SERVICES - Dr Jehron Pillay Inc.

SERVICES

Cardiac Surgery

Cardiac surgery, or cardiovascular surgery, is surgery on the heart or great vessels performed by cardiac surgeons.

CORONARY ARTERY DISEASE (CAD) (Ischemic heart disease)

Coronary artery disease (CAD), also known as coronary heart disease (CHD), ischemic heart disease (IHD), or simply heart disease, involves the reduction of blood flow to the heart muscle due to build-up of plaque (atherosclerosis) in the arteries of the heart. It is the most common of the cardiovascular diseases. Types include stable angina, unstable angina, myocardial infarction, and sudden cardiac death. A common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw. Occasionally it may feel like heartburn. Usually symptoms occur with exercise or emotional stress, last less than a few minutes, and improve with rest. Shortness of breath may also occur and sometimes no symptoms are present. In many cases, the first sign is a heart attack. Other complications include heart failure or an abnormal heartbeat.

Risk factors include high blood pressure, smoking, diabetes, lack of exercise, obesity, high blood cholesterol, poor diet, depression, and excessive alcohol. A number of tests may help with diagnoses including: electrocardiogram, cardiac stress testing, coronary computed tomographic angiography, and coronary angiogram, among others.

CORONARY ARTERY DISEASE (CABG)

Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG, pronounced "cabbage") surgery, and colloquially heart bypass or bypass surgery, is a surgical procedure to restore normal blood flow to an obstructed coronary artery. A normal coronary artery transports blood to the heart muscle itself, not through the main circulatory system.

There are two main approaches. In one, the left internal thoracic artery, LITA (also called left internal mammary artery, LIMA) is diverted to the left anterior descending branch of the left coronary artery. In this method, the artery is "pedicled" which means it is not detached from the origin. In the other, a great saphenous vein is removed from a leg; one end is attached to the aorta or one of its major branches, and the other end is attached to the obstructed artery immediately after the obstruction to restore blood flow.

HYBRID CABG PROCEDURE

Hybrid coronary revascularization (HCR) or hybrid coronary bypass is a relatively new type of heart surgery that provides an alternative to traditional coronary artery bypass surgery (CABG) or percutaneous coronary intervention (PCI or PTCA) by combining the two into one operation. It is this combining aspect that "hybrid" refers to. HCR is one of several types of hybrid cardiac surgery; it is not to be confused with a MIDCAB (minimally invasive direct coronary artery bypass) procedure, which uses the smaller thoracotomy incision but does not involve coronary stenting

ARTERIAL REVASCULARIZATION

Transcarotid Artery Revascularization (TCAR) is a clinically proven, minimally invasive procedure to treat carotid artery disease and help prevent future strokes. TCAR is unique in that blood flow is temporarily reversed during the procedure so that any bits of plaque that may break off are diverted away from the brain.

HEART VALVE SURGERY

Heart valve surgery is a procedure to treat heart valve disease. Heart valve disease involves at least one of the four heart valves not working properly. Heart valves keep blood flowing in the correct direction through your heart.

The four valves are the mitral valve, tricuspid valve, pulmonary valve and aortic valve. Each valve has flaps — called leaflets for the mitral and tricuspid valves and cusps for the aortic and pulmonary valves. These flaps open and close once during each heartbeat. Valves that don't open or close properly disrupt blood flow through your heart to your body.

In heart valve surgery, your surgeon repairs or replaces the affected heart valves. Many surgical approaches can be used to repair or replace heart valves, including open-heart surgery or minimally invasive heart surgery.

Your treatment depends on several factors, including your age, your health, the condition of the affected heart valve and the severity of your condition.

ATRIAL FIBRILLATION PROCEDURE

Atrial fibrillation (AFib) is a type of heart disorder that can cause an abnormally high heart rate. The best type of treatment that is recommended for a patient is based on their symptoms. Treatment options of AFib include lifestyle changes, medications, and procedures such as cardioversion or ablation.

AORTA SURGERY

Open aortic surgery (OAS), also known as open aortic repair (OAR), describes a technique whereby an abdominal or retroperitoneal surgical incision is used to visualize and control the aorta for purposes of treatment. OAS is used to treat aneurysms of the abdominal and thoracic aorta, aortic dissection, acute aortic syndrome, and aortic ruptures. Aortobifemoral bypass is also used to treat atherosclerotic disease of the abdominal aorta below the level of the renal arteries. In 2003, OAS was surpassed by endovascular aneurysm repair (EVAR) as the most common technique for repairing abdominal aortic aneurysms in the United States.^[1] In OAS for abdominal aortic aneurysm, the aneurysmal portion of the aorta is replaced with a graft, usually made of dacron or PTFE.

OAS is distinct from aortic valve repair and aortic valve replacement, as OAS describes surgery of the aorta, rather than of the heart valves. When the aortic valve is diseased in addition to the ascending aorta, the Bentall procedure is used to treat the entire aortic root. An axillary-bifemoral bypass is another type of vascular bypass used to treat aortic pathology, however it is not true open aortic surgery as it reconstructs the flow of blood to the legs from the arm, rather than in the native location of the aorta.

HEART FAILURE SURGERY

CABG or valve replacements may be the procedure of choice in patients with poor heart failure. A multi-disciplinary approach is used to evaluate these patients with cardiology colleagues to ensure that the correct option is given to the patient.Therapeutic option will depend on the underlying cause for the cardiac failure and may include biventricular pains, CABG/valve procedures, temporary assist devices of referral to a cardiac transplant centre.

Thoracic Surgery

Thoracic surgery is the repair of organs located in the thorax, or chest

CHEST WALL SURGERY

Chest Wall Reconstruction Techniques. A median sternotomy is a surgical procedure in which a vertical incision is made along the sternum (also known as the breastbone), after which the sternum is divided or cracked. This procedure provides access to the heart and lungs for surgical procedures.

PLEURAL SURGERY

Surgery for pleural mesothelioma. Pleural mesothelioma starts in the layers of tissue that cover the lung (the pleura). Some people can have surgery to try to remove the mesothelioma. It can't usually get rid of the mesothelioma for good. The aim is to try and keep the disease under control and help you to stay well for as long as possible.

TRACHEAL- AND BRONCHIAL SURGERY

Tracheal and Bronchial Stenosis Treatments. Traditional tracheal resection surgery: The narrowed area of your trachea is removed and the other sections are joined together. Laser resection: Using a laser, the surgeon removes scar tissue that is causing the stenosis.

LUNG CANCER TREATMENT

Treatment for lung cancer is managed by a team of specialists from different departments who work together to provide the best possible treatment. This team includes the health professionals required to make a diagnosis, to stage your cancer and to plan the best treatment.

ECMO

Extracorporeal membrane oxygenation (ECMO), also known as extracorporeal life support (ECLS), is an extracorporeal technique of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life.

SURGERY FOR ESOPHAGEAL CANCER

Surgery for Esophageal Cancer For some earlier stage cancers, surgery can be used to try to remove the cancer and some of the normal surrounding tissue. In some cases, it might be combined with other treatments, such as chemotherapy and/or radiation therapy.

SURGERY FOR FAILED GASTRIC REFLUX PROCEDURES

In patients, where previous endoscopic reflux procedures were performed and now re- presents with ongoing heartburn or a diaphragmatic hernia, repeat surgery is offered to reduce the hernia and/or repair the reflux problem. This is complex procedures and is done in conjunction with general surgeons.

Minimally Invasive Surgery

Multiple less invasive cardiac and thoracic surgical procedures are now performed with keyhole incisions. Aortic and mitral valve procedures are performed with small incisions if the patient are suited for such a procedure.

TAVI PROCEDURE

Transcatheter aortic valve implantation (TAVI) allows the aortic valve to be replaced without the need for open-heart surgery, and is therefore a good option for patients in whom the risks of open-heart surgery are unacceptably high.

ECMO

VATS LOBECTOMY

VATS lobectomy - Traditional approach to lung cancer surgery: thoracotomy Anatomic lung resection, i.e. pulmonary lobectomy or pneumonectomy, in conjunction with removal of the lymph nodes from the mediastinum is the treatment modality that provides the greatest chance of long-term survival in patients with early stage non-small cell lung cancer.

PECTUS REPAIR

Pectus excavatum repair is always performed with the patient under general anesthesia. An epidural catheter is inserted for the management of pain after the operation. The surgeon makes two incisions over the sternum, on either side of the chest, for insertion of a curved steel bar or strut under the sternum. He or she proceeds to remove the deformed cartilages. The rib lining is left in place to allow renewed cartilage growth. The sternum is then repositioned, and the metal strut is placed behind it and brought out through the muscles and skin for future attachment to a brace, which will stay in place six to 12 weeks. The metal strut is fixed to the ribs on either side, and the incisions are closed and dressed. A small steel grooved plate may be used at the end of the bar to help stabilize and fix the bar to the rib. A blood transfusion is not required during surgery. The surgeon may insert a temporary chest tube to re-expand the lung if the lining of the lung is entered. A variety of surgical procedures are available to repair pectus excavatum.