Department of Adult Cardiology

Offering the best available diagnostic and therapeutic modalities, The Department of Adult Cardiology operates through interventional and non-interventional arms that together encompass the entire realm of adult craniological practice.

Interventional Cardiology is offered through the use of two state-of-the-art cineless catheterization laboratories, the first of its kind in the country. These utilize digital technology to store and retrieve data in compact discs and perform approximately 6000 procedures annually. Percutaneous Transluminal Coronary Angioplasty (PTCA) with placement of intracoronary stents is a routine procedure. It was in this unit in June 1993, that the first bail out stent placement was performed in India following a PTCA. In keeping with cutting-edge technology, the placements of drug eluting stents are also routine practice.

Balloon Valvuloplasty is another area this department is well known for, in the treatment of mitral, aortic and pulmonary stenosis. Balloon angioplasties make up a sizeable practice in this laboratory especially for peripheral vascular disease, coarctation of the aorta and peripheral pulmonary artery stenosis. Deployment of coils to interrupt arterio-venous malformations and other abnormal vascular anomalies also fall within the realm of the interventional cardiologist. Non-invasive Cardiology has as its major arm the echocardiography service.

Department of Cardiac Surgery

The Department of Cardiac Surgery has adult and pediatric units. The Institute of Cardio Vascular Diseases takes great pride in affirming that it is the most experienced unit in the country performing homograft valve replacements. Having the first homograft valve bank in the country employing cryopreservation techniques helps in providing for the large demand for homograft’s within the Institute.

Paediatric Cardiac Surgery.

Unique facilities to handle the entire spectrum of congenital Cardiac anomalies from newborns to adults. It operates 350-400 cases per year. The unit is the first in the country to utilize inhaled nitric oxide therapy for severe pulmonary hypertension and modified ultra filtration during open heart surgery in neonates and infants. The Institute of Cardio Vascular Diseases has the largest series of single stage unifocalization for the correction of ventricular septal defect pulmonary atresia and major aorto pulmonary collateral arteries (MAPCA). The Paediatric Ross program is worthy of special note.

Department of Paediatric Cardiology

This department deals with congenital heart disease in children. It also deals with adults whose congenital cardiac anomalies have been diagnosed later in life, and who therefore require a different approach to management vis-à-vis children with similar problems. Its team of committed Paediatric cardiologists deals with both interventional and non-interventional treatment modalities. Over 4000 Paediatric echocardiograms are performed annually using the latest high resolution echocardiographic equipment. Most children can now undergo surgical repair based on echocardiography alone without having to resort to cardiac catheterization. With the addition of the trans-esophageal echo graphic probes, diagnostic accuracy is enhance both pre and post operatively. Its availability in the operating rooms facilitates precise surgical correction of complex congenital cardiac anomalies.

Department of Electrophysiology.

Cardiac Electro Physiology Laboratory set up in 1998, has aided the Institute of Cardio Vascular Diseases to become one of the few centers with expertise to manage end-stage heart failure by means of the latest electrophysiological techniques including biventricular pacing. Equipped with the Bard Duo 32 channel computerized recording system (Billerica, Ma), Radionics RFG-3E (Burlington, Ma) radio frequency generator with power and temperature control modes and Micropace (Sydney, Aus) PC based stimulator, it is one of the busiest cardiac electrophysiology centers in the country dealing with a wide range of diagnostic studies and radiofrequency ablative procedures both in adult and pediatric patients. The unit is headed by a cardiologist trained specially in interventional cardiac electrophysiology.

The Automatic Implantable Cardiovertor Defibrillator (AICD) is a sophisticated pacemaker, with an incorporated defibrillator/cardiovertor that is implanted routinely for the treatment of resistant life threatening arrhythmias.

Paediatric Cardiologists at the Institute routinely perform catheter-based interventions for closure of cardiac defects like atrial septal defects, patent ductus arteriosus and ventricular septal defects. Balloon atrial septostomy, coil embolization of patent ductus arteriosus and major aorto-pulmonary collaterals, balloon dilatation / stenting of coarctation of the aorta and balloon valvuloplasties ar some of the routine interventional procedures that are particularly significant because surgery could be avoided altogether facilitating a shorter hospital stay for the child.

