Thoracic and Cardiovascular Care

MIOT Institute of Cardiac Care

Thoracic and Cardiovascular Care

Overview

The MIOT Centre for Thoracic and Cardio Vascular Care (CTCC), which specialises in complex heart surgeries, performs more than 1000 surgeries annually with a success rate matching global standards. Patients benefit from the expertise of highly skilled cardiac surgeons with vast and varied experience, who adopt a patient-centric approach right from the first out-patient consultation. Patients and relatives are made part of the treatment process to ensure adequate post operative care and care after discharge, so critical for good long term results in this speciality.

Comprehensive Cardiac Care

MIOT’s dedicated surgeons are aided in their efforts by state-of-the-art diagnostic systems and treatment facilities, which include some of the best equipped operating theatres and surgical ICUs in India today.

Today MIOT Institute of Cardiac Care is a referral centre for Coronary Arterial Bypass Graft (CABG: Off pump – beating heart surgery), complex Mitral Valve Repairs, Re-do cardiac surgeries, complex Aortic Aneurysm surgeries, Endovascular stenting & Hybrid procedures, Minimally Invasive Cardiac Surgeries (MICS), Video Assisted Thoracoscopic surgeries (VATS) and surgery for Heart Failure.

Treatments & Procedures

MIOT International’s CTCC is a referral centre for coronary arterial bypass graft (CABG). Our areas of expertise also include:

A. Coronary Artery Disease

A.1 – Beating Heart bypass surgery or Off pump CABG
MIOT has been one of the pioneer cardiac surgical units in India which spearheaded beating heart surgery. It continues to be one of the institutions where almost all bypass surgeries are done by this technique.

 

A.2 – Total arterial revascularisation

Bilateral Internal Mammary Artery (BIMA) Surgery – The possibility of total arterial revascularization has further improved the long term outcome of CABG. BIMA operations have excellent outcomes in suitable patients.

 

A.3 – MICAS (Minimally invasive coronary artery surgery)

Bilateral Internal Mammary Artery (BIMA) Surgery – The possibility of total arterial revascularization has further improved the long term outcome of CABG. BIMA operations have excellent outcomes in suitable patients.

 

A.4 – Redo CABG

Many years after a patient undergoes a CABG, a small percentage of patients can experience new blocks or re-blockage of the coronary arteries or the grafts. Some of these patient’s require a Redo CABG.

 

A.5 – CABG with MV Repair

Patients who have suffered a heart attack sometimes have extensive heart muscle damage. This may result in leak of the mitral valve, an important left sided heart valve, as the supporting wall of the valve is weakened by the heart attack.

 

B. Valvular Heart disease

B.1 – Valve Repairs

Repair of cardiac valves has immense benefits to a patient with diseased cardiac valves. The existing native tissue of the valve is used to correct the defect in the valve.

 

B.2 – Mitral, Aortic and Tricuspid valve replacement

Leakage of mitral valve can be due to various causes, they may be because of a structural weakness in the valve or rheumatic heart disease pathology, where the valve gets thickened and rolled up.

 

B.3 – MIVS(Minimally invasive valve surgeries)

In the past 10-15 years, technological advances have made it possible to perform cardiac surgery through smaller incisions. This has been made possible with the use of special instruments.

 

B.4 – TAVI (Transcatheter Aortic valve Implantation)

This advanced technique of replacing the aortic valve in patients considered high risk for surgical AVR, is available at MIOT. The valve loaded on a catheter based technology is deployed in a cath lab.

 

C. Diseases of Aorta

C.1 – Aneurysm surgeries

MIOT is one of India’s highest volume centers for Aortic Aneurysm surgery and attract patients from all over the world. The center has a 24-hour dedicated team of specialists who can operate in less than 30 minutes for emergencies arriving at the hospital.

 

C.2 – Bentall’s operation

 

C.3 – Dissection of Aorta (acute & chronic) repairs

 

C.4 – Arch aneurysm surgeries

 

C.5 – Hybrid surgeries for Aortic aneurysms

For some patients, surgery or stenting alone are not complete treatment. Hybrid surgeries ensure complete treatment for complex aortic disease. Hybrid surgery offers good long term results in this disease with the least invasive and safe approach.

 

C.6 – EVSR(Endovascular vascular stent repair) for aortic aneurysm

A cohesive team of surgeons, interventional radiologists and cardiologists deliberate on treatment strategies. They execute the management of the disease with close cooperation leading to the best possible treatment.

 

D. Heart failure treatment

D.1 – CABG for severe LV Dysfunction

In patients where the muscle of the heart has good potential for recovery, the possibility of a high risk coronary artery bypass grafting (CABG) is perhaps one of the good options. These are typically patients who have suffered a significant heart attack with extensive muscle damage.

 

D.2 – Left ventricular aneurysm repair

 

D.3 – Post myocardial infarction ventricular septal repair

 

D.4 – LVAD (Left ventricular assist device)

In certain stages of heart failure, medications alone cannot sustain good hemodynamic condition. The need for mechanical support to the heart then becomes crucial. Most of the mechanical support devices used are usually temporary, to tide over a crisis, but there are also condition where it may be the only option for long term treatment.

 

D.5 – ECMO ( Extra corporeal membrane oxygenation)

The ECMO machine allows establishment of rapid support for heart, lungs or both organs, in times of crisis. This machine takes over the function of the lungs by oxygenating the blood going through the membrane of the machine.

 

D.6 – Cardiac Transplantation

In end stage heart failure, other surgical options as mentioned above will not be suitable for recovery of function of the heart. In such cases, the option of heart transplant can save a patient with end stage heart failure.

 

E. General Thoracic surgeries

E.1 – Lung Resections

The excision of a part of the lung may be required in certain diseases. The removal of a lobe of the lung or a complete lung on one side may be necessary in some patients. Disease like cancer, tuberculosis sequelae are common reasons for this.

 

E.2 – VATS (Video Assisted Thoracoscopic Surgery)

As in other surgical specialities, the use of minimally invasive approach through small incisions for surgery, is also an option in thoracic surgery. The technique of video assisted thoracoscopics surgery (VATS) uses two to three small incisions (ports) in the side of the chest.

 

E.3 – Tracheal reconstruction

 

F. Vascular surgeries

F.1 – Aorto bypass

 

F.2 – Femero-popliteal bypass

Occlusive diseases of the arteries of the lower limbs, result in threatening the viability of the limb. Percutaneous angioplasty of the narrowed portions of the arteries is an option for these blockages. When not suitable for angioplasty, a surgical bypass vascular surgery is the treatment required.

 

F.3 – Carotid Endaterectomy

Atherosclerosis (degenerative disease of blood vessels) affecting the carotid arteries (arteries supplying the neck and brain) can result in patients experiencing major stroke. When diagnosed to have significant critical blockage of these neck arteries, the treatment may be a carotid artery stenting or carotid endaterectomy.

 

G. Adult Congenital heart diseases

G.1 – ASD, VSD closure

 

G.2 – TOF( Tetrology of fallot) repair

Meet the Doctors

Dr. Vijit K. Cherian

Director, Adult Cardiothoracic Surgery

Dr. Vijit K. Cherian has an experience of over 20 years in the field of Cardio thoracic surgery. Having qualified in Cardiac surgery from the Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, he obtained an overseas fellowship in coronary artery surgery from the Royal Australian College of Surgeons. He is a graduate of Seth GS Medical College and KEM Hospital, Mumbai.

Dr. Cherian has a  vast experience in the area of beating heart Coronary Artery Bypass Grafting. Almost all CABGs are done by the beating heart technique which has proven to reduce morbidity of these surgeries. This technique also has widened the spectrum of patients who benefit from CABG by including a high-risk group, who now tolerate the surgery well.

He specialises in using arterial conduits and also is an expert in Minimally Invasive Cardiac Surgery (MICS). Minimally Invasive Mitral Valve Repair / Replacement, Aortic Valve Replacement and CABG are done routinely. MIOT is one of the few Hospitals in South India performing MICS regularly. MICS has resulted in less trauma to the patient with reduced ICU and hospital stay.

Dr. Vijit has operated on a large number of patients with heart failure, many of them presented with low pumping failure of the heart. High risk CABGs, CABGs with mitral valve repair, surgical ventricular restoration procedure wherein the left ventricle of the heart is repaired and reshaped. These procedures have benefited many patients who were otherwise in very critical condition.

Heart transplantation is another area where he has experience in. Transplantation of the heart for end stage heart failure gives a new lease of life to these patients.

Aneurysm of Aorta are complex challenging surgical cases. Dr. Cherian treat these patients along with a team of doctors involving the Interventional radiologists and Cardiologists. Open surgery, Endovascular stent repair and Hybrid procedures are regularly performed at the MIOT International with good results.

Dr. Cherian has an interest in general thoracic surgery, having treated disease of the lung, mediastinum and trachea.

He has performed a large number of mitral valve repair with good results. Mitral valve repairs benefit the patient significantly by retaining the patient’s own valve tissue.

Having served as Associate Professor in CMC, Vellore earlier, he has a keen interest in academic studies. He has various publications in national and international journals.