Ischemic heart disease (IHD) is the No. 1 killer in Karnataka, accounting for every 12th death in the state.

The disease is caused by reduced blood flow to the heart; some 43.12% of deaths are caused due to IHD.  The 2009 report on medical certification of cause of death (MCCD), prepared by the office of the chief registrar of births and deaths, shows that every 10th reported medically certified death has been that of an infant (less than one year of age).

Bangalore tops the list with nearly 30% of over 1.15 lakh registered deaths in the state. Medical certification of cause of death provides data on death by age and sex in respect of specific causes.  Besides IHD, which is categorized under ‘diseases of circulatory system’, deaths due to “certain infectious and parasitic diseases” is the next most killer. Tuberculosis and septicimia constitute 43% and 21% of deaths under this major group of diseases.

Poisoning by drugs and biological substances and toxic effects substances, which is categorized under deaths due to “injury, poisoning and certain other consequences of external causes”, is the third most killer in the state. The government obtained information from over 1,200 hospitals.  At least 85% of infant deaths have been reported due to certain “conditions originating in the perinatal period”. Among the children aged between 1 and 4 years, “certain infectious and parasitic disease” has taken the highest toll of 32.03%. When taken gender-wise deaths, more than 63% constitute male.

What is IHD
Ischemic heart disease is caused due to decreased blood supply to the heart. It happens due to blockages developed in the blood vessels. These blockages are cholesterol deposits along with calcium; 99% of heart diseases are due to these blockages, says Dr Deepak Krishnamurthy, cardiologist, Fortis Hospitals.

Top 5 Reasons for  Ischemic heart Diseases

1. Circulatory-system diseases
2. Infections and parasitic diseases
3. Injury, poisoning and external cause
4. Certain condition origination in the perinatal period
5. Endocrine, nutritional and metabolic diseases

   Source : TOI

Fortis Hospitals Recently was featured in Wired Magazine /Dailymail.co.uk and Sky TV,  Featuring “Dr Vivek Jawali” of Fortis  who had  pioneered this procedure almost a decade ago.

The patient stares out at the camera, his fragile heart exposed during life-saving surgery.The astonishing picture of Swaroup Anand shows just how far open-heart surgery has come in the last decade.The 23-year-old went under the knife in Bangalore at Wockhardt Hospital while he was still very much awake.

Doctors chose to numb his body with an epidural to the neck rather than send him to sleep with general anaesthesia.

The Seven Steps of Awake Open-heart surgery

1. Insert an epidural catheter into the patient the day before the operation.

2. Patient to theatre. Administer a test dose of the epidural below the nape of the neck.

3. Give the patient the full dose and wait 20 minutes for all sensation from the chest to be blocked. Test by prodding the patient’s skin with a needle.

4. Open breastbone using electric saw.

5. Main surgery.

6. Close the breastbone with steel wire and close skin.

7. Transfer patient to intensive care.

This article was taken from the February issue of Wired UK magazine.

In recent years, new ways of doing heart surgery have been developed. One new way is off-pump, or beating heart, surgery. This is like traditional open-heart surgery, but it doesn’t use a heart-lung bypass machine. Minimally invasive heart surgery uses smaller incisions (cuts) than traditional open-heart surgery. Some types of minimally invasive heart surgery use a heart-lung bypass machine and others don’t. Heart surgery is used to treat people who have severe heart diseases and conditions when other treatments have failed.

Minimally invasive heart surgery in India is performed through a small incision, often using specialized surgical instruments. The incision is about 2 to 4 inches instead of the 6- to 8-inch incision required for traditional surgery. Keyhole approaches or port-access techniques are also available for some types of surgery.  Traditional open-heart surgery is done by opening the chest wall to operate on the heart. The patient is connected to a heart-lung bypass machine. This machine takes over the pumping action of the heart, makes sure the blood gets enough oxygen, and allows surgeons to operate on a still heart.

Minimal Invasive Heart Surgeon at Fortis Hospitals, Bannerghata Road

Dr. Rehan Sayeed is an alumnus from the prestigious Madras Medical College where he did his basic medical education and went onto to complete his general surgery training. His quest for knowledge and skill took him to the United Kingdom where he graduated to become a Fellow of the Royal college of Surgeons of Edinburgh. He subsequently returned to India to do his Cardiothoracic training  at Chennai under the mentorship of Dr. M R Girinath where he graduated with a Diplomate of the National Board of Examinations.Dr Rehan Sayeed has performed more than 6000 heart surgeries and more than 2500 thoracic surgeries,more than 1500 minimal access valve procedures and more than 50 heart transplants.

Having laid a solid foundation in India he went on to do a Fellowship in Adult Cardiothoracic Surgery at the Boston University Medical Center where he was the chief resident. In 2004 he joined the prestigious Children’s Hospital of Boston, Harvard University as Senior Resident in Pediatric Cardiac surgery training to do complex congenital heart surgery. The last but not the least leg of his training years were spent at The Cleveland Clinic Foundation, Cleveland, Ohio, America’s No.1 heart center for the last 13 years in a row. Here he specialized in Heart failure surgery and Mechanical Assist devices/cardiac transplantation. He is certified in Cardiac Transplantation and was a part of the team that implanted the early Total Artificial hearts ( cardiowest). At the clinic he also trained in minimal access cardiac surgery and valve repair surgery. Today he has to his credit over thousand plus minimal access procedures.

Dr Rehan Sayeed’s  main area of Interests are

• Minimally invasive cardiac surgery
• Valve repair surgery
• OPCAB- Total arterial revascularisation
• Management of Sick Ventricles
• aortic aneurysm repair
• Heart transplantation and Ventricular assist devices
• Thoracic Oncology
• Tracheal reconstructive surgery

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Dr. Vivek Jawali is a pioneer in minimally invasive cardiac surgery in India. He is the founder of two premier heart institutions in Bangalore – the Sri Jayadeva Institute of Cardiology and the Fortis Hospital and Heart Institute. The establishment of these two institutes encouraged many more to follow suit, changing Bangalore into a preferred healthcare destination.

Dr. Jawali has performed over 16,000 surgeries and has been the president of the Indian Association of Cardiovascular and Thoracic Surgeons (IACTS). He is the founder member of the International Society of Minimally Invasive Cardiac Surgeons (ISMICS) and is the only Indian on the editorial board of its journal – Innovations in Cardiac Surgery. He is also the council member of the Asian Association of Cardiothoracic Surgeons. He has been the Vice President of the Indian College of Cardiology. He is on the editorial board of the journal of Indian Association of Cardiothoracic Surgeons
(IACTS), journal of Cardiac Anaesthesia, CTSNET (a comprehensive global website of cardiac surgeons around the world). He is the founder and the web administrator of the iacts.orgia (a website of the Indian Association of Cardiothoracic Surgeons).

Professional qualifications
Dr. Jawali completed his MBBS from M R Medical College. Gulbarga, Karnataka, in 1974. He stood first in Karnataka University and also won the award for the ‘best all-round outgoing student’ for his participation in various extracurricular activities such as debating, writing, painting, and student leadership. He acquired his MS from JJMMC, Davangere, MCh in CVT Surgery from KEM Hospital and Seth GS Medical College, Mumbai.

Dr. Jawali has several papers, publications, and awards to his credit. He has 11 indexed publications and is the most experienced in the world on ‘awake’ open heart surgery. He has presented more than 200 scientific papers and conducted demonstrations of new techniques in heart surgery at various hospitals in India and abroad. Dr. Jawali has given lectures in many institutions and universities in USA and Europe, and has been featured in prominent media like Time.

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