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Cardiac Surgery

Department of Cardiovascular & Thoracic Surgery is dedicated to providing the safest and highest-quality surgery for our patients. We offer virtually every type of adult cardiac surgery in Mumbai’s Dr L H Hiranandani hospital including elective or emergency surgery for heart valve disease, aortic aneurysm, coronary artery disease, arrhythmias, heart failure, Marfan syndrome and other less common conditions. Cardiac surgery at our hospital is done by the heart surgeons with vast experience and expertise in several areas of cardiac surgery, cardio-vascular surgery and thoracic surgery.

The hospital has all facilities from taking a simple ECG to the most complex coronary interventions like Primary Angioplasty, use of rotablators, multi-vessel angioplasty, IVUS (Intra Vascular Ultrasound) imaging guided optimal stentings, implantation of anti heart failure devices to name a few. These are carried out by the Philips ‘Clear View’ Flat Panel Detector Cath Lab. Such state-of-the-art equipment and technology is available in but a few centers in the country. 

The department is run by trained team of Interventional and non interventional Cardiologist. Cardiologists here carry out high volumes of procedures daily.

“Dr L H Hiranandani Hospital hosted the 1st live summit on Chronic total occlusion in Dr L H Hiranandani Hospital. The show was beamed pan India and internationally. 592 interventional cardiologists watched us doing cases from our hospital.”

American College of Cardiology (ACC) selects Dr L H Hiranandani Hospital to bring standardization in cardiac care.


Apolipoproteins are proteins that bind to lipids to form lipoproteins (Lipids + Proteins), whose main function is to transport lipids. These are amphipathic molecules capable of interacting with both the lipids of the lipoprotein core and the aqueous environment of the plasma.  Apolipoproteins are important in maintaining the structural integrity and solubility of lipoproteins and play an important role in cholesterol metabolism.
There are six major classes of apolipoproteins: A, B, C, D, E and H. There is increasing knowledge and awareness of the importance of apolipoproteins and their relevance to a variety of clinical disorders. From cardiac point of view we are mainly concerned of Apolipoprotein A1 and B
Apo A1
  • Apolipoprotein A is the major protein component of HDL ("good") cholesterol. It helps to start the process for HDL to remove bad types of cholesterol (LDL) from your body. In this way, apolipoprotein A can help to lower your risk for cardiovascular disease.
  • Elevated levels of apolipopro­tein A-I predict a lower risk of cardiovascu­lar events
  • In some studies it was found that ApoA1 was the best predictor for ischemic heart disease mortality in elderly men than many other conventional markers for cardiovascular disease.
  • Deficiency of apo A1 is associated with HDL deficiencies, including Tangier disease (rare disorder which cause increase in cholesterol deposit, cloudy cornea, neuropathy) and systemic non-neuropathic amyloidosis.
  • Apo A1 may have a role in protection against Alzheimer's disease (memory disorder).
Apolipoprotein B (apo B)
·         While apo A1 is major protein in good cholesterol, apolipopro­tein B is major component of all proatherogenic lipo­proteins (bad cholesterol) in a 1:1 ratio, hence high levels appear related to increased heart disease.


  • Apolipoprotein B and the apo B/apo A1 ratios are thought to be a better marker of risk of cardiovascular disease and a better guide to the adequacy of cholesterol treatment.
  • Apo B and the apo B/apo A1 ratio have been shown to be predictive of ischaemic stroke (paralysis episode) in patients with previous transient ischaemic attack.
  • While absent or very low apo B is associated with fat malabsorption, progressive ataxia, abnormal red blood cells and retinitis pigmentosa (a vision disorder).
  • Measurement of apo B is available through automated and standardized immunoassays and provides an efficient and inexpensive method to reflect the number of atherogenic particles. The benefits of measuring apolipoprotein Binclude the ability to use serum from non­fasting patients, standardization, and direct measurement compared with the calculated measurement of low-density lipoprotein cholesterol, which may be inaccurate in patients with hypertriglyceridemia.
  • The 2020 European Society of Cardiology and the European Atherosclerosis Society guidelines have ranked apoB as the most accurate marker representing atherogenic lipoproteins for predicting cardiovascular risk. A number of studies have reported higher ASCVD risk among people with discordantly high apo B concentrations relative to LDL-C or non-HDL-C.

FAQs Cardiology

1.Q. What are the risk factors for coronary artery disease?

