Medical Services

Cardiology

Coronary Angiography is the Gold Standard test to diagnose coronary  artery disease. It is safe, effective, less time consuming and highly reliable. The procedure involves using a special dye (contrast) and x-rays to see how blood flows through the arteries in your heart. The procedure most often lasts 30 to 60 minutes. The same procedure is used to determine blockages in other vessels like renal artery (Kidney).

Angiography 2

An angioplasty is a technique used to dilate a narrowed coronary artery with a balloon catheter. A small tube (catheter) is inserted in the groin which is then manoeuvred into the heart and coronary arteries. A balloon is then inserted through the catheter. The balloon is inflated inside a blood vessel to flatten any plaque that blocks it and cause it to become narrowed, decreasing the blood flow.

After the obstruction is relieved by the balloon dilation, most patients then immediately receive a stent. Stents are small, metal mesh cylinders that are delivered to the site of obstruction and expanded in the artery. Stents act as scaffolds to hold the artery open so it can heal with a normal diameter to allow blood to flow freely.

Elective angioplasty is performed on patients who are not experiencing a heart attack, but have blockages significant enough to require an interventional procedure. Primary (or emergency) angioplasty (PAMI) is performed on a patient who is in the throes of an acute myocardial infarction (heart attack).

Angioplasty

 Intravascular ultrasound (IVUS) enables healthcare providers to assess blood vessels from the inside. It uses sound waves to check for narrowing and blockages that can compromise blood flow. IVUS is a minimally invasive procedure involving tiny FFR (Fractional Flow Reserve) is a guide wire-based procedure that can accurately measure blood pressure and blood flow through a part of the coronary artery. FFR is done through a standard diagnostic catheter at the time of coronary angiography. The measurement of Fractional Flow Reserve is useful in assessing whether or not to perform angioplasty on certain blockages.

Optical coherence tomography (OCT) is a novel invasive imaging technique done along with coronary angiography that produces high resolution intracoronary images. Using infrared light, OCT allows detailed evaluation of coronary atherosclerotic plaques and fills up the gaps in conventional invasive coronary angiography.

Sometimes, when the plaque (buildup of fat, cholesterol in artery’s inner lining) is particularly hard, or so narrow that the balloon can’t pass through it during angioplasty, rotablation may be used. A special catheter (a thin tube) is inserted along the wire with a tiny drill at its tip. This drill is used to grind away the plaque to gradually widen the narrowing in the artery. Once this is done, a balloon can be inserted and the angioplasty proceeds as usual.

Ivus ffr oct guided rotablation for complex cases

In this procedure, a thin catheter is inserted through an artery in the groin or arm and threaded into the heart. When the tube reaches the narrowed heart valve, a balloon located on the tip of the catheter is inflated, causing widening of the valve.

Balloon valvuloplasty

 Transcatheter aortic valve replacement (TAVR) is a treatment for aortic valve stenosis. In this condition, also called aortic stenosis, the heart’s aortic valve thickens and becomes stiff and narrow. As a result, the valve can’t fully open and blood flow to the body is reduced. TAVR is an alternative to open-heart aortic valve replacement surgery. People who have TAVR often have a shorter hospital stay than those who have heart surgery to replace the aortic valve. Transcatheter aortic valve replacement also may be called transcatheter aortic valve implantation (TAVI) 

Tavi

Pacemaker can monitor and record the rate and rhythm of the heart. The main purpose of a pacemaker is to make sure the heart rate does not get too slow. It is implanted under the skin on the chest.

Arrhythmias, which are abnormal heart rates or rhythms, are caused by issues with the electrical system of the heart. ICD (Implantable cardioverter-defibrillator) is a device that can correct these life-threatening arrhythmias. It can perform cardioversion, defibrillation, and pacing of the heart. It is implanted under the skin on the chest.

A CRT-D is a special device for heart failure patients who are at high risk for sudden cardiac death. A CRT-D device can treat dangerously fast heart rhythms (arrhythmias) that can lead to sudden cardiac arrest. If the device senses heartbeats that are dangerously fast, it delivers a shock to the heart. This shock (defibrillation) stops the abnormal rhythm. Without this life-saving therapy, the dangerously rapid rhythm could lead to death in minutes.

CRT devices are fitted with a battery which will run out over time. Since the battery is permanently placed inside the device, it can’t be replaced when it’s down. So if the battery runs out, the entire device needs to be replaced. The battery life depends on the settings your doctor programs and how much therapy you receive.

Pacemaker

Electrophysiology studies are minimally invasive procedures used for diagnostic study which tests the electrical conduction system of the heart. It is recommended in people with heart rhythm problems (arrhythmias).