Coronary artery bypass procedures make up the bulk of the work load in this unit. In keeping with current techniques and technological advancements, Off Pump Coronary Artery Bypass (OPCAB) has come to be an important and common means of surgical revascularization. While valve replacements are done in large numbers, special emphasis is given to repair techniques in an effort to preserve the native valves as and when possible. Novel as well as time tested repair techniques like chordal shortening, quadrangular resection and use of artificial (PTFE) chordate are used as needed. Besides the replacement of aortic and pulmonary valves, the unit has also performed homograft replacement of the mitral valve. The Ross operation involves using the native pulmonary valve as an autograft and a homograft valve at the pulmonary position as an allograft. This operation has distinct advantages in selected patients in avoiding the use of anticoagulants, significantly fewer re-operations and better cardiac hemodynamic. The Institute of Cardio Vascular Diseases has performed Ross operations in patients aged between 3 months to 70 years.

New Cathlab

Institute of Cardio Vascular Diseases (ICVD) installed 3rd cathlab INNOVA IGS 520 manufactured by GE Healthcare, USA.This is the first fully loaded state of art cathlab from GE Healthcare in South Asia.

The Innova IGS 520 is a fully integrated imaging system that meets a wide range of clinical needs for interventional and diagnostic imaging with excellent image quality, extensive real-time processing, and innovative dose management, ease of positioning, improved workflow and image management for excellent clinical versatility without compromise. The new cathlab has many unique features as follows

56 inch Large Display Monitor, helping physicians perform routine and advanced procedures in the Cathlab. The StentViz enhances visibility of the stent structure. One with the guide wire in view and a second one where the guide wire is subtracted out in the area between the two balloon markers to allow better visualization of the stent struts or borders. It’s provides 3D imaging for internal body structures and interventional devices in one image. Innova CT for tissue reconstruction is intended for imaging bone, soft tissues, and other internal body structures. Innova Vision dynamically fuses in real time 2D X-ray images and 3D models from multiple modalities to support localization and guidance of catheters, coils and other devices during interventional procedures.

Innova EP Vision is an advanced application that dynamically fuses in real time 2D X-ray images and 3D models, such as the 3D Cardiac model, from multiple modalities to support localization and guidance of guide wire, ablation catheters and other devices during interventional procedures, such as EP procedures or structural heart procedures.Advanced patient contouring technology uses an intelligent algorithm during gantry motion to select the optimal position for the image receptor relative to the patient. By reducing the distance from receptor to patient, the system optimizes imaging geometry and helps reduce radiation exposure. Users can select measurement points with a fingertip directly on the selected image frame displayed on the Innova Central tableside touch screen – no mouse or joystick is required.Innova OneTouchQA is available for stenos is analysis and distance measurements.

World’s first commercial 3D imaging system for real time use in interventional cardiology procedures. The features of coronary 3D includes real time 3D construction, accurate 3D based quantitative measurements, cross section area and eccentricity graph, bifurcation and side branch analysis etc.

Coronary Care Unit (CCU)

A-16-bedded and fully equipped to deal with all cardio vascular emergencies supervised round the clock by qualified cardiologists, it is supported by physician assistants and well trained nursing staff.

Intensive Care Unit (ICU)

The adult and Paediatric units separately in a 36-bedded unit. Its modern monitoring facilities are comparable to the best in the world. Our team of intensive care specialists is specially trained to manage adult and Paediatric intensive care units and have contributed significantly to our excellent surgical results. Individual nursing care, cardiac output monitoring and hemodialysis facilities are available. Mechanical cardiac assist devices are used for providing support for the failing heart and also as a bridge to transplant. Inhaled Nitric Oxide (NO) is available for use in patients with pulmonary artery hypertension, many of whom would otherwise be inoperable. The excellent facilities and clean, spacious interiors make convalescence for the patient a pleasant and memorable experience.

Department of Cardiac Rehabilitation

This unit focuses on the quick functional recovery of the cardiac patient. While most of the patients attending this unit are post operative patients, its service is open to patients who seek advice regarding modification of life-styles to alter or reverse heart disease from the outpatient departments also.

Patient counseling forms an integral part of health education in weight reduction, physical exercise, and living habits. Pain management, whether by sophisticated electro-analgesia, counseling or medications, is co-ordinated through the department of rehabilitation.