1.A. Following are risk factors for coronary artery disease:

  • Uncontrolled diabetes
  • High blood pressure
  • History of heart disease in the family
  • Smoking
  • Obesity
  • Diet containing a large number of saturated fats
  • High cholesterol
  • Inactivity

2.Q. What is a heart attack?

2.A. A heart attack is a condition that occurs when the supply of blood and oxygen to a particular area of the heart muscle gets disrupted. This blockage is the leading cause of arrhythmias (irregular heartbeat) that cause a fatal decline in the pumping function of the heart.


3.Q. What are the Symptoms of Heart attacks?

3.A. The most common symptoms that occur in the case of a heart attack include chest pain, sudden perspiration, palpitations, breathlessness, pain in the left shoulder and neck region.


4.Q. Is chest pain the norm during a heart attack?

4.A. Not everyone will have chest pain (angina pectoris), some will have only breathlessness or giddiness with or without sweating, but If one is having any chest pain, then a doctor should be consulted.


5.Q. When can a patient go back to work after a heart attack?

5.A. Most heart attack patients go back to work within two weeks to three months depending on the severity of the heart attack. The doctor will determine when a patient can go back and whether the current job is suitable for a person who has had a heart attack


6.Q. What is Coronary Angiography?

6.A. Coronary angiography is a diagnostic process that is performed for detecting the blockages in the blood vessels of the heart. A radio-opaque dye is injected in the coronary arteries with the help of a thin tube inserted either through your groin or wrist and images are taken under cath-lab. It shows the narrowing of the lumen of blood vessels if there is a blockage.


7.Q. What are the Risk Factors of Coronary Angiography?

7.A. Angiography complications are extremely rare. A detailed list of possible complications is provided in the consent form. Please go through the consent form in detail and if have any doubt, please ask the doctor for clarification. To have an allergic reaction to the contrast is extremely unusual. If you have any allergies please remember to inform the cardiologist before the procedure is started.


8.Q. How much time does angiography take?

8.A. Angiography is carried out in a hospital in Cath Lab. It normally takes between 15- 30 minutes, and you can usually go home the same day.


9.Q. What is Angioplasty and a Stent?

9.A. Coronary Angioplasty is a medical procedure used to restore the blood flow through a blocked artery. In this non-surgical procedure, a thin tube with a balloon is inserted to expand the site of blockage in the coronary artery. It is also referred to as PTCA (percutaneous transluminal coronary angioplasty).


A stent is a stretchy wire mesh tube that is inserted into the expanded artery for keeping it open and allowing the flow of blood.

Stents are of two types:

  • Plain metal variety.
  • The drug-release type that disperses the drug while in place for assisting in keeping the artery dilated.


10.Q. What are the risks involved in the process of angioplasty?

10.A. Following are the risks involved in the procedure of angioplasty:

  • Bursting of the artery
  • Kidney problem due to the iodine contrast dye in X-rays
  • Restenosis or re-blockage of the blood vessels


11.Q. Can a patient lead a healthy normal life again after angioplasty?

11.A. There are excellent chances of leading a healthy life & go back to work. Most people are back to their earlier lifestyle within a week after angioplasty if they have not suffered a heart attack & if ejection fraction of heart (heart pumping) is >50%.

All that needed is to make a few modifications in lifestyle in terms of Diet, Exercise, etc which will help to become normal much faster and prevent the chances of Restenosis.


12.Q. What occurs after angiogram and angioplasty/stents?

12.A. After the angiogram, the patient is monitored while in the recovery area before given a discharge. If the process was of angioplasty/stents, one has to stay overnight, during which the patient is closely observed. In both cases, the patient must have someone to accompany since one is not in a condition to drive.

The doctor discusses the preliminary results of the angiogram before the patient is discharged. There is a discussion about any side effects that a patient might experience at home. Sometimes, the use of clot-preventing medicines is also prescribed after the process.


13.Q.What is cardiac rehabilitation?

13.A. The cardiac rehabilitation program is a medically supervised program that helps in the improvement of the health and well-being of people suffering from different kinds of heart problems.


14.Q.What types of physical exercises are recommended to promote heart health?

14.A.Regular physical activity like brisk walking for 30-40 minutes a day, strengthens and protects the heart from major cardiovascular diseases. While an intense exercise for 20-30 minutes is optional as it concentrates more on body muscle building. A person recovering from a heart attack is advised to rest for 2-3 weeks with minimal physical activity. However, mild cardio exercises and slow walking are very helpful to speed up the recovery process. But, it must be done as per Doctor's advice.


