New Delhi [India]: With increasing lifestyle problems, Cardiovascular Diseases (CVDs) have emerged as a leading cause of mortality worldwide, followed by cancer.
Studies have estimated that Cardiovascular Diseases will account for one third of all deaths in India by 2020, said Dr Kewal Krishan, Program In-charge – Heart Transplant and Ventricular Assist Devices Sr. Consultant – CTVS, Max Super Speciality Hospital, Saket.
# Who is at a higher risk?
A recent Delhi and NCR survey showed that most patients suffering from heart diseases fall in the age group of 25 to 45. Around 38 percent of men in this age group have alarmingly high cholesterol level, which is one of the key risk factors for heart disease. Also, most respondents in Delhi NCR were aware of the repercussions of obesity on their heart, yet the situation has continued to become graver. Surprisingly, cardiac arrest and heart attacks in people as young as 18-19 years of age are being reported.
Heart failure, which is the ‘end-stage’ of most of the heart diseases, has emerged as a major health problem in India. The incidence of heart failure and heart rhythm problems is a rising trend in India yet there is a large population still unaware of the symptoms, precautions and first-aid that should be provided to heart failure patients. The best way to treat such patients is through medical management, assisted devices and finally, a heart transplant.
# What is a Heart failure program?
Heart failure is a condition in which the heart is unable to pump enough blood to meet the body’s needs. In some cases, the heart can’t pump enough blood. In others, the heart is unable to pump blood with enough force to the rest of the body. In certain cases, both problems exist. It is a serious condition that requires medical care. Heart failure develops over a period of time as the heart’s pumping action grows weaker. The condition can affect the right side of the heart only, or both sides as well.
A Heart failure program is for patients who are suffering from heart failure and are in need of a heart transplant and a ventricular-assist device. Mostly, the term ‘heart failure’ is misunderstood as a condition where your heart has stopped or is about to stop working. According to an estimate, the incidence of heart failure in India is about 10 to 20/ 1000 people over the age of 65 years. The growing incidence is a result of multiple factors including increasing prevalence of coronary heart disease, hypertension, obesity, diabetes and rheumatic heart disease.
# Heart failure program
Addressing the burden of increasing mortalities due to CVDs and heart failure, a tertiary speciality hospital like Max Super Speciality Hospital, Saket has developed a ‘Comprehensive Heart Failure Programme. A programme of this nature, must assure complete cardiac services, LVAD, ECMO and Heart Transplant. . If medical therapy is deemed failing or for patients, who have already undergone cardiac procedure and are still symptomatic, cardiac replacement therapies like heart transplant or ventricular assist device are proposed.
Unfortunately, thousands of patients lose their life to lack of heart donors every year. For them, LVAD (Left Ventricular Assist Device) is the only alternative that offers a ray of hope. LVAD is placed in one of the chambers of the heart in the patient’s chest and helps the heart pump oxygen-rich blood throughout the body. In the case of end-stage heart failure, when a person’s heart is too weak to effectively pump on its own or has to undergo an open-heart surgery and can’t wait for a donor; LVAD comes as a ray of hope to pull the patient from the jaws of death. But LVAD is an advanced procedure that needs special training and the patient needs to be carefully monitored afterwards. . High-end technology like CentriMag has helped save lives in cases of acute heart failure. India’s first HeartMate 3 procedure which is the most advanced LVAD pump so far was also done at the hospital.
When patients reach a stage when either the lungs and/or heart are damaged to a life-threatening state, Extracorporeal Membrane Oxygenation (ECMO) is used to rescue them. It is used as a highly advanced cardiovascular support system in the intensive care units (ICU) in potentially irreversible cases. With severe heart failure, it is recommended to use this device to provide oxygen to the body.
When blood is removed from the body, it passes through a special membrane in the ECMO machine that removes carbon dioxide and adds oxygen to the blood. The newly oxygenated blood is then returned to the body. The ECMO machine takes over the work of the heart. This treatment is used to allow the heart to recover.
# Ventricular Assist Device
Heart transplant is the gold standard treatment for end-stage heart failure. Our hospital’s cardiac surgery program has brought unprecedented access to advanced cardiac services to the region and has received exemplary reviews and outstanding patient satisfaction since its inception. We have an Advanced Heart Failure Clinic for identifying patients who require LVAD or heart transplant to increase their survival and relieve symptoms. (ANI)