Arterial Switch Operations Treatment in India

Healzone Medical Tourism: Guiding Your Journey to Top Hospitals and Doctors

Are you or your loved one facing the challenge of an Arterial Switch Operation (ASO)? When it comes to matters of the heart, you deserve the very best in medical care. Look no further than India for Medical Tourism, the best trusted destination for healthcare worldwide with various state of the art hospitals. In this comprehensive guide, we'll explore the intricacies of ASO, the top hospitals in India, and the best doctors for this life-changing procedure.

Understanding Arterial Switch Operation (ASO)

ASO, stands for Arterial Switch Operation, is a groundbreaking open-heart surgical procedure designed to correct a congenital heart defect known as dextro-transposition of the great arteries (d-TGA). This remarkable surgical innovation has transformed the lives of countless individuals from all around the world, offering them the promise of a healthier future.

Pioneers of ASO: William Mustard and Adib Jatene

The journey of ASO procedure began with the pioneering work of two exceptional cardiac surgeons: Canadian surgeon William Mustard and Brazilian surgeon Adib Jatene. It was Adib Jatene who successfully implemented this procedure, which had initially faced technological constraints, making it the last method of d-TGA repair to be widely adopted by the medical professionals.

The Evolution from Atrial Switch Procedures

Prior to ASO, two atrial switch methods, namely the Senning and Mustard procedures, were available to address d-TGA. However, these procedures had few limitations. ASO emerged as an anatomically and physiologically appropriate solution to overcome these shortcomings, setting new standards in the field of cardiac surgery.

The Significance of Timing

Timing is of the essence when it comes to ASO procedure. The procedure is ideally performed during the second week of life. This specific timeframe ensures that the left ventricle can be able to adapt lower pulmonary pressure, enabling it to support the systemic circulation effectively. In cases of sepsis or delayed diagnosis, alternative methods like pulmonary artery banding (PAB) and shunt construction may be employed to increase the left ventricular mass, making an arterial switch possible at a later stage of infancy.

Prognosis and Success Rates

The success of an ASO procedure completely depends on several critical factors, including the availability of state-of-the-art facilities, the skill and experience of the surgical team, and the overall health of the particular patient. Under favourable conditions, the intra-operative and post-operative success rate surpasses 90% approximately. Similarly, the survival rate after five years remains promising. However, it's worth noting that approximately 10% of ASO recipients may develop residual pulmonary stenosis post-operatively, which, if not treated, can lead to right heart failure. Treatment typically involves endovascular stenting and/or xenograft patching.

A Closer Look at ASO: The Surgical Procedure

The ASO procedure is the meticulously choreographed dance of precision and expertise. Here's an overview of the steps involved:

General Anesthesia and Cardiopulmonary Bypass: The journey begins with general anesthesia and the initiation of cardiopulmonary bypass.

Repositioning the Arteries: The aorta and pulmonary artery are detached from their native roots and reattached to the opposite root, essentially swapping roles.

Coronary Artery Transplant: The coronary arteries are transplanted from their original positions to new homes within the heart.

Surgical Duration: The entire procedure, from the initiation of anaesthesia to its conclusion, typically spans around 6 to 8 hours.

The Importance of Preparation

Prior to the ASO procedure, meticulous preparations are essential:

Blood Donation: If the procedure is anticipated well in advance and the patient's blood type is known, family members with compatible blood types may donate blood for transfusion during the use of a heart-lung machine (HLM). In certain cases, maternal or autologous blood donation may be possible. However, most patients receive donated blood from a blood bank.

Imaging Procedures: Various imaging techniques, including angiography, magnetic resonance imaging (MRI), and computed tomography (CT) scans, are utilized to map out the individual anatomy of the great arteries and, most crucially, the coronary arteries. This step is vital in preventing unexpected intra-operative complications during the transplantation process.

