Dr. Darius Soonwala a leading orthopedic surgeon from Mumbai explains the hip replacement procedure and what to expect after the surgery.
Dr. Rahul Gupta, Chief Interventional Cardiologist at Apollo Hospital, Mumbai, discusses the symptoms of a heart attack, the difference between acid burn and heart pain and the immediate steps to take in case of a heart attack.
Dr. Rahul Gupta, Chief Interventional Cardiologist at Apollo Hospital, Mumbai, talks about the different kinds of heart attacks, the available treatment options, and their success rates. He also sheds some light on how to live a healthy life to avoid any of these circumstances.
Dr.K.K. Sethi, the Chairman of Delhi Heart & Lung Institute and an initiator of Interventional Cardiology imparts his knowledge regarding Transcatheter Aortic Valve Replacement (TAVR) and distinctly points out the differences between tissue valves and metal valves.
Dr. KK Sethi, an expert in the field of cardiology explains the TAVR procedure, replacement surgery, what happens to the old valve once it is replaced with a TAVR procedure and some simple tips to lead a healthy life.
Dr. Bakul Arora, a specialist in joint replacement surgery, suggests implants for patients with metal allergy, recovery phase after a knee replacement surgery, and the difference between an original and replaced knee.
Dr. Bakul Arora, a specialist in joint replacement surgery, explains what a minimally invasive knee replacement surgery is, the difference between Indian and international knee implants and why patients should not avoid surgery.
Undergoing a stent implant is daunting for most people, but having information at hand can demystify the process and make the situation a tiny bit less scary. While most of your questions can and should be answered by your cardiologist, here are a few things you should know about before getting a stent.
What is a stent made of?
After all, in some situations like metal stents, it is likely to be a permanent part of your body going forward. To understand what stents are made of, let us quickly go over what stents are and what they do. As the cardiologist may have already informed you, our hearts are supplied blood by a network of arteries known as coronary arteries. With age and improper lifestyle, these arteries narrow and become filled with plaque deposits which can lead to Coronary Artery Disease, heart attacks, or even death. A coronary artery stent is simply a small, self-expanding, metallic mesh tube meant to be inserted inside the artery post a procedure referred to as balloon angioplasty. The stent keeps the artery wide open and the blood flow, continuous. Now as to their make, stents were traditionally made of a metallic or plastic mesh-like substance; however, stent-grafts are manufactured from fabric. These metallic stents are classically composed of medical-grade metal alloys including stainless steel, nitinol (nickel-titanium alloy), cobalt-chromium alloys (L605). However, these stents are fast falling out of favor. The most common type of stents in use these days, in fact, the ones that are the standard of care presently, are DES or Drug-Eluting Stents. These stents are not only made of polymers that dissolve in one’s blood after a few years but are also coated with drugs that reduce the risk of blockages.
Why is DES the standard of care?
The biggest advantage of DES is that they have thinner struts which can be as thin as < 100 μm, with some ultrathin struts reaching approximately 60 μm. This is vital as the thinner the strut, the lesser chance there is of restenosis or the recurrence of abnormal narrowing of an artery. Thinner struts have also been found to cause a lower inflammatory response which could potentially lead to clotting.
The other benefits of these stents are that they allow the artery to return to its natural shape and curvature, promote early healing, and allows for flexibility and normal dilation and constriction.
Advantages of stents
1) First and foremost, stents literally save lives by alleviating the damage that happened to one’s heart muscles during the heart attack. It does so by replenishing blood flow to one’s heart.
2) Immediately relieve/decrease symptoms of heart disease.
3) Reduce the risk of heart attack or stroke in the future.
4) Getting a stent placement may diminish the need to undergo a CABG (Coronary Artery Bypass Grafting).
5) Stenting is not only comparatively much less invasive versus CABG it also boasts of a much shorter recovery period.
Disadvantages of stents
1) One can get an allergic reaction from one’s stent
2) Angioplasty can result in hemorrhage of a blood vessel or even heart damage, or arrhythmia.
3) In rare cases, complications such as heart attack, stroke or renal failure can also occur.
4) Post-stenting scarring may occur that may require another procedure to remove it.
5) There is a risk of further blood clot formation; however, the cardiologist will already have you on blood thinners for prevention.
6) Stenting is not a cure for coronary artery disease. One needs to be vigilant about one’s diet and exercise while managing the contributing risk factors for coronary artery disease such as hypertension, higher body weight, diabetes, or high cholesterol.
So there you have it, a short primer on stents, how they are made and what you should be aware of while getting them implanted. Hope it has been of help!
Mr. Gonsalves was leading a normal and active life till arthritis crept up and set his life in turmoil. From being an active 60+ grandpa, he soon became confined to his bed and dependent on his walker. After years of physical therapy, medication and non-invasive procedures, the pain simply did not subside. Faced with debilitating pain that prevented the senior citizen from even getting a good night’s sleep, his family doctor and orthopedic surgeon recommended a Total Knee Replacement as the solution to the problem at hand. Six months post-surgery,
Mr. Gonsalves is now a changed man who has gained a new lease at life. Here is his side of the story.
