India is a perfect destination for medical tourism that combines health treatment with visits to some of the most alluring and awe-inspiring places of the world. A growing number of tourists are flocking India because of the superlative medical care, equipments and facilities that India offers.

India excels in providing quality and yet cheap health care services to overseas tourists. The field has such lucrative potential that it can become a US $2.3 billion business by 2012, states a study by Confederation of Indian Industry (CII). In 2004, some 1,50,000 foreigners visited India for treatment, and the numbers have been rising by 15 per cent each year.

India is in the process of becoming the “Global Health Destination” owing to the following advantages:

• The cost of medical services in India is almost 10-25% of that in Western countries and one of the cheapest in South-east Asia / World .
• Language is a major comfort factor that invites so many foreign tourists to visit India for medical and health tourism. India has a large populace of good English speaking doctors, guides and medical staff. This makes it easier for overseas guests to relate well to Indian doctors.
• Indian hospitals excel in cardiology and cardiothoracic surgery, joint replacements, transplants, cosmetic treatments, dental care, Orthopaedic surgery and more.
• All medical treatments and investigations are done using the latest, technologically advanced diagnostic equipments.
• Indian doctors have got high expertise in performing successful cardiac surgeries, bone marrow transplants, liver transplants, orthopaedic surgeries and other medical treatments.

Areas of Medical Tourism

• Allopathy-Surgery-Mostly cardiac, vascular, spinal, cosmetic and joint replacement
• Ayurveda & Naturopathy

Heart Care in National Heart Institute, New Delhi, India

National Heart Institute offers world-class healthcare that costs substantially less than developed countries, using the same technology and delivered by competent Specialists attaining similar success rates. National Heart Institute uses some of the best know-how and technology and caters to the entire spectrum of cardio vascular disorders. In a nutshell, National Heart Institute epitomizes high technology with a humane touch reflected in the spirit of good health and happiness in our health care delivery.

A heart care surgery which costs upwards of US$ 30,000 in USA can cost as low as US$ 8,000 in India. This clearly states the price difference that exists in India when compared to the west.

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Coronary Artery Bypass Surgery

CABG surgery may be an open or closed heart operation in which arteries or veins are taken from another part of the body to channel needed blood flow to the coronary arteries. The arteries or veins used in the operation are expendable, removing them does not significantly affect the blood circulation of the part they are taken from.

Typically, the arteries used are from the inside of the chest along the side of the breast bone (Internal mammary artery), on the inner aspect of forearm (Radial artery) and along the stomach (Right Gastro-Epiploeic artery). The vein that is typically used comes from just beneath the skin on the inside of the leg & thigh (saphenous vein). Some times vein may be removed from the back of legs or arms.

During surgery one end of these arteries or veins are connected directly to the coronary arteries on a still heart. on the surface of the heart beyond the blockages and the opposite end is attached to the main artery of the body called “Aorta” This way blood can flow through them to bypass the narrowed or closed points.

Coronary artery bypass operations are performed either by using a heart lung machine or on beating heart. In the former technique this machine maintains the blood flow & circulation through the body. Then the grafts can be precisely connected to the tiny coronary arteries on a still heart. In the latter technique, heart beat is not stopped and the heart lung machine is not used. Instead an external stabilizer system is used to reduce the mobility of heart in the area we are operating. The technique to be used in your case will be decided by your surgeon. However as the latter technique is safer & better for the patient with earlier mobilisation & return to normalcy, we prefer to do all our surgeries on beating heart.

What will Coronary Artery Bypass Graft Surgery Accomplish?

The purpose of coronary artery graft surgery is to improve blood flow to the heart. Restoration of blood flow should eliminate chest pain (angina) that comes with exercise. It will also greatly increase the ability to exercise. Other benefits include amelioration of fatigue, reduced need for medications and restoration of a sense of well being. In persons with severe coronary artery disease and damaged hearts, even life span is prolonged. Incidence of life threatening heart attacks is reduced & further deterioration in the function of heart muscles is avoided.

Heart Valve Surgery

There are four valves in your heart, which act like one-way doors. They let blood in and out of the heart chambers each times it beats. Heart valve surgery replaces or repairs damaged or scarred heart valves. These valves can be damaged or scarred by birth defects, rheumatic fever or infection. The aortic and mitral valves are the ones most often damaged. When the heart valves do not open or close as they should, the heart has to pump harder to get blood to the body. This can weaken the heart and cause chest pain, shortness of breath, dizziness or other feelings. When medicines can’t correct these problems, heart valve surgery is needed. If the damage is relatively less and technically the valve is suitable for repair then every effort is made to repair rather than replace the valve. However, if the valve must be replaced, your doctor decides in consultation with you on the kind of valve you need. It will be either a mechanical or a tissue valve.

Mechanical Valves:Mechanical valves are made of special metal. Advantage of these valves is that they are durable and last life long if proper precautions are taken. Disadvantage is that blood thinning tablets have to be taken daily and the dose has to be monitored closely with periodical blood tests (PT & INR Test).

Tissue Valve: Tissue valves are made from either ‘Bovine’ (cow) heart membrane or ‘Porcine’ (pig) heart valves. Advantage of this valve is that blood-thinning drugs are not required to be taken. Disadvantage of this valve is that it may degenerate in 8 to 10 years and repeat surgery may then be required.

Aortic Surgery

The aorta is the main blood vessel that runs from the heart supplying blood to every organ in the body. Occasionally the aorta can become diseased by dilating or enlarging (aneurysm) or by splitting, separating into an inner and outer layer (dissection). Surgery is then undertaken to replace the segment of diseased aorta. The approach may be through the sternum or through an incision in the left chest (thoracotomy). The heart lung machine (cardiopulmonary bypass) is usually required for this type of surgery. Your surgeon will discuss this in greater detail with you. Preparation for and recovery is similar to that of coronary artery bypass or valve surgery.

Congenital or Birth Defects

As mentioned earlier, the heart has two parallel blood streams passing through its chambers. Impure blood travels through the right-sided chambers and goes into the lungs. Blood from here gets oxygenated (pure blood) and streams through the left sided chambers of the heart to be pumped into the body. Any birth defect, such as a hole in the heart, produces mixing of these two streams. When the left sided blood stream escapes and mixes with the right sided stream, it is called left to right shunt. When the right side stream finds its way into the left side stream, then it is called right to left shunt. In this right to left shunt, impure blood mixes with pure blood and is circulated in the body. The result is blue discoloration of the body and some time these children are called ‘blue babies’ these defects can be corrected by open-heart surgery using the heart-lung machine.

Beating Heart & Minimally Invasive Coronary Artery Bypass Surgery

Conventional coronary artery bypass surgery generally has excellent long term results. However to perform a conventional surgery one has to use the heart lung machine and it is therefore an open heart surgery. This leads to certain damaging effects on various organs of the body. These effects are usually temporary, self-limiting, and revert to normal within 3-5 days’ time in most patients. However there are some patients who have certain risk factors for use of the heart lung machine such as advanced kidney failure or long-standing lung problem or severe damage to the heart. In these patients, the use of heart lung machine may be detrimental. Therefore in those patients, where the blockages in the coronary arteries are amenable to beating heart surgery, we do not use the heart lung machine and perform bypass surgery on an unsupported and beating heart. This avoids the damaging effects of hurt lung machine. Currently nearly 99% patients in our hands qualify for beating heart surgery. Only your surgeon can decide whether you are suitable for beating heart surgery or not. This is a technical matter and the final decision is always taken on the operation table after the heart is exposed and detailed evaluation made.