A BLOG BY A CARDIAC SURGEON FEATURING ALL ABOUT THE PRACTICE OF CARDIAC SURGERY....INFORMATIVE, INTERACTIVE AND SHARING
Sunday, 15 May 2022
Starting a new Cardiac Surgery set up
Substandard Cardiac Surgery Centres
All hospitals including the small nursing home types like HH, MH here in tricity of Chandigarh aspire to have the most prestigious speciality services of Cardiac Surgery with them which is not only highly skill oriented but is very man power intensive if you want to save lives. This is the only speciality which gives you seconds to rescue a life in danger and help needs to be in house 24x7. Recently these over ambitious small setups have spoiled the stature of speciality in encouraging the younger generation Surgeons to work without back ups, on refurbished equipment which thankfully Govt is banning them now, cheap reused disposables just for the sake of operating and inturn earning the meager bucks not bothering whether life will be saved or not. All kinds of unscrupulous means to earn extra money underhand even from Govt schemes are adopted in the name of viability knowing Honble Courts have nothing to offer as a quick relief. Years pass on to get small redressal.
This approach in highly critical and skilled speciality has destroyed the image of the speciality and the profession. Crowds gather on each mortality, police uses force still the show goes on.
NABH approvals have become another farce with hired team and hired equipments to fill the forms for approval.
My question is simple:
Can't the Govt ban or bar these small funny setups from operating this highly skilled speciality or makes it mandatory to provide standardised care at these hospital cum nursing homes? It will go a long way to save many bread winners of the families and save huge avoidable losses of life!
#team #nursing #hospital #hospitals #work #money #power #surgery #cardiacsurgery #heartsurgery #drsarwal #sarwalheartivillage
Wednesday, 9 March 2022
End to end Heart care from comfort of patient's homes!
Sunday, 3 November 2013
18-yr underprivileged boy from Kashmir gets new lease of life at Max Super Specialty Hospital, Mohali
His free cardiac surgery was funded by Max India Foundation
CHANDIGARH: Partially deaf by birth, 18-year old Asif Wani sordid tale of despair and victory is heart rending. The sixth child of a daily laborer, Abdul Azeea Wani, Asif was brought to Max Super Speciality Hospital, Mohali with complaints of breathlessness and palpitation.
Asif’s mother Zareefa Bano was speechless with gratitude as her son narrated the story of their strife to get treatment for their son. Asif had been diagnosed with the multiple congenital heart defects as early as 2 months of his birth. His parents took him to the local doctors at Srinagar but were turned away due to lack of funds. Even the best hospital in Srinagar refused free treatment to the boy. The procedure to save him, the family was told, would cost lakhs of rupees, which was impossible for the destitute daily wager to collect. Through a common acquaintance, Max India Foundation took up the case and Asif was successfully operated upon by Dr. Virendar Sarwal, Senior Consultant, Cardiology at Max Super Speciality Hospital Mohali. The 5-hour surgery involved one week of post operative care under expert supervision of critical care experts.
Belonging to an obscure little village Handwara in the far reaches of Kupwara Distt about 10-12 Kms from LOC, Asif’s parents were devastated when they realized that he was suffering from congenital heart disease. Asif was advised immediate surgery. Helpless and penniless, Asif and his family were in a dilemma as to how they would bear the cost of such an expensive surgery. It was then that he was referred to Dr Sarwal, who volunteered to take up his case. Since Asif belonged to a poor family and his parents could not afford the expensive treatment, an acquaintance, who had been helping the family since last 2 years in arranging funds, approached Max India Foundation for financial assistance. Max India Foundation decided to help the young boy by bearing the entire cost of surgery and offering him world class medical treatment at Max Super Speciality Hospital.
Ever since Abdul Azeea Wani, Asi’s father lost his eyesight 5-6 years back, Asif’s mother has been working as a labourer on a meager daily wage with no other source of income. We have been running from pillar to post for 2 years but all efforts to secure funds for the surgery bore no fruit. Our fellow villagers managed to gather Rs 16000 for our travel and stay once they came to know that Max Hospital was helping us, said .
Dr. Sarwal said that since these were birth defects, these were high risk surgeries. Asif lungs had developed early hypertensive changes and it was a long on pump surgery because of three congenital defects. His pulmonary valve was too small for his age. Asif underwent intracardiac repair on Cardiopulmonary bypass at Max Super Speciality Hospital on October 14 and soon recuperated. He would be requiring regular medication to support his heart condition.
For the past 18 years, my world was full of just pain and helplessness, said an emotional Asif, while expressing gratitude towards Max India Foundation for their support With this crippling disease, all I could do was sit or lie down on my bed and take a few faltering, painful steps to go to the toilet. It was a very depressing state of affairs for my family and me and many times I would wonder what was the point of existing like this, he remarked.