What made you choose to undergo a Total Knee Replacement?
Unfortunately, all the initial efforts at managing my condition like physical therapy, medicine and more, failed and I was left battling the pain and restricted movement. As someone who previously led a very active life, picking up my grandchildren from the bus stop, going for a walk with my friends every morning, this condition started affecting me mentally and emotionally. Lastly, my family doctor and orthopedic surgeon recommended Total Knee Replacement as the solution to my condition.
Was it an easy decision to make?
To be honest, I was a little apprehensive about undergoing the surgery as would anyone who is in this situation. Fortunately, both my family doctor and orthopedic surgeon were very helpful when it came to assuaging my doubts and fears. They told me that this procedure is one of the most common orthopedic surgeries in the world with a vast majority of people experiencing significant improvement in pain and mobility after the procedure. The final decision to undergo the surgery was made cooperatively by me, my family, my family physician, and my orthopedic surgeon. Here I must add that my family physician first referred me to an orthopedic surgeon for a thorough evaluation to determine whether I might benefit from this surgery.
Would you recommend a knee replacement surgery to lakhs of people suffering from knee pain?
Only if your condition is unmanageable through non-invasive means like mine was, will they recommend the surgery. In fact, your orthopedic or family doctor won’t recommend you undergo one without due cause. In most cases, the patient’s family doctor will recommend the patient to an orthopedic surgeon who will evaluate if the patient is the right candidate for Total Knee Replacement. This was the process that I myself underwent before undergoing the surgery. From what I realized after having spoken at length with my orthopedic surgeon is that they only recommend surgery if:
- The patient has severe knee pain that restricts their movements. These include regular movements like walking, climbing stairs and sitting in and getting off chairs. The knee pain in such cases is usually so severe that one cannot walk too far without significant pain or the use of a cane or walker.
- The pain interferes with the patient’s resting or sleeping both during day and night.
- The inflammation and swelling are severe and do not improve with rest and medications.
- The knee starts showing signs of a deformity like bowing in and out.
- Lastly, when everything from anti-inflammatory medications, cortisone injections, lubricating injections, physical therapy, or other surgeries have failed.
How is your life post-surgery?
To say that it is incredible is an understatement! I feel as if I have got a new lease in life. The reduction in stiffness was almost immediate after the surgery. The pain took some time to go, but that was because of the surgery itself. Now I can confidently state that I am pain-free and happy! I was able to walk with the help of a walker almost 24 hours after surgery and was driving within 6 weeks. I am back to my old routine and my grandchildren are thrilled to have their grandpa back at school pick-up duty! Going for walks and socializing with my friends is also something I really enjoyed getting back to. All those years of pain and discomfort seem like a bad memory now. I am so glad to have undergone the surgery and would advise anyone in severe and unmanageable knee pain to undergo the surgery instead of waiting for their condition to worsen. I made my choice and I am truly thankful that it was the best one for me!
The heart is one of the most important organs in the human body. The function of the heart is to pump blood. The human heart has four chambers. Each chamber has its own valve to make sure blood flows in the right direction. The aortic valve is the last of the four valves that blood passes through before leaving the heart. The job of the aortic valve is to pump that oxygen-rich blood into the aorta, the largest blood vessel in your body.
The aortic valve has leaflets which open and closes during each heartbeat. In some heart diseases, the valve does not open or close properly disrupting the blood flow to the body. This may lead to the valve leaking and is called valvular regurgitation.
Another form of valve disease is valvular stenosis that commonly affects the aortic valve. This condition occurs due to calcium build-up on the leaflets leading to the stiffing of the valve. The severity of aortic stenosis increases with age and can be classified as mild, moderate, and severe. The stiffing of the valve prevents it from opening fully which reduces or blocks the blood flow from the heart to the rest of the body.
When the blood flow through the aortic valve is reduced or blocked, your heart needs to work harder to pump blood to your body. Eventually, this extra work limits the amount of blood it can pump, and this can cause symptoms as well as possibly weaken your heart muscle.
Calcium build-up in the valve, heart defects at birth and rheumatic fever are some of the causes of aortic stenosis.
Some people with aortic valve stenosis may not experience any symptoms for many years.
Signs and symptoms of aortic valve stenosis may include:
- ·Abnormal heart sound (heart murmur) heard through a stethoscope
- ·Chest pain (angina) or tightness with activity
- ·Feeling faint or dizzy or fainting with activity
- ·Shortness of breath, especially when you have been active
- ·Fatigue, especially during times of increased activity
- ·Heart palpitations — sensations of a rapid, fluttering heartbeat
- ·Not eating enough (mainly in children with aortic valve stenosis)
- ·Not gaining enough weight (mainly in children with aortic valve stenosis)
If you have the above symptoms, don’t worry. Visit your doctor today.