Cardiology services include non-invasive investigations (including imaging modalities) and invasive studies and interventions.
Invasive Cardiology and Interventions
Our main invasive investigations and treatment are centred on the treatment of coronary artery disease. We perform a high volume of coronary angiograms and coronary interventions (angioplasty and stenting) annually. These procedures may be accessed from either the groin (femoral route) or from the wrist (radial route). We have maintained our competencies and often times our procedures are at the edge of technology.
We have a strong Electrophysiology (EP) Unit for treating patients with abnormal heart rhythms (arrhythmias). We routinely implant permanent pacemakers for bradyarrhythmias (mostly dual chamber), cardiac resynchronisation therapy for patients with heart failure and radiofrequency ablation for tachyarrhythmias as well as atrial fibrillation
We also perform peripheral interventions of renal, lower and upper limb and carotid arteries by angioplasty and stenting. In addition to this we also offer endovascular repair for abdominal and thoracic aneurysms.
We have also embarked on new technologies such as the prevention of stroke using a left atrial appendage occluder device, renal denervation for resistant hypertension, transcatheter aortic valve replacement (TAVI) for the treatment of aortic stenosis as well as the mitral clip device in the treatment of severe mitral regurgitation in patients who are at high risk for conventional surgery.
Non Invasive Cardiology Procedures & Imaging
We have modern equipment for imaging and these include echocardiography, multislice CT imaging, nuclear imaging and cardiac MRI. Well trained and experienced staff are involved in performing these procedures. We have highly specialised echocardiography services which include standard 2D echocardiography (with M-mode, colour flow imaging and Doppler), pulse-wave and color tissue Doppler imaging (TDI), 3D echocardiography, 2D-strain echocardiography (speckle tracking), 2D and 3D transesophageal echocardiography, dobutamine stress and treadmill stress echocardiography and intra-operative transesophageal echocardiography.
General anaesthesia is given to a patient during surgery to alleviate the patient from pains they may feel. An Anaethesiologist will explain the entire procedure prior to the surgery. When a patient is about to undergo general or specialized surgical procedures he/she will first be given medication via and intravenous catheter, they will then be told to breath in a special gas. Once this occurs, the patient will go into a deep sleep.
The anaesthesiologist will be responsible for the patient during the surgery in the terms of making sure that the patient does not awaken or experience any pain. Special instruments are used to monitor the patient during the operative period and while the patient is receiving anaesthesia. Once the patient is asleep, if general surgery is going to be performed, the anaesthesiologist will most likely put a special tube into the patient’s trachea (endotracheal tube) to maintain an adequate oxygen flow. Oxygen will be given throughout the surgical procedure to maintain a certain acceptable oxygen level.
As the operation is ending the surgeon will advise the anaesthesiologist, who will then begin to decrease the anaesthesia to allow the patient to regain consciousness. This will be done slowly to coincide with the operative procedure. When the surgery has been completed the patient will be taken to the Recovery Room. The endotracheal tube will be left in place until the patient begins to fully awaken. Once it has been determined that the patient is able to breath on their own the endotracheal tube will be removed. The patient will be kept on oxygen to maintain a proper level of oxygenation during the rest of the Recovery Room stay.
The patient may feel some discomfort in their throat following general anaesthesia. This should be minor and will go away in a few days. Throat lozenges might be given to the patient to help with the throat pain.
Apart from imaging, we also provide other important services such as electrocardiograms (ECG), treadmill stress testing, heart rhythm monitoring systems (24-hour Holter, ‘King of Hearts’ and rhythm cards).
Paediatric Cardiology Overview
One of the most difficult things that could happen to a parent is to be told that your child might have some type of a cardiac problem. The suspected cardiac problem might require the doctor to perform different tests to reach a suspected diagnosis. Some cardiology tests are invasive meaning the child will have to be sedated and have an intravenous line. The child might need a cardiac catheterization which will allow the doctor to look closely at the arteries and chambers of the heart. Or, perhaps a non-invasive study similar to an echocardiogram might be necessary. In this case the child will most likely be awake and conversing, the parents can often be in the room with the child during this test.
No matter which test is required it is still going to be very stressful for you, the parent/parents. Thinking about your child being ill, and then to require tests that might not be familiar with, or to you sound very difficult, will, in most cases cause you to become concerned and anxious.The Cardiology Department has specially trained individuals who can not only comfort you, but also to discuss your concerns giving you an explanation that you can understand more easily.
Although there is nothing that is going to fully comfort you during this time these trained counselors will be there for you and your child. You may be assigned a special counselor based on the required testing, or a generalized counselor might meet your needs. Whatever the case someone will be there for your and your family.Prior to meeting with your counselor it is a good idea to have your questions either written down or mentally organized so the counselor can give you the most logical, accurate information.
The department of cardiothoracic surgery is staffed by one of the region’s most experienced team of heart surgeons. The department has performed a total of 59,674 surgeries over a period of 22 years and in 2014 alone, it has performed 2,954 open heart surgeries and 1136 closed heart surgeries.
There are eight dedicated operating theatres (OT), 1 hybrid operating theatre, 48 adult Intensive care unit (ICU) beds and 10 paediatric intensive care unit (PICU) beds.
The dedicated team of Cardiothoracic Surgeons perform the whole range of adult and paediatric heart surgeries including:
- Adult Cardiac Surgery
- Coronary artery bypass grafting (on-pump, beating heart, minimally invasive)
- Heart valve repair and replacement
- Minimally invasive cardiac surgery (MICS)
- Sutureless aortic valve replacement
- Transcatheter aortic valve implantation (TAVI)
- Congenital Heart Surgery
- Pediatric – simple and complex congenital heart surgery
- Adult – adult congenital heart disease
- Thoracic Surgery
- Surgery for lung diseases
- Surgery for mediastinal diseases
- Minimally invasive thoracic surgery
- Vascular Surgery
- Surgery of the aorta – aneurysm, dissection
- Thoracic endovascular aortic repair (TEVAR)
- Surgery for heart failure
- Heart/Lung/Heart-Lung Transplant
- Left ventricular assist device (LVAD)
- Minimally Invasive Cardiac Surgery (MICS)
- Minimally Invasive Direct Coronary Artery Bypass Surgery (MIDCAB) and Multi Vessel MIDCAB.
- Minimally Invasive Valve Repair and Replacement surgery.
- Minimally Invasive Thoracic Surgery
- Video Assisted Thoracic Surgery (VATS)
- Minimally invasive lung resection surgery (VATS Lobectomy)
- Minimally invasive repair for pectus excavatum (sunken chest)
- Surgery for sweaty palms (Hyperhidrosis)
- Endoscopic thoracic sympathectomy (ETS)
- Arrhythmia surgery
- Maze Procedure for atrial fibrillation
- Surgery for Hypertrophic obstructive cardiomyopathy (HOCM)