Cath Labs:
Cardiac cath lab is currently the hub of activity in any cardiac unit considering the increasing need for angiography/ percutaneous techniques like coronary angioplasty (ballooning). The Fortis Escorts Heart Institute Cardiac Catheterization Laboratory is one of the largest and most advanced Cardiac Cath labs in Asia. The labs have been functional since October 1988 and cardiologists here currently perform more than 12,000 procedures annually.
The Fortis Escorts Heart Institute has four “state of the art” advanced flat panel cardiac cath labs. [figures]. Of these three labs are for adult/paediatric interventions. One lab is a dedicated Electrophysiology Lab. The staff are well qualified and are leaders in their respective fields. The labs has the distinction of training a large number of cardiologists from India as well as South East Asia in the field of Interventional Cardiology.
Our Services and Procedures
The Cardiac Cath Lab offers diagnostic catheterization of the heart chambers, valves, coronary arteries, aorta and pulmonary circulation.
Interventional procedures performed here include PTCA, including most complex cases, directional atherectomy, rotablator, peripheral angioplasties and valvuloplasty. The hospital also runs a 24 hour acute myocardial infarction intervention (primary PCI) program which is supported by 24 hour functional cath lab, onsite interventional cardiologist, cath lab nurse and technologist. The average “door to balloon time” here is less than 45 min which is comparable to the best centers in the world.
The cath lab procedures are supported by an expert team of anaesthesiologists who make the procedures safe and pain free. Well equipped Day cath facilities, pre and post cath areas of international standards make the procedure a very pleasant experience.
Coronary Artery Disease:
Due to factors like smoking, diabetes, high blood pressure, hyperlipidemia (increased fat in blood), obesity, lack of exercise, stressful life and family history of coronary artery disease, or simply ageing, a plaque starts getting deposited in the inner walls of the coronary arteries leading to partial or full blockage of the arteries. The blood flow does not remain normal and this leads to chest pain (angina). If it is not treated promptly, a heart attack (myocardial infraction) may result.
Test to Diagnose Coronary Artery Disease: Coronary Angiography
The diagnosis of CAD is made on the basis of symptoms, ECG and stress testing. Coronary Angiography, as the final test, to determine the following:
- Number, severity and the length of blockages
- Weakness of heart muscles
Angiography result along with clinical data guides the cardiologist to take proper decision regarding the final treatment. A special iodine based dye is injected into the coronary arteries of heart and x-rays are taken. The dye shows up on the x-ray monitor revealing the presence of blockages.
Interventional Cardiology
Angioplasty or PTCA:
Angioplasty, medically called PTCA is a non-surgical procedure designed to dilate (widen or expand) narrowed coronary arteries. As the result of this procedure, the blood vessel is dilated and blood can flow more easily through the formerly narrowed part of the coronary artery. It is used mostly to treat angina, but is sometimes used as an emergency procedure to improve blood flow during a heart attack (primary angioplasty). A stent is placed in the artery to improve upon the result. The percutaneous nature of this procedure along with prompt recovery and discharge has made this a preferred treatment for patients who need revascularization.
A stent is a small stainless steel/cobalt chromium tube that is permanently placed inside an artery to keep it open. Stents can be placed inside many different arteries. Stents can be used to open the coronary arteries, arteries in the leg, kidney, neck (carotid), or other peripheral arteries. Stents are mounted on the top of a balloon catheter and then pushed through the blockage. The balloon is then inflated and the stent expands pressing against the artery wall. The balloon is then deflated and removed leaving the vessel lumen held open by the stent. Some stents are self expanding and are deployed without the aid of a balloon catheter.
Rotablator: In this procedure the plaque is actually “removed” from the inside of the blocked artery by a coarse burr (rotablator) which grinds the plaque into small bits. These bits float away in the blood stream.
Non-Invasive Cardiology
Advanced diagnostic procedures are carried out at the state of the art Heart Stations at the Escorts Heart Institute. These Heart stations complement the other world class facilities at the Fortis Escorts Heart Institute. The diagnostic equipments include eight treadmill machines, eighteen latest 2-D color Doppler Echocardiography machines, Holter monitoring systems, Ambulatory blood-pressure monitoring equipment and 2 Pulmonary Function test labs.
The use of this full range of equipment and tests ensures that a complete picture emerges before preventive and curative measures are worked out.
Fortis Escorts Heart Institute constantly strives to procure cutting edge technology and was the first to acquire the first 3-D echocardiography machine in India. It regularly applies the techniques of multiplane transesophageal echocardiography, Stress echocardiography, on-line acoustic quantification and colorkinesis for patients with Ischaemic Heart Disease, which is the most important cardiac illness in the adults.
The diagnostic tests which are routinely done include – Stress ECG, transthoracic 2-D and 3-D color echocardiography, 2-D and 3-D transesophageal echocardiography, tissue Doppler imaging for cardiac resynchronization therapy and optimization of device, exercise and pharmacological stress echocardiography , carotid Doppler, peripheral Doppler ( arterial and venous ), renal Doppler, internal mammary artery Doppler, PFT, Holter and ambulatory BP monitoring..
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