 

Electrophysiology study

Cardiac ablation uses heat or cold energy to create tiny scars in the heart to block irregular electrical signals and restore a typical heartbeat. The procedure is used to correct heart rhythm problems (arrhythmias).

Cardiac ablation is most often done using thin, flexible tubes called catheters inserted through the veins or arteries. Less commonly, ablation is performed during cardiac surgery.

Radiofrequency

Cardiothoracic Surgery

NMWIC is a pioneer in cardiac operation theatre set up which was established in 1990. Our cardiac setup includes two dedicated operating rooms with modern equipment which includes Laminar flow with HEPA filter, Drager – Fabius plus anaesthesia machine, Philips MP 70 anaesthesia invasive monitor along with two indigenous Heart-lung machines, two latest Datascope intra-aortic balloon pumps etc.

NMWIC has performed all types of cardiac surgeries including paediatric cardiac surgeries. Types of surgeries done at NMWIC –

Coronary artery bypass surgery, also known as heart bypass or bypass surgery is a surgical procedure to restore normal blood flow to an obstructed coronary artery. The procedure involves taking a healthy blood vessel from the thigh, arm or chest and connecting it beyond the blocked arteries in the heart, thereby creating a bypass for improved blood flow. It is a major open-heart surgery indicated in patients with more than one diseased coronary artery.

Coronary artery bypass surgery

 Diseased and narrowed heart valve which cannot be repaired/ replaced in cath lab can be repaired in an open-heart surgery. In this surgery, a large incision is made in the chest and the heart stopped for a time so that the surgeon can repair or replace the valve(s).

These are the surgeries performed on diseased blood vessels of the peripheries. Examples – Peripheral bypass, embolectomies, carotid endarteriotomies for prevention of strokes etc.

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Cardiac Diagnostic Services

ECG is a test that measures the electrical activity of the heart. With each beat, an electrical impulse (or wave) travels through the heart. This wave causes the muscle to squeeze and pump blood from the heart. In order to perform an ECG, electrodes are positioned on the chest, wrists and ankles and a recording is made. An ECG reflects what is happening in different areas of the heart and may pick up an abnormality or previous damage.

Ecg

An ECHO (echocardiogram), also known as a transthoracic echocardiogram (TTE), is an imaging technology that uses ultrasound waves to create images of your heart. It is a diagnostic test used to examine the heart and its blood supply, determine how large the heart is, how well it contracts, and how its valves function. In this, an ultrasound probe is placed on the patient’s chest (thorax) and high frequency sound waves are used to create images of the heart. Doppler technology is used to analyze the speed and direction of blood flow

A stress echo is a combination of an ultrasound and exercise test. Dobutamine is a medication administered to place your heart under a similar amount of strain as would be achieved with exercise and then ECHO is done. This information helps cardiologists in assessing the state of your heart muscle and the arteries feeding that muscle.

2d 3d echo

 In this test, sound waves are used to create pictures of heart muscle, chambers, valves as well as blood vessels. This test gives more details than a standard echocardiogram can give. In this test, the echo transducer is attached to a thin tube which is passed through the mouth, down the throat and into the esophagus.

Transesophageal echo

Stress test measures the heart’s ability to respond to external stress in a controlled clinical environment. The stress response is induced either by exercise (treadmill test) or by intravenous drug stimulation (Dobutamine). As your body works harder during the test, it requires more oxygen, so the heart must pump more blood. The test can show if the blood supply is reduced in the arteries that supply the heart (coronary arteries).

Stress test 2

This is the exercise stress test that usually involves walking on a treadmill while your heart rhythm, blood pressure and breathing are monitored through ECG. Throughout the test, the speed and incline of the treadmill increase. The results show how well your heart responds to the stress of different levels of exercise.

Tmt

Holter – A Holter monitor is a small, wearable, portable device that continuously records the heart’s electrical activity (ECG) continuously for 24 to 48 hours or longer. It can detect abnormalities in heart rhythm that an electrocardiogram cannot detect.

Holter monitor

Ambulatory blood pressure monitor is a portable blood pressure recording device. It is used to record blood pressure at specified times during a 24-hour period. A one-time blood pressure measurement is often not enough to confirm whether your blood pressure is too high or too low. If your doctor suspects that you have hypertension or other blood pressure problems, they may refer you for ambulatory blood pressure monitoring.

Ambulatory blood pressure monitor

Imaging Services

The radiology department  plays a crucial role in diagnosing and treating disorders accurately. It helps the surgeons and doctors to plan their surgery thoroughly. In addition, it helps diagnose the medical condition at an early stage. Our infrastructure consists of the latest equipment managed by qualified doctors and staff

This service helps create images of soft tissue areas like the liver, gallbladder, heart, kidney, liver, female reproductive organs, etc., through the ultrasound method. The process also helps patients detect any kind of blockages they are going through inside their blood vessels. It also helps the doctors find the reason for pain, swelling, or any infection in the body. 