Ms Mohini Daljeet Singh, Head, Max India Foundation said that living up to our social responsibility of an integral part of the core philosophy of Max India Foundation, we were very glad that we have been able to get an opportunity to serve the needy. We would continue doing so in the times to come with sincerity and passion, she asserted.
It may be mentioned here that under various CSR programs like immunization, health awareness and health camps, artificial limbs camp, palliative care for cancer patients, Max India Foundation has now crossed the 1435 free and subsidized surgeries mark. Over 477147 people have benefitted from the various CSR programmes of Max India Foundation till now.
Dr. Ashutosh Sood, GM operations at Max Super Speciality Hospital Mohali said that this whole package bearing cost of Rs 2 lacs, was done entirely free of cost. However, it was well worth it because today Asif presented a heartwarming sight. Having recovered very well, he was up and about, talking and playing like a normal teenager.. The joy on his face was priceless and nothing compared to the satisfaction of having helped tears turn into smiles, remarked Dr Sood.
Sunday, 8 September 2013
High risk Octogenarian successfully treated for Coronary Artery Disease with Beating Heart Bypass Surgery successfully
Tuesday, 30 April 2013
Max Hospital, Mohali helps save life of a critically ill Poor Patient with Life Saving Heart Surgery
Friday, 29 March 2013
Adding years to your Heart….Life beyond Heart surgery
-- Blood pressure: Less than 130/80 mm Hg.
-- Blood cholesterol: LDL (low-density lipoproteins, or “lousy cholesterol”) below 100 mg/dL; HDL (high-density lipoprotein, or “healthy cholesterol”) above 40 mg/dL for men and above 50 mg/dL for women;
-- Triglycerides: Below 150 mg/dL.
-- Body mass index: Healthy range is 18.6 to 24.9, with a waistline smaller than 35 inches for women, 40 inches for men.
Tuesday, 22 January 2013
Affordable healthcare only possible with value based medicine
As per one study, our country has only 20 doctors per 10,000 people as compared to 650/10,000 in US. The budgetary provisions for healthcare are so low that even the primary healthcare cannot be delivered efficiently with the result the rural population is the worst sufferers. That is how there is mushrooming of quacks and invaluable lives are at risk.
In such a dismal scenario only alternative to improve upon the services and make each step in healthcare delivery more justified and economical, if we look at an evolving healthcare delivery system all over the world and even in developed countries like US, is Valve Based Medicine. So far, we have been practicing Evidence Based Medicine where in based on the evidence of the disease, we treat it with the costliest way of treatment. It ignores the logic of benefit vs cost ratio whether it is concerned with writing costly medicines or adopting the costliest intervention.
The value based medicine concept is different from the evidence based medicine concept in the sense that we are treating human beings and not symptoms. The treatment plan has to be based on the effective control of the disease with respect to the perception of the patient and his family in terms of benefit as compared to the cost involved in it.
Let’s say in heart disease a patient having coronary artery disease in two or three vessels can be treated with bypass surgery as well as ballooning and stenting. Now, whereas stents will cost him a big money and will also not be durable so bypass surgery becomes more economical and more durable. What the patient wants here is effective quality of life improvement with an economical and durable procedure. So, of course, bypass surgery is the best answer here. Similarly, a sore throat can be effectively treated with low-end antibiotic treatment and supportive therapy instead of expensive and high-end antibiotics.
Value based medicine is a means to compare all healthcare interventions on the same scale and a measure that can be combined with the cost of an intervention to arrive at a cost utility ratio. It provides most effective assessment of the patient perceived worth of an intervention. It also measures quality of life and/or length of life. The irony of healthcare industry is that it is one of the few industries where purchasers or the patients are unable to measure the valve of what they purchase.
So, value based medicine allows highest quality care, maximization of healthcare rupee and incorporation of patient based perception of quality of life. The goal of value based medicine is to promote what is best for the most important people in healthcare i.e. patients. It provides transparency backed by scientific opinion, communication by personal attention, no scare or fear by involving empathy, economics and 24×7 availability.
Similarly, if we come to procedures, the beating heart surgery is value based medicine. Minimal invasive surgery goes a step further in that direction as it makes the patient up and about early and the patient does not lose productive days of earning and is back to work at the earliest with less stress on the body. Also, in terms of logistics there is less ICU stay, less hospital stay, less use of blood products. Value based medicine also incorporates all the forthcoming evidence which is percolated to the patient level and helps in decision making for the patients.
Now, coming to stent vs surgery, two major trials — one in 2009 Syntax trial and the other in November 2012 Freedom trail — have clearly established and concluded that in multi-vessel disease and diabetes, bypass surgery scores over drug coated stents in terms of death, second heart attack and second or repeat intervention. So, all patients with multi-vessel disease should be offered bypass surgery as the first option for durable economical treatment.
