Open Heart Surgery (CABG) in India
In this article, we have covered the following aspects of Open Heart Surgery (CABG) in India
- Top hospitals for open heart surgery in India
- Top Cardiac Surgeons in India expertised in CABG.
- Cost of Open Heart Surgery in India
- Understanding Open Heart Surgery
Top Doctors and Hospitals for Open Heart Surgery hospitals in India
Following is a list of the most reputed specialists in India for Open Heart Surgery.
Please click the ‘contact doctor‘ button on the right side for seeking opinion or requesting an appointment with your chosen specialist.
(*On mobile device, please click the ‘+’ symbol on the left to access the contact form)
Cost of Open Heart Surgery in India
An Open Heart Surgery in India will cost you between USD 6000 -8000 in most cases. Please share reports for best estimate.
Understanding Open Heart Surgery
Open heart surgery is a surgical procedure to treat certain types of heart diseases. As the name suggests the area is cut opened to expose the heart and perform the surgery. The term is often used for ‘Heart Bypass Surgery’ as the ‘open and cut’ method is used to conduct coronary artery bypass surgery (CABG).
Also known as traditional heart surgery, open heart is done by making five to eight inches surgical cut in the chest wall through the patient’s breastbone or sternum. The whole procedure is performed under general anesthesia.
Heart conditions treated through open heart surgical method
- Repair or replace heart valves
- Heart defects by birth
- Coronary artery disease
- Heart transplant
Indications for Open Heart Surgery/ CABG
Class I indications:
- Left main coronary artery disease (LMCAD) with 50% or greater narrowing
- Anatomically equivalent LMCAD with 70% or greater narrowing in both the proximal left anterior descending (LAD) coronary artery and the left circumflex artery
- Three-vessel coronary artery disease (CAD), particularly in the setting of an deceased left ventricular ejection fraction (LVEF)
Class II indications:
- Proximal LAD coronary artery stenosis (impaired LVEF becomes a class I indication)
- One-vessel or two-vessel CAD ( not involving the proximal LAD coronary artery) if a moderate area of viable myocardium is at risk
Class III indications:
- One-vessel or two-vessel ( not involving the proximal LAD coronary artery)with only a small area of viable myocardium
CABG & Angioplasty
Studies comparing CABG with coronary intervention (Angioplasty) for multivessel disease demonstrated that the two strategies had similar mortalities.
Some studies have showed improved mortality in diabetic subgroups that undergo CABG, though findings may differ in different population.
Before the widespread use of drug-eluting stents, the main advantages of CABG over percutaneous cardiac intervention (PCI) included a lower rate of redo procedures, greater success with 100% total cut off of coronary arteries, and protection of the entire vessel anastomosis of a mammary graft.
The disadvantage of CABG is the surgical risks and surgery related complications.
Introduction of Drug-eluting stents have improved angioplasty results, particularly with regard to repeat revascularization, and there are chances of decrease in restenosis with drug-eluting stents (DESs) which will further reduce the need for repeat procedures in patients with multivessel coronary artery disease
Types of Open Heart Surgery
Minimally invasive coronary artery bypass grafting(MICABG)
With advancement in skills of performing CABG led surgeons to avoid performing a median sternotomy, thereby reducing pain , respiratory complications and above all preventing the large scar associated with this incision.
MICABG includes surgical techniques that allow access to the heart through small thoracotomy incisions with endoscopic robotic surgery using a computer-enhanced telemanipulation system
Minimally invasive direct CABG (MIDCABG) can be performed with or without Cardio-pulmonary bypass
In robotic CABG, the surgeon, with the help of computer console, introduces instruments through small thoracotomy chest incisions and manipulates them with robotic arms
Early results of robotic surgery were successful on anterior vessels, and this success led to the development of complete multivessel Robotic CABG
Small incisions substantially reduce the morbidity related to median sternotomy and offer a quicker recovery
MIDCABG without CPB is primarily performed in the following circumstances:
- For anterior lesions (lesions of the LAD in particular) when angioplasty is unsuitable due to some reasons
- For patients in whom conventional bypass cannot be performed safely because of comorbid conditions associated with high surgical risk
- For redo surgery, when sternotomy or CPB is contraindicated because of the risk of bypass grafts, cardiac structures adherent to the sternum, previous sternal wound infection, mediastinal radiation therapy, or a calcified or diffusely atherosclerotic aorta
MIDCABG to the LAD in conjunction with angioplasty stenting of the right coronary artery or left circumflex artery is also performed. This surgery is done off the pump through a small anterior thoracotomy. Typically, MIDCABG offers access only to the LAD and diagonal coronary arteries
When MIDCABG is done through a limited anterior thoracotomy with CPB, Heart-Lung machine is used for optimal myocardial protection. This approach offers better myocardial protection, better access, freedom to manipulate and expose the entire heart which is necessary for multivessel CABG
OPCABG is performed via median sternotomy, which facilitates harvest of the internal mammary artery and access to all coronary arteries. Temporary endovascular shunts are used to limit myocardial ischemia
Off-pump CABG (OPCABG) or Beating Heart Surgery usually involves a medial sternotomy but avoid usage of heart lung machine for cardiopulmonary bypass (CPB), thus perhaps reducing bleeding and the frequency of renal failure.
The main advantage of OPCABG is that it prevents complications of artificial perfusion and CPB,reductions in inflammatory response, postoperative infection, and arrhythmias.
Risks of open heart surgery
Open heart bypass surgery is a common surgical procedure. The risks involved with the surgery are same as with any other surgery like bleeding, infection or stroke etc., which are well care taken by the surgeons. It is important to note that the risks increase for elderly patients, diabetics, and those with weak heart muscles.
Recovery after Open Heart Surgery
The recovery after open heart surgery is gradual. For the first two months after the surgery, you will be strictly advised by your cardiologist about precautions to be taken, dietary changes, and light activities that could be done. You are required to strictly follow the medications and instructions prescribed.
After about two months your doctor may allow you to get back to work gradually depending upon your medical condition. There will be regular follow-up visits to the doctor for the first few months.
Recommended lifestyle changes after Bypass Heart Surgery for quick recovery and greater benefits:
- Eat healthy nutrient-rich diet
- Low intake of foods high in fat, sugar, and salt
- Control high blood pressure and cholesterol level
- Moderate exercises
- Stop smoking and taking alcohol
- Maintain active lifestyle
Note (for foreign patients):
Besides South Asian countries (Afghanistan, Bangladesh, Bhutan, Maldives, Nepal, Pakistan, Sri Lanka), every year, India gets thousands of medical tourists from African countries- Nigeria, Kenya, Ethiopia, Sudan, Uganda, Ghana, Somalia,Gambia etc and Middle Eastern countries like Iraq, Iran, Saudi Arabia, Oman, UAE, Yemen etc. Hence, if you are a citizen of any of these countries, there is good likelihood that you will be meeting some fellow citizens or same language speakers in the major hospitals in India. Almost all the top hospitals have translators for people of these region. Our patient support team is also well placed to assist you.