As we all know, Interventional Cardiology is a department of Cardiology through which particular strategies are used to diagnose the issues associated to blood move, in addition to, strain within the coronary arteries and chambers of the center. It contains numerous technical procedures and medicines to deal with abnormalities that impair the operate of the cardiovascular system. To make it extra clear for our viewers, we had a dialog with Dr. Rajnesh Kapoor.
Dr. Rajneesh Kapoor is the Vice-Chairman within the Division of Interventional Cardiology at Medanta The Medicity. He has been working with Medanta for over 10 years. At Medanta, he performs every kind of invasive procedures which embody coronary angioplasty, peripheral angioplasty, carotid angioplasty and every kind of valvular interventions that are getting standard lately.
Equally, he’s an knowledgeable in performing many different new procedures like TAVR. Earlier than this, he has additionally labored with different high services like Apollo Hospitals.
Interview Questions Answered by Dr. Rajneesh Kapoor
Query 1: How can we tackle the dearth of donors regarding coronary heart transplants? What measures are taken to protect the well being of a affected person in case the donor’s coronary heart is just not instantly out there?
Reply: Dr. Kapoor stated that if we speak in regards to the pool of end-stage coronary heart sufferers, the center failure sufferers, now we have ‘N’ variety of sufferers who come for followup, the place the medicines and different therapies will not be working. This is named refractory coronary heart failure. So now the affected person is at a stage the place he/she could be handled clinically solely with a heart transplant.
The physician discusses this with the sufferers and their households. A coronary heart transplant is just not a one sitting phenomena. It requires a number of sittings with the sufferers and their kin.
Dr. Rajneesh Kapoor talked about that the outcomes of coronary heart transplants are superb. The issue in coronary heart transplant is that the donor is just not immediately out there. A really perfect donor is a younger particular person whose blood group matches with the affected person and is mind useless due to some causes however with a functioning coronary heart.
Actually, in Northern India, if some affected person is mind useless, the household is just not able to donate his/her organ due to emotional attachments. However, in Southern India, persons are far more receptive in donating the organ of any member of the family who’s mind useless. So right here we have to work to boost the notice in most people. Now we have to make folks perceive that donating organs of mind useless sufferers can save somebody’s life.
In some circumstances, the affected person wants a transplant however they aren’t receiving the suitable donor on the proper time. In that case, we should hold the affected person balanced or no less than hold the affected person going till he/she will get the appropriate donor. This contains some procedures, good medicine and in addition affected person’s cooperation in following an excellent way of life, by limiting the salt consumption or fluid consumption, be very compline with the drug consumption.
So by using both a tool or acceptable drug regime or adjustments in way of life, the medical doctors can get the affected person going until the purpose he receives a donor.
Query 2: What’s the way forward for interventional cardiology? Can we count on extra improvements within the catheter-based therapy that it minimizes the necessity for cardiac surgical procedures?
Reply: Up to now two to 3 many years, there was a speedy progress in interventional cardiology. Now we have been doing coronary interventions and every kind of valvular intervention. Medanta The Medicity has a distinct form of experience in dealing with very advanced coronary heart situations.
However the development in interventional cardiology is extra about structural coronary heart interventions. The cardiology procedures have moved from coronary to structural coronary heart issues. Now structural coronary heart issues are the valvular coronary heart issues.
Suppose, if one of many coronary heart valves begins leaking. Usually in such conditions, the surgical procedure is the one therapy. However at instances the affected person’s comorbidity, frailty or the age of the affected person are among the components that add extra threat throughout the surgical procedure. So, in such circumstances, there’s a want for sure procedures which may give advantages to sufferers and are non-surgical. That is included within the development which is current lately.
These days, we’re treating aortic stenosis by a catheter-based percutaneous valve substitute popularly often called TAVR. Dr. Rajneesh stated that Medanta is THE main centre in India who has carried out the utmost variety of TAVR. Equally, they’re additionally doing percutaneous mitral valve intervention the place they’re changing the valve or doing clip process.