In this scenario, value based medicine (VBM) stipulates that when it come to coronary artery disease each and every patient should meet the surgeon with his angiography report to reach to a conclusion whether he needs to go for stents or surgery. The other thing, which our country needs to incorporate into VBM is the availability of cost effective medicines, disposables and equipment. Most of the equipments, disposables used in high-end surgeries is still being imported and thereby making huge loss and leading to escalation of prices of these essentials.
The government has to encourage use of generic drugs, which should be free and easily available and encourage manufacture of disposables and equipments in our own country. It will do away the huge profit margin taken by the multinational companies when the middlemen and dealers add to the cost. There are very innovative products available in India and effort should be done to produce them at mass level and promote them at all levels. In fact, all hospitals should be told to use them as the first priority.
The infrastructural resources for the primary, secondary and tertiary healthcare delivery are very less so a policy needs to be made wherein the government and the private sectors should join hands in making the total available infrastructure at the disposal of all the patient population group. There should not be any differentiation and all available beds should be utilized to the maximum by one and all. It will help in reducing the waiting list and huge queues seen in government hospitals today. All it needs is rationalization of compensation to the private sector.
Today also many government agencies are utilizing the private resources for tertiary care by reimbursing them the subsidized cost of treatment. Why can’t it be applied to the primary and secondary care? The public private partnership (PPP) is another good concept of upgrading and bringing secondary and tertiary care in all cities and rural areas.
To promote healthcare delivery in rural areas the doctor should be encouraged by arranging for them good housing and transport facility and good schooling for their children. In fact, the concept of rural dispensaries should be abandoned and what we need is a good primary/secondary healthcare centre within a radius of 20 kilometres and that area on daily basis should be covered for OPD service by mobile vans with fixed hours backed by strong ambulance service which most states have already adopted. This will help getting the medical and paramedical manpower stationed at these centres as they will get basic facility and necessities of life for themselves and their family and doctors will be able to deliver better healthcare with better facility in terms of equipment and beds in an upgraded hospital environment. It will also help in running the various preventive healthcare programmes in true earnest.
These primary/secondary healthcare centres should be backed by tertiary care centres whether in private or government sectors at treatment cost rationalized by a committee of experts consisting of knowledgeable people from the government and the private sectors.
We need to understand that health is the ultimate necessity of life and is very important for the economic growth of this country. If we get developed this concept of value based medicine, it will see us through in building a healthy and capable society which in turn will produce a workforce which will work hard to take this country forward and will make it a world leader.
Sunday, 9 September 2012
CROSSED 100 MARK IN CARDIAC SURGERIES AT MAX HOSPITAL,MOHALI WITH 99.2% SUCCESS RATE
GREAT TEAM WORK WITH GREAT INFRASTRUCTURE COUPLED WITH VERY QUALITY ORIENTED ETHICAL APPROACH.
Tuesday, 14 August 2012
Friday, 13 July 2012
High Risk End stage Coronary Artery Disease treated successfully with Beating Heart Surgery
Sunday, 22 April 2012
Sunday, 19 February 2012
Self CPR
If you've already received this,
It means people care about you.
The Johnson CityMedicalCenter staff actually
Discovered this and did an in-depth study
On it in our ICU.
The two individuals that discovered this then did
An article on it, had it published and have had it incorporated into ACLS and CPR classes.
It is very true and has and does work.
It is called Cough CPR.
A cardiologist says it's the truth,
If everyone who gets this sends it to 10 people,
You can bet that we'll save at least one life.
It could save your life!
Let's say it's 6:15 p.m. And you're driving home
(alone of course), after an usually hard day on the job.
You're really tired, upset and frustrated.
Suddenly you start experiencing severe pain
In your chest that starts to radiate out
Into your arm and up into your jaw.
You are only about five miles from the hospital
Nearest your home.
Unfortunately you don't know if you'll be
Able to make it that far.
What can you do?
You've been trained in CPR
But the guy that taught the course didn't tell
You what to do if it happened to yourself.
Since many people are alone when they suffer a heart attack, this article seemed to be in order.
Without help, the person whose heart is beating improperly and who begins to feel faint,
Has only about 10 seconds left before losing consciousness.
However, these victims can help themselves by coughing repeatedly and very vigorously.
A deep breath should be taken before each
Cough, and the cough must be deep
And prolonged, as when producing sputum
From deep inside the chest.
A breath and a cough must be repeated
About every two seconds without let up
Until help arrives, or until the heart is felt to be beating normally again.
Deep breaths get oxygen into the lungs and coughing movements squeeze the heart and
Keep the blood circulating.
The squeezing pressure on the heart also helps it regain normal rhythm. In this way, heart attack victims can get to a hospital.