Pre-Operative Preparations: As with any procedure requiring general aesthesia, arterial switch recipients must fast for several hours beforehand to reduce the risk of aspiration during anaesthesia induction. During this stage, the patient may receive a range of drugs, including inhalational aesthetics, muscle relaxants, opioid analgesics, antifibrinolytics to prevent excessive bleeding, methylprednisolone to reduce swelling and inflammation, and prophylactic antibiotics to prevent infection.

The Precision of Intra-Operative Care

The actual ASO procedure is an intricate and meticulous process:

Accessing the Heart: The heart is accessed via median sternotomy, and heparin is administered to prevent blood clotting. A section of pericardium is harvested and prepared for use.

Cardiopulmonary Bypass: The procedure involves the use of a heart-lung machine (HLM). Cannulas are inserted into the ascending aorta, right atrium, and right superior pulmonary vein. The patient's body is cooled to a rectal temperature of 20°C (68°F) to prevent brain damage during temporary circulatory arrest.

Separation and Marking: During the cooling phase, several crucial steps take place, including the ligation and transection of the ductus arteriosus, separation of the left pulmonary branch, and marking of the aorta's transection site.

Arterial Switch: The great arteries are carefully maneuvered and arranged, typically employing the LeCompte maneuver. Coronary arteries are examined closely, their ostia excised, and they are then transplanted onto their new locations.

The Final Stages: Post-Operative Care

After the ASO procedure, post-operative care is critical:

Chest Tubes and Ventilation: The patient is fitted with chest tubes, temporary pacemaker leads, and ventilation support.

Inotropic Support: Inotropic drugs are administered to assist the heart in contracting adequately.

Managing Chest Wounds: While the external surgical wound is bandaged, the sternum and chest incision are left open to provide room for the heart to swell and prevent pressure caused by pleural effusion.

Post-Operative Recovery

Post-surgery, the sternum and chest can typically be closed within a few days. However, certain support measures such as chest tubes, pacemakers, ventilators, and medications may still be required. Gradual reintroduction of nutrition, typically via nasogastric tube (NG tube), is initiated after a few days. The primary goal is for the infant to regain lost weight and continue to gain weight at a normal or near-normal rate.

Why Choose Healzone Medical Tourism?

At Healzone, we understand the emotional and physical challenges that come with seeking medical care abroad. Our mission is to make your medical journey as seamless and stress-free as possible. When you choose Healzone, you're not just selecting a medical tourism agency; you're choosing a partner who cares about your well-being.

India's Top Hospitals for Arterial Switch Operations

India has emerged as a global hub for advanced medical treatments, and ASO is no exception. Here are some of the top hospitals in India renowned for their excellence in performing Arterial Switch Operations:

Fortis Escorts Heart Institute, New Delhi

Established in: 1988, Number of Beds: 285, Multi-Specialty Cardiology Hospital

Welcome to Fortis Escorts Heart Institute, New Delhi - a beacon of hope for heart health. Since 1988, this hospital has been passionately saving lives and leading the way in cardiac care. Over 70,000 patients treated in the last 22 years. It is voted as India's Best Cardiology Hospital by the Consumer Department

At Fortis Escorts Heart Institute, Healzone partners in heart wellness for our beloved clients. Join us on your journey to a healthier heart.

Indraprastha Apollo Hospital, New Delhi

Established in: 1996, Number of Beds: 1000, Top-Ranked Cardiology Hospital

Welcome to Indraprastha Apollo Hospital, New Delhi - where hearts find a home for healthier future with the association of Healzone Medical Tourism. Its legacy spans 152,000 cardiac surgeries, setting new standards in cardiac care.

Here 100 advanced and basic cardiac procedures are conducted daily. It pioneers 95% beating heart surgeries for faster recovery and leading the way in Coronary Artery Stenting and LASER angioplasty since 2002

This hospital is renowned for complex cases like Coronary artery bypass surgery, Neonatal heart surgery, and Valvular heart disease.