15.Q.What kind of diet is to be followed?


  1. Avoid fried, fatty things especially saturated trans-fat.
  2. Eat more vegetables & fruits
  3. Select whole grain and high fiber diet



16.Q.Can a patient go through an X-Ray or CT scan or MRI post stenting?

16.A. X-Ray or CT scan can be done at any time, MRI can be done after one and half month of the procedure (please consult your Doctor before MRI).


17.Q.Will the presence of the metallic stent inside the artery cause the security or metal alarm goes on during security checks etc. like on airport security checks?

17.A. NO


Newer Generation Cath Lab

For Appointment Booking :

022 25763595 / 25763298


Facilities/ Services

Non-Invasive Cardiology

1.  ECG (Electro Cardiography) with 16 lead capability

2.  TMT (Treadmill test or Stress test):
Stress test of the heart is an established method of detecting the functional reserve of the heart.

3.  2D Echo: Echocardiography (echo):
The use of ultrasound to examine the heart – is a safe, powerful, non –invasive and painless technique.

4.  High-end Real-time 3D Echo/ 4D Echo:
This Echocardiography machine is capable of adult, paediatric, neonatal and fetal echo, transoesophageal echo, Q lab analysis, stress echo, myocardial perfusion imaging

5.  Vascular Elasticity/Arterial Stiffness:
The instrument measures the arterial stiffness and determines the age of your vessels. The loss of vascular elasticity is the earliest change in vessels before the blocks starts developing.

6.  Carotid intimal media thickness:
This again gives the earliest evidence of health of blood vessels and early treatment can prevent formation of new blocks.

7.  TEE (Trans Esophageal Echocardiogram):
The TEE uses a transducer mounted upon a modified probe similar to those used for upper gastrointestinal endoscopy and allows examination of the heart without a barrier to ultrasound usually provided by the ribs, chest wall and lungs. By advancing the probe tip to various depths in the oesophagus and stomach, manoeuvring the tip of the transducer and by altering the angle of the ultrasound beam with controls placed on the handle, a number of different views of the heart can be obtained.

8.  DSE (Dobutamine Stress Echo):
This type of echocardiography aids in the diagnosis of ischaemic heart disease. It helps to localize the site and quantifies the extent of ischaemia by the demonstration of regional wall motion and thickness abnormality with stress which is not present at rest.

9.  Non Invasive Multi-slice CT Coronary Angiography (CTCA):
CT-Coronary Angiography is new, non-invasive direct procedure to assess blockage and condition of coronary arteries. The procedure is of just 5 minutes with overall duration of 1 hour in the hospital. For emergency cases CTCA can help to segregate non-cardiac chest pains. A normal CTCA has 100% negative predictive value. In addition, it helps to identify the types of plaques and degree of blockage along the arteries, the status of Heart Chambers, Cardiac Muscles, Valves, Aorta & Pulmonary vessels and Development of collaterals

Cardiac Arrhythmia Services

Non-Invasive Cardiac Arrhythmia Services:

  • Cardiac arrhythmia and pacemaker clinic
  • Transtelephonic monitoring
  • Holter Monitor: This is a 24 hour ECG monitoring. The recorder is connected to the patient’s body, which he takes home and brings back after 24hours. The recorder is connected to the computer and ECG is analyzed for arrhythmia problems.
  • V Patch System: Extended monitoring of heart rhythm up to 7 days is possible with continuous update on server through transmission using global sim card. The doctors can visualize your rhythm whenever they want.

Invasive Cardiac Arrhythmia Services:

  • Intracardiac diagnostic electrophysiology investigations
  • Therapeutic catheter ablation of supraventricular and ventricular arrhythmias
  • Permanent pacemaker implantation
  • Implantable cardioverter defibrillator implantation
  • Anti heart failure devices (biventricular pacemakers)

IV Invasive Diagnostic and Interventional Services :

  • Cardiac catheterisation
  • Coronary angiography
  • Coronary angioplasty, rotablator, rotational atherectomy and stent implantation
  • Balloon valvuloplasty
  • Intraaortic balloon counterpulsation
  • Device closure of ASD/VSD/PDA
  • IVUS
  • FFR

Cardiac Angioplasty

Dr L H Hiranandani Hospital treats heart attack patients with the most effective and advanced procedure available, namely primary angioplasty. It is the preferred treatment for heart attack according to the American College of Cardiology.

Heart attacks are caused when blocked arteries prevent the heart from receiving oxygen. Traditional treatment uses drugs to dissolve blood clots. While effective, it does not treat the underlying cause of the blockage, resulting in possible re-hospitalization and further procedures. With primary angioplasty a balloon is inflated to open the clogged artery and a stainless steel wire mesh, called a stent, is inserted. This acts as a scaffold to keep the artery open. The result: blockages are completely cleared, heart damage is lessened, the risk of stroke and/or subsequent heart attack is reduced and the hospital stay is shortened.

"There are basically two ways to treat someone having a heart attack,” "One way is to use clot-dissolving medications. But they only work about 70 percent of the time and do not address the underlying blockage. The safest way to treat an acute heart attack and avoid subsequent procedures is to open the blocked artery with a balloon and insert a stent. We have the trained personnel and the equipment to perform emergency primary angioplasty right away on our heart attack patients."

Patients experiencing symptoms of a heart attack are evaluated within minutes of arriving in the Accident & Emergency Department at the Hospital. When the diagnosis is a heart attack, most patients are transferred immediately to the Catheterization lab for emergency balloon angioplasty. The interventional Cardiologist inserts a balloon-tipped catheter into the artery, threading it towards the heart. When the balloon is inflated, it dislodges the obstruction and restores blood flow to the heart. A wire mesh stainless steel tube called a stent is inserted to keep the cleared artery open, acting as scaffolding to keep the artery open.
Dr L H Hiranandani Hospital offers 24X7 emergency primary angioplasty programme. Primary angioplasty complements the comprehensive cardiac services provided at the hospital - from the patient's doorstep and transport to the hospital with our cardiac ambulance units, to their safe return home. Don't ignore the warning signs of a heart attack - chest pain with or without nausea, shortness of breath, vomiting, profuse sweating, breathlessness, fainting, weakness and intense feelings of dread. Call us at 022 25763323, the sooner treatment starts the better. While you wait, chew on an aspirin to help dissolve the blood clot.

With an aging population on the rise in India, complex coronary cases are presenting frequently to the cardiologists. In these patients the arteries supplying the heart muscles (coronary arteries) are blocked by hard calcium laden plaques. A rotablator is used to treat such complex blockages which is much less invasive than surgery, can be safer than other minimally invasive catheter based procedures.

For these complex hard and calcified blockages, an atherectomy or in plain language reducing the amount of calcified plaque within the artery by the rotablator (plaque debulking) actually puts less strain on the arterial walls than the routine balloon angioplasty.

What is a Rotablator?
The Rotablator is a sophisticated drill with a tiny olive shaped diamond- tipped burr. The burr travels through a catheter over a thin guide wire into the blood vessel supplying the heart (coronary artery). Once close to the hard calcific blockage, the rotablator spins between 140,000 to 200,000 revolutions per minute and is driven by turbine technology. As it crosses the blocked or narrowed area, it ablates or sands or pulverizes away the hardened calcific blockages (plaques). These small bits of plaques then harmlessly travel through the blood stream and are eventually eliminated from the body circulatory system.

How Is the Procedure Performed?
Like a routine angioplasty procedure, the patient is awake during the procedure and given a local anaesthetic. The interventional cardiologist makes a small incision at the top of the patients groin and inserts a catheter in to a blood vessel using an x-ray camera. A dye is injected to confirm the amount of blockage in the artery. At the end of this tube is the rotablator. Once the burr is in place, the cardiologist turns the turbine motor on with a foot paddle to break the plaque off the walls of the artery. These small pulverized calcific particles are eliminated from the body through the circulatory system.

After the Procedure
Once the calcific hard particles are removed and the lumen of the artery is restored, the case is completed by the usual stenting. At times it is combined with the routine balloon angioplasty. This combination has proven to be effective in treating severely hardened blocked arteries which a routine angioplasty fails to address it. It is specifically a choice of treatment for hard blockages which are more common in elderly age group (who are otherwise high risk for bypass surgeries) or post bypass repeat procedures and at time even younger patients with significant heart disease. After the procedure, the patient is kept overnight at the hospital, and can return to work within two or three days.

Is It Safe?
A Rotablator is designed not to damage artery wall. The Rotablator burr cuts away only inelastic, