow)

 In view of his symptomatic status we decided to offer him surgery. A thoraco bifemoral graft was performed. Thoracic aorta was exposed via a lt thoracotomy(black arrow) and using a bifurcated aortic graft vascular supply was restored to both lower limbs (white arrows)relieving his pain and preventing gangrene.

Post-operative CT- thoraco bifemoral graft in place with restoration of blood supply.

Conclusion- Aorto iliac occlusive disease is a serious disease causing lot of morbidity and mortality. Amputation rates are very high in these patients. Atherosclerosis is the most common cause. Smoking is another major cause. Aorto arteritis is a cause in the young. In the symptomatic patients blood supply has to be restored either by surgery or percutaneous intervention to relieve symptoms and prevent amputation.