Taking heart with technology

Time was when you simply had a heart attack and died. But as technology has advanced, it does not let you die. Not that easily, at least....

Time was when you simply had a heart attack and died. But as technology has advanced, it does not let you die. Not that easily, at least. It is now possible to have laser angiographies that are completely bloodless. To have a bypass surgery done on a beating heart, without a heart-lung machine. To install an internal defibrillator that could revive your heart in case it fails, without your even knowing it!

If all this does not sound like Greek to you, then it at least sounds unbelievable. But that is exactly what a few cardiac care centres in the city are doing 8211; bringing the best that technology has to offer to the citizens of Pune. At the N.M. Wadia Institute of Cardiology and Ruby Hall Clinic, cardiac patients can at least expect to receive optimum medical care, as far as technology is concerned. Take arrhythmias, for example. This is a cardiac problem that involves an abnormal heart beat. Says Dr. Manoj Pradhan, chief cardio-thoracic surgeon at N.M. Wadia,8220;If a person8217;s heart for some reason beats 200 to 300 times a minute, the amount of blood the heart receives is almost nil and he can die. In fact 40 percent of cardiac deaths are due to arrhythmias.8221;

Arrhythmia can go undetected, till a person suddenly collapses and dies, one fine day. Till recently, this condition was treated with drugs. But at N.M.Wadia if a man8217;s pocket is willing, he can install an internal defibrillator that will automatically sense these abnormal heart beats and administer appropriate shocks to revive the heart. In fact, the system is so efficient, that a patient will not even know when his heart has reached the near collapse stage and when the defibrillator has revived it. Says Pradhan,8220;This works with the help of a battery that has a life of eight to 10 years. But if a patient has several such attacks, then it needs to be replaced sooner.8221;

Like all things new and phenomenal, the defibrillator does not come cheap. Says Pradhan,8220;Along with the machine and the surgery of installing it, it can cost up to Rs. eight and a half lakhs to nine lakhs.8221; This may be too high a price to pay for living, but if one can afford it, then the facility exists. At Ruby Hall Clinic, angioplasty is not always done the conventional way. The hospital uses laser technology to open clogged arteries. As a result, it8217;s a non surgical procedure. Says Purvez Grant, chief cardiologist at Ruby Hall Clinic,8220;A 100 per cent block cannot be opened with a wire in a normal angioplasty operation. But a laser can, thus preventing the need for a by-pass surgery. Blocked arteries can also be treated with stents a mesh-like spring that holds the walls of the artery open.

8220;Lasers help to reduce a lot of problems associated with cardiac surgery. First of all, there is no surgery. As a result there are no problems with after care and no loss of blood. The patient does not feel the extreme fatigue and weakness that he would after a by-pass surgery.8221; And the cost? 8220;It8217;s about the same as a by-pass operation which earlier used to cost Rs. 95,000. A stent costs Rs. one lakh.8221;

That is not all that these two hospitals have to offer. Calcified blocks are generally harder to open in angioplasties. Says Pradhan,8220;The wire we use cannot open these blocks. So we have a technique that drills the calcified block breaking it into small particles that eventually get washed away by the body.8221;

Rotablation, as this drill is called, is one of the latest technological instruments in the city.

Story continues below this ad

Among the best technological advances available in Pune is the by-pass surgery done on a beating heart. This is available at both the hospitals. While Ruby Hall Clinic uses the MICAS Minarase cardiac Surgery, at N.M. Wadia, this is done with the help of the octopus stabiliser. Through this method the part of the heart that requires surgery is immobilised while the rest continues to beat normally.

Says Pradhan,8220;This reduces a whole lot of problems for us and the patient. In the Eighties we would ask a patient to arrange 15 bottles of blood and use up all of it for an open heart surgery. Now we use just two or three bottles. The success rate then, was 50 percent. Today, we have a 90 percent success rate.8221;

Testing methods too are hi-tech in these hospitals. The Cardiac Catheterisation Lab uses a digital system that not only informs the doctor about where the blockage is, but how extensive it is, what percentage of the artery is blocked. Says Pradhan,8220;Anaesthetic techniques too, have improved greatly and we surgeons, have greatly benefitted by it. Ultra short-acting anaesthetics that give the same depth of anaesthesia, but for a shorter period, without affecting the cardio-vascular system, help in quicker recoveries.8221;

Great technology that helps increase the quality and quantity of life is all fine in theory, but in practice, is it easily available to all those who need it? Says GE Narielwala, administrator, N.M. Wadia,8220;It is true that certain techniques are prohibitive, cost wise. But at N.M. Wadia, we try to help all those who need the help of this hi-tech procedures. We have tie-ups with several charitable trusts like Tatas, Saibaba Sansthan and so on.

Story continues below this ad

If a person cannot really afford a MIDCAB, or a Complex Valve Replacement, CVR, we refer their case to these organisation so that they end up paying as low an amount as Rs 10,000 to 20,000 with the rest coming from charity. Our policy is to help all those that come here.8221;

So, now whether you like it or not, technology is going to ensure that you stay alive!