Lourdes Heart institute

Lourdes Heart Institute and neuro center (LHINC)is a new block set up in Lourdes Hospital, Cochin, Kerala, India, to cater to tertiary level care for the entire spectrum of cardiovascular and neurological disease. It was inaugurated on the 16th of march, 2007 by Mr. A K Antony, the defence minister of India.This institute was started to meet a long felt need to provide state-of-the-art cardiac and neurological interventional facilities at a price to suit every facet of society, and especially to provide interventional neurological facilities for the precise and targeted treatment of strokes, including selective thrombolysis and primary angioplasty for stroke which was hitherto unavailable in this part of India

Facilities

Lourdes Heart institute has the first biplane digital flat panel cathetherisation laboratory ( Cath lab)in South Asia, which is especially suited for the rigorous demands of neurological and cardiological intervention work, including carotid stenting, intra cerebral vessel stenting, primary angioplasty, valvotomy, electrophysiologic procedures and pediatric cardiology.Biplane, flat panel cath labs are the most expensive and the cutting edge of cardiac imaging technology and are rarely come across even in first world nations, such as the United States [http://www.lufkindailynews.com/hp/content/business/stories/2007/12/23/hospital.html] . Biplane cath labs are more advanced, and involve technology to make a cath procedure faster, safer and more accurate [http://en.wikipedia.org/wiki/Coronary_catheterization] A new,centrally airconditioned building was built behind the main Lourdes hospital block, with outpatient departments and invasive cardiology on the ground level, the cath lab and ICCU suites on the first level and well appointed airconditioned rooms on the higher levels.

Treatments available

The LHINC Cath lab is capable of handling every type of interventional cardiology procedure, with the advantage of its biplane system, it has the unique capability of performing interventional procedures in lesser time with the advantage of using far lesser contrast than in a routine single plane cathlab, such a facility is rare, this being the first in South Asia, and even as late as December, 2007, there were only 8 such labs in the United States [http://www.lufkindailynews.com/hp/content/business/stories/2007/12/23/hospital.html. The improved technology translates to quicker, more efficient angioplasty procedures and a substantial decrease in the load of contrast the patient needs to be given for almost every procedure. This is of great benefit in patients with acute and chronic renal failure and may decrease the incidence of renal failure secondary to contrast nephropathy

Interventional Cardiology

LHINC has round the clock, 24/7 availability of primary angioplasty which is the standard state-of-the-art treatment for heart attacks and results in the best results and the lowest mortality and morbidity. Other facilities include regular, elective angioplasties, day care angiography, which is done via the artery in the wrist, the radial artery which allow the patient to be discharged in a few hours and does not require extended lying down, radial angioplasty;temporary and permanent pacemaker implantations;mitral valvuloplasty, which enables the opening of narrowed heart valves, without the need for open heart surgery, with a minimally invasive "pinhole" incision in the groin;Automated Implantable cardioverter-defibrillator or AICD implantation for the prevention of sudden cardiac death in individuals at high risk and non surgical closure of "holes in the heart".

The availability of the biplane catheterisation system results in quicker and more accurate performance of this wide variety of interventional procedures, with a higher degree of safety,especially in patients with renal failure

The interventional cardiac approach to tackling blocks in the heart involves a tiny incision in the groin or the wrist, threading a fine tube (catheter) to the heart and using a variety of small instruments, balloons,wires and stents to displace or remove the blocks in the arteries. This can obviate the need for open cardiac surgery, many times with comparable results. The "pin hole" aspect of such procedures ( as opposed to the more popularly known,but more invasive "keyhole surgery" ), results in far less pain, post operative recovery times and associated complications of surgery such as chest infections, clots in the legs deep vein thrombosis and results in an earlier return to home and productive life.

Interventional Neurology

LHINC is among the very few centres in India performing catheter guided intra arterial thrombolysis and primary angioplasty for patients suffering from strokes. Treatment of a stroke using agents to dissolve clots or by mechanical removal/modification of the blood vessels supplying the brain is the cutting edge treatment to limit the damage and residual morbidity and mortality associated with many strokes. Primary angioplasty and stenting for Carotid artery and Vertebral arteryand the basilar arteries can be performed to open up blocked arteries.

Catheter guided thrombolysis can be used to treat sudden blindness secondary to blocks in the central retinal artery ( central retinal artery occlusion )when used within 6 hours of the onset of symptoms. Mechanical removal of clots may be of use in patients presenting with post operative strokes or later than 6 hours.

Other interventional neurology procedures done at LHINC include carotid stenting which help in the opening of blocked major arteries in the neck which can result in dizziness, loss of consciousness,( syncope), stroke and other problems. These are done via a minimally invasive fashion, through a small puncture in the groin, avoiding the need for major surgery. LHINC neuro-intervention also provides treatment of aneurysms in the brain. Aneurysms can rupture and cause bleeding into and around the brain. Using endovascular coils, such aneurysms can be treated through "pin-hole" techniques obviating the need for major open brain surgery. Embolization procedures and coil occlusion procedures using Guglielmi Detachable Coil,are less invasive, painless and the patient can be mobile soon after the procedure.Embolization of cerebral arteriovenous malformation (AVMs) of the brain and spinal cord can be performed through catheter based techniques. Glue or Onyx are commonly used for embolization of these malformations. Embolization can be curative or palliative, prior to conventional or radiosurgery, when it is performed to reduce the size of the lesion.

Percutaneous vertebroplasty is a new technique that is used to treat compressive fractures of the vertebrae of the spinal column. These fractures can occur due to osteoporosis, malignancies or primary tumours of the spine. Through a small needle inserted in the affected vertebra, bone cement can injected to strengthen the bone, avoiding the need for costly and painful surgery. Pain relief can be almost immediate and spinal deformities can be corrected.

Cardiac Surgery

LHINC provides cardiac surgery in adult patients including coronary artery bypass surgery,both on pump and off pump surgery aortic arterial repair, valve replacement and aortic stent graft procedures

Neurosurgery

All routine neurosurgical procedures, acute and elective are done at LHINC on a regular basis

Faculty

General Cardiology,Interventional Cardiology and Cardiac Surgery

Dr. George Thayil MD, FAMA (Card), FCCP (Austrian specialty Board)

Dr. Balakrishnan N MD, DM (Trivandrum Medical College )

Dr. Thankachan Attacheril MD,DNB,DM ( Christian Medical College & Hospital, Vellore )

Dr. Mohan Komaranchath MD (JIPMER), DM (Sri Jayadeva Institute of Cardiology)

Dr. Praveen Menon MS,FRCS, Fellow in CT Surgery (Boston University )

Dr. Riaz Ashraf MD, PDCC

Dr. Rani George MBBS

Dr. Indira Manghat MBBS

Dr. Shoba MBBS

Dr. Raj MD

Neurology and Interventional Neurology

Dr. Boby Varkey Maramattom MD,DM (SCTIMST, Trivandrum), Fellow in Critical care Neurology (Mayo Clinic)Interventional Neurologist

Dr Celin George MBBS.

Neurosurgery

Dr Utham Kumar, MS, MCh.