Cardiology Care

CABG is open-heart surgery that reroutes blood around one or more blocked or narrowed coronary arteries using a healthy blood vessel taken from elsewhere in the body, most commonly the leg, chest wall or forearm.

It is recommended when coronary artery disease has narrowed the heart's blood vessels significantly, causing severe angina, multi-vessel blockage, left main artery disease, or when angioplasty/stenting is not a suitable option.

Under general anaesthesia, the surgeon accesses the heart (traditionally via a mid-sternal incision, or through smaller keyhole/robotic-assisted approaches at select centres) and grafts the harvested vessel above and below the blockage so blood can bypass the diseased segment. The procedure may be done on a heart-lung bypass machine (on-pump) or on a beating heart (off-pump), and typically takes 3-6 hours.

Most patients experience significant relief from angina and improved blood flow to the heart muscle, with graft patency rates remaining high for 10-15 years, especially when arterial grafts are used and risk factors are controlled.

This surgery repairs a patient's own valve or replaces it with a mechanical or biological (tissue) prosthetic valve to restore normal, one-directional blood flow through the heart.

Indicated for valve stenosis (narrowing) or regurgitation (leaking) caused by congenital defects, degenerative disease, rheumatic fever or infective endocarditis that is causing breathlessness, fatigue, or heart strain.

Performed under general anaesthesia with the patient on cardiopulmonary bypass. The surgeon either repairs the native valve leaflets or excises the diseased valve and sutures a mechanical or tissue valve in its place, most often through open chest surgery, though minimally invasive and catheter-based options exist for select patients.

Symptom relief is usually rapid, with restored valve function confirmed on echocardiogram; mechanical valves can last a lifetime but require lifelong blood thinners, while tissue valves avoid this but may need replacement after 10-20 years.

TAVI/TAVR delivers a new collapsible aortic valve to the heart via a catheter, usually inserted through the femoral artery, avoiding the need to open the chest.

It is offered mainly to patients with severe aortic stenosis who are at intermediate-to-high surgical risk due to age or comorbidities, making open valve replacement riskier.

Under local or general anaesthesia, a catheter carrying the compressed replacement valve is threaded from the femoral artery to the heart under live imaging guidance; the new valve is expanded inside the diseased native valve, pushing its leaflets aside and immediately taking over blood-flow function.

Most patients notice improved breathing and energy within days; studies show outcomes comparable to surgical valve replacement in appropriate candidates, with shorter procedure-related trauma.

A minimally invasive catheter procedure that widens a narrowed or blocked coronary artery using a balloon, followed by placement of a metal mesh stent to keep the vessel open.

Used for patients with significant single- or double-vessel coronary blockage causing angina or, urgently, during a heart attack to quickly restore blood flow.

A catheter is inserted through the wrist or groin artery and guided to the blocked coronary artery using X-ray imaging. A balloon at the catheter tip is inflated to compress the plaque, and a drug-eluting or bare-metal stent is deployed to hold the artery open, typically completed within 30-90 minutes under local anaesthesia and light sedation.

Blood flow is restored immediately, relieving chest pain in most patients; stents have high long-term patency, though a small percentage may need repeat intervention over time.

A pacemaker is a small implantable device that sends electrical impulses to prompt the heart to beat at a normal rate when its natural rhythm is too slow or irregular.

Recommended for bradycardia, heart block, or certain arrhythmias causing dizziness, fainting or fatigue that are not correctable by medication alone.

Under local anaesthesia with sedation, the surgeon makes a small incision below the collarbone, threads thin leads through a vein into the heart chambers, and connects them to a pulse generator implanted just under the skin; the whole procedure usually takes about an hour.

Heart rate and rhythm normalise almost immediately, resolving symptoms like fainting and fatigue; modern pacemaker batteries typically last 8-12 years before replacement.