Heart Health and Surgical Excellence: Exploring Cardiac Care with Dr. Sushant Srivastava
Dr. Sushant Srivastava, the esteemed Chairperson of Cardiac Surgery and Heart,Lung Transplant at Artemis Hospital, is a distinguished figure in the field of cardiac surgery. With an illustrious career marked by expertise and innovation, Dr. Srivastava has consistently pushed the boundaries of cardiac surgery. His journey is a testament to unwavering dedication and a commitment to advancing heart healthcare. In this exclusive interview, Dr. Srivastava shares insights into the evolving landscape of cardiac surgery, the importance of heart health, and the strides made in ensuring patient safety.
Join us as we delve into the world of cutting-edge cardiac care with a visionary leader.
Q: Can you share your journey and experience in the field of cardiac surgery, and what inspired you to specialise in this area?
A: Two individuals played pivotal roles in shaping my journey in cardiac surgery. Firstly, my mother kindled my early aspirations by reading stories about the renowned cardiac surgeon, Doctor Denton Arthur Cooley, to me when I was just six or seven years old. These stories instilled dreams and inspired me to envision a future where I, too, could perform heart operations like him.
Secondly, during my tenure at the All India Institute of Medical Sciences (AIIMS), I had the privilege of being guided by Doctor P Venu Gopal, a visionary in the field. He achieved a significant milestone by conducting the first successful heart transplant in India on August 4th, 1994, a day on which I was fortunate to be a part of his team. Doctor Venu Gopal's vision and leadership propelled cardiac surgery from its rudimentary beginnings to the advanced state it has reached today. AIIMS played a crucial role in this transformative journey.
In essence, these two individuals—my mother and Doctor Venu Gopal—stand as the most influential figures in my pursuit of a career in cardiac surgery.
My journey started in 1992 at the All India Institute of Medical Sciences (AIIMS), where I began as a resident trainee. At AIIMS, I was exposed to the highest calibre of cardiac surgery in India. During my time there, I had the privilege of witnessing groundbreaking achievements in the field, including the first successful heart transplant and the implantation of the first mechanical heart in the country. In 1994, after completing my residency, I joined the faculty at AIIMS as an assistant professor. This period allowed me to operate on thousands of patients and learn from pioneering seniors and teachers who were at the forefront of cardiac surgery. The experience at AIIMS transformed my thinking and provided the essential exposure needed to excel as a cardiac surgeon.
Upon entering private practice, I encountered numerous rewarding experiences. One notable case involved performing bypass surgery on a 96-year-old gentleman in 2014, who miraculously survived. Remarkably, he lived until the age of 99 before succumbing to stomach cancer. Additionally, I had the privilege of conducting the first sutureless, or
stitchless, valve surgery in India. Throughout my career, I have undertaken complex surgeries, and met with successful outcomes. It has been an incredibly fulfilling journey, and my passion for cardiac surgery continues to drive me forward.
Q: What are some of the most common cardiac conditions or procedures you can't encounter in your practice, and how have treatments evolved over the years?
A: Coronary artery bypass surgery, commonly known as bypass surgery, holds the distinction of being the most frequently performed cardiac operation worldwide. This prevalence is attributed to the high incidence of coronary artery disease, particularly in India, which has earned the unfortunate title of the "world capital of coronary artery disease."
Shockingly, approximately one out of every ten adults in India suffers from this condition.
The management of coronary artery disease varies, with some patients undergoing medical treatment, while others opt for angioplasty. However, as the disease progresses, many individuals eventually reach a stage where bypass surgery becomes the only viable option. This scenario is not unique to India but resonates globally, making bypass surgery a ubiquitous procedure.
In developing countries like India, cardiac surgeons also confront heart valve diseases, often stemming from conditions like rheumatic fever, particularly affecting young patients. Additionally, congenital heart defects in children necessitate surgical interventions. Surgeons may also address issues related to major vessels, such as the aorta, which can develop conditions like aneurysms or dissections. Furthermore, patients with heart muscle diseases may require procedures like heart transplants or mechanical assist devices like LVADs to support failing hearts.
The field of cardiac surgery has witnessed remarkable advancements over time. For instance, the introduction of beating heart surgery has reduced the reliance on the heart-lung machine in specific procedures, facilitating faster recovery for patients. Despite the increasing complexity of cases due to patients presenting with multiple comorbidities, continuous improvements in techniques and technology empower surgeons to effectively manage these challenges.
Q: And what about the safety of these surgeries? Many people are concerned about the risks associated with them. What steps do you take to ensure the safety and well-being of your patients before, during, and after surgery?
A: Ensuring the safety of cardiac surgery is of utmost importance, and I want to emphasise that the success rates are excellent. For routine bypass surgery, the mortality rate is typically below 2%, meaning a success rate of approximately 98-99%. It's crucial to recognise that while all surgeries carry some risks, including cardiac procedures, these risks are generally outweighed by the benefits of treating heart disease. However, it's worth noting that the presence of other health conditions can increase these risks, such as uncontrolled diabetes, high blood pressure, kidney disease, or a history of smoking. Nevertheless, even in patients with multiple health issues, the risks can be managed, and most individuals recover well and lead healthy lives. Age alone is not a significant risk factor, and cardiac surgery is routinely performed on patients in their 70s and 80s as long as their overall health is good.
Q: What role does lifestyle play in heart health, and how can individuals make positive changes to reduce the risk of cardiac problems?
A: Lifestyle is pivotal in maintaining heart health. Positive changes can significantly diminish the risk of cardiac issues.
Here's how:
- Diet: Prioritise a heart-healthy diet. Avoid fast food, fried items, and excess unhealthy fats. Embrace fruits, veggies, whole grains, and low-fat dairy.
- Exercise: Regular physical activity is crucial. Aim for 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise weekly.
- Smoking: Quit smoking immediately if you do. It's a major heart disease risk.
- Alcohol: Limit alcohol intake. Excessive drinking can harm the heart.
- Weight Management: Maintain a healthy weight through balanced eating and exercise. Obesity is a heart disease risk.
- Stress Management: Manage stress with techniques like meditation or yoga. Chronic stress negatively affects heart health.
- Regular Check-ups: See your healthcare provider for check-ups and screenings. Early detection of high blood pressure and high cholesterol is vital.
- Medication Adherence: If prescribed medications for conditions like high blood pressure or high cholesterol, take them as directed.
- Sleep: Ensure adequate, quality sleep. Poor sleep can contribute to heart problems.
These changes reduce cardiac risks and enhance overall well-being. Prevention and early intervention are keys to
heart health.
Q: Thank you, doctor, for sharing that valuable information. Now, is there anything else you'd like to add or any final advice you have for our readers regarding heart health or cardiac surgery?
A: Promote heart health through lifestyle changes: diet, exercise, stress management. Consult healthcare pro for concerns/family history. Trust in cardiac surgery when needed; benefits outweigh risks.