Query 3: Within the age of technological advances, how typically is open-heart surgical procedure indicated?
Reply: The development of interventional cardiology has diminished the variety of open-heart surgical procedure however not utterly prevented. Nonetheless, there are particular subsets through which open coronary heart surgical procedure is the primary indication of therapy.
For instance, Open coronary heart surgical procedure is indicated within the case of left foremost advanced bifurcation illness. Open coronary heart surgical procedure can also be required in closely calcified arteries, calcified blockages and CTO. Aside from these, many sufferers are affected by valve issues like mitral valve ailments or congenital issues in children could be handled with the assistance of open-heart surgical procedure. Catheter-based therapy has turn into increasingly more superior however nonetheless, there’s a large scope of cardiac surgical procedure. In lots of circumstances, open surgical procedures are the one answer.
Query 4: Roughly 200,000 kids per 12 months are born with congenital coronary heart ailments. One-fifth of those kids require medical intervention within the first 12 months of their life. What do you assume are the primary causes behind these numbers? Can anticipating moms undertake some preventive measures throughout their being pregnant to scale back the danger of congenital coronary heart ailments?
Reply: In lots of circumstances, the kids are born with congenital coronary heart issues after which the medical doctors present the therapies. This observe is essential and in addition crucial for his/her good well being. However most significantly we have to perceive the rationale behind the congenital coronary heart issues. For that, now we have to see the being pregnant section.
Dr. Rajneesh talked about that being pregnant must be wholesome. Ensure that the mom is just not affected by malnutrition. There must be an excellent provide of iron and nutritional vitamins. Your loved ones historical past additionally issues loads and wishes particular investigations in such circumstances. There are numerous cardiac issues which could be identified throughout being pregnant.
Typically when the situation could be very vital, then now we have to terminate the being pregnant. Usually, congenital issues are widespread in girls getting pregnant after 30 years of age or in consignors marriages, that are widespread within the Muslim neighborhood. In such circumstances, medical doctors advocate a easy fetal echocardiography test. This take a look at clears whether or not or not the child has any coronary heart dysfunction.
As talked about within the query, 2,00,000 kids are born with congenital coronary heart ailments. Even when the kids get identified with coronary heart issues at an early stage, they are often handled utterly with the assistance of sure procedures or surgical procedures.
Query 5: What are the success charges of stent implantations for treating cardiac ailments? Is it doable that surgical procedure is additional indicated publish stenting?
Reply: These days, we’re into an period the place the stent know-how has reached the purpose the place it’s superior. The stents are actually miniaturized, very small and really refined. The probabilities of any failure of any stenting process at the moment are lower than 1%. Equally, the probabilities of recurrence are no more than 3-4%. This additionally depends upon the experience and the hospital. The success fee of such procedures will increase if the hospital is following very strict protocols and has an efficient group of cardiologists like Medanta.
Extensively the stent success fee is excellent, however at establishments the place strict protocols are adopted, the outcomes are even higher. There are a number of segments or subsets of sufferers the place stenting stays a dangerous course of and wishes surgical procedure.
At Medanta, a number of brains are working collectively at one cut-off date to have the very best final result for the affected person.
About The Physician
Dr. Rajneesh Kapoor is a number one heart specialist and the Vice-Chairman within the Division of Interventional Cardiology at Medanta -The Medicity, Gurgaon. He has a wealthy expertise of 23 years in his area.
He has accomplished his MBBS from Govt. Medical Faculty Amritsar, Punjab, Guru Nanak Dev College in 1994, MD from Govt. Medical Faculty & Hospital Patiala, Punjabi College in 1997 and DNB from Escorts Coronary heart Institute & Analysis Centre, New Delhi in 2002. He has printed over 100 articles, critiques and abstracts in numerous nationwide and worldwide journals
Earlier he was related to Escorts Coronary heart Institute and Indraprastha Apollo Hospital, New Delhi as a Senior Advisor Heart specialist.
For a precedence appointment or extra info, contact us at +91 8010994994 or e-book an appointment with Dr. Rajneesh Kapoor right here