Ultrasonography

We offer our patients the benefits of computed radiography by replacing the conventional X-ray with a digital one. It provides enormous advantages in the inspection.

X ray

Cardiac Rehabilitation And Physiotherapy

The physiotherapy department at NMWIC provides pre-op physiotherapy assessment and post- operative phase-1 rehabilitation for all patients undergoing heart surgeries. The importance of post-op cardiac rehabilitation lies in its well-structured program which helps to improve quality of life of the patient and reduce the hospital stay. The programs are designed by our physiotherapists who are experts in this field and are working with cardiac patients for many years.

The different kinds physiotherapy provided at NMWIC are:

 âœ§   Cardio-respiratory physiotherapy in ICU and wards

  ✧   Phase 1 cardiac rehabilitation post-surgery

  ✧   Patient education and home exercise program

  ✧   Pain management

Services offered:

✧   Ergonomics

✧   Pain management

✧   Low back pain, neck pain

✧   Knee and shoulder pain

✧   PFT

✧   IFT (Interferential therapy), Ultrasound treatment

✧   Manual Therapy

✧   Taping

We also offer home visits through prior appointments.

Cardiac Anaesthesia Services

The Department of Cardiac Anesthesia provides specialized anaesthesia services in the perioperative management of coronary artery bypass surgeries, heart valve repair and replacements, surgeries on the aorta, paediatric heart surgeries, repair of complex congenital heart diseases, thoracic surgeries  and  helps in handling interventions and emergencies in the cardiac coronary care unit

Cardiac Emergency Services

In a cardiac emergency, every second matters. NMWIC is here for you with rapid, expert care. Our trained intensivists and specialists are available round the clock  to quickly stabilize you and take care of your condition. We have the equipment  and skills to perform life saving procedures, using advanced  surgical and nonsurgical techniques.

We stay on the leading edge of cardiac care through continuous quality initiatives.

Cardiac Ambulance Services

NMWIC has a fully equipped cardiac ambulance with state of art facilities for ACLS (Advanced Cardiac Life Support) for patients requiring advanced cardiac care. Our ambulance is equipped with reliable, sophisticated high-tech cardiac equipment such as multichannel monitor defibrillator, ventilators etc. which makes it capable of providing treatment for all complex cardiac emergencies. Our ambulance service is available 24*7 with rapid response and manned by ACLS certified staff.

Laboratory Services

The pathology laboratory at NMWIC is fully equipped with advanced technology and state-of- the-art equipment including fully automated clinical chemistry analyzer, Hematology cell counter, Blood gas analyzer, Coagulometer, electrolyte analyzer, Quo-Test analyzer for HbA1c, fully automated Fluoro checker for Troponin –I, anti pro BNP, procalcitonin and D Dimer quantification. For adhering to highest quality standards, the lab has been participating in external quality assurance (EQAs) program in clinical chemistry since 2001 which is conducted by CMC Vellore.

The lab services include the following:

   âœ§   Clinical biochemistry

   âœ§   Haematology

   âœ§   Clinical Pathology

   âœ§   Microbiology

Our staff includes a team of expert pathologists, biochemists, microbiologists and lab technologists. The laboratory functions 24*7 including emergency services for in-patients as well as out- patients. We also provide home visit services round the clock in the Pune region.

Nutrition And Dietary Services

The Dietetics and Nutrition department of NMWIC makes sure all dietary needs of a hospitalized patient are taken care of. We have expert dietitians with many years of experience, especially in cardiac facilities, who know what it takes to help you recover and heal in terms of your caloric and protein intake requirements. Our department provides a complete range of food services for all hospitalized patients, from bed tea to dinner. Our dietitians are available from 8 am to 6 pm on all working days. They study your individual needs as per your build, specific clinical condition and design a diet chart for you. They also Supervise the food being served to you. Our dietitians are also available for counselling patients on OPD basis wherein they will educate you on the right food choices. Cardiac diet is an unofficial term for a heart friendly diet. This is the plan to eat plenty of nutrient rich foods, fruits and vegetables e.g. whole grains, fish etc. Cardiac diet also means avoiding saturated fats, trans-fats and excess sodium and sugar.

Nutrition and dietary services

Pharmacy Services

The hospital runs a 24 hour pharmacy shop on the ground floor next to the daycare. All medicines / consumables for patients are from the in-house pharmacy.

Dialysis Services

We provide haemodialysis services available on IPD and OPD basis. We have a pre-appointment schedule system available for everyone. Our 2-bedded Dialysis unit is armed with multichannel advanced monitor, ventilator and dialysis machines. We have well trained staff headed by qualified and experienced doctors.