BLK Super Speciality Hospital, New Delhi

Established in: 1959, Number of Beds: 650, The Epitome of Cardiac Excellence

Welcome to BLK Super Speciality Hospital, New Delhi - where hearts beat stronger. Our internationally acclaimed cardiology team leads in total arterial grafting, minimally invasive cardiac surgery, and coronary bypass surgery.

Performing over 20,000 Interventional procedures, including endovascular and congenital heart procedures

Conducting 4000+ total arterial grafting and 400+ minimally invasive cardiac surgeries

Experience the heartbeat of superior cardiac care at BLK Super Speciality Hospital. Your heart deserves nothing but the best care.

Behind every successful ASO procedure is a skilled and experienced surgical team. India boasts a pool of talented cardiac surgeons who specialize in ASO. Here are a few of the best doctors in India known for their expertise in this field:

Meet India's Premier Cardiac Surgeons

Dr. Y K Mishra, Cardiac Surgeon, New Delhi, India

Dr. Mishra is director with 32 years of glorious experience that have brought hope for thousands of lives.

Dr. Y K Mishra is a renowned expert and has done over 14,000 successful open-heart surgeries along with more than 500 robotic surgeries.

He is a global lecturer, dedicated to training, education, and research in the field of Cardiology.

Dr. Ajay Kaul, Cardiac Surgeon, New Delhi, India, Chairman with 36 years of experience. He will be the best healthcare companion in your medical well-being journey.

Dr. Ajay Kaul is a recognized Cardiothoracic Surgeon with over 10,000 Cardiac Surgeries under his belt. Dr. Kaul is a maestro in 4000 Total Arterial Coronary Bypass Surgeries and Arterial Switch Operation. He has been leading the charge in minimally invasive cardiac surgery in BLK Hospital.

Dr. Z S Meharwal, Cardiac Surgeon, New Delhi, India

Dr. Meharwal is director with 27 years of experience and precise skills. He is a leading Cardiac Surgeon and a founding pillar of Fortis Escorts Heart Institute. Dr. Meharwal has done over 20,000 successful various cardiac surgeries with at most success rate that include Arterial Switch Operation.

He has built a legacy on excellence in cardiac care with his years of dedicated excellent services. Entrust your heart's health to these distinguished cardiac surgeons. Your well-being is their lifelong commitment towards the health care and humanity.

Your Journey to a Healthier Heart Begins with us

At Healzone Medical Tourism, we're committed to guiding you on your path to better health. We provide comprehensive assistance, from hospital selection to post-operative care, ensuring your ASO journey in India is not just successful but also comfortable and hassle-free.

Your health is paramount for us. Choose us, and embark on a journey to a brighter, healthier future. Contact us today to start your captivating healing voyage. Your heart deserves nothing but the best!

In conclusion, Healzone Medical Tourism is your trusted partner in your pursuit of the best medical care in India. Whether you're seeking an Arterial Switch Operation or any other medical procedure, we're here to make your journey smooth, safe, and successful. Your health is our priority, and your heart deserves the very best.

Faqs

What is an Arterial Switch Operation (ASO)?

ASO is a groundbreaking open-heart surgical procedure to correct a congenital heart defect known as dextro-transposition of the great arteries (d-TGA).

Who pioneered the ASO procedure?

Canadian surgeon William Mustard and Brazilian surgeon Adib Jatene played pivotal roles in pioneering the ASO procedure.

How does ASO differ from previous atrial switch procedures?

ASO emerged as a more anatomically and physiologically suitable solution compared to the Senning and Mustard procedures.

When is the ideal time for an ASO procedure?

ASO is ideally performed during the second week of life to ensure the left ventricle can effectively support the systemic circulation.

What are the success rates of ASO?

Success rates depend on several factors, but under favourable conditions, both intra-operative and post-operative success rates can surpass 90%. However, approximately 10% of recipients may develop residual pulmonary stenosis, which may require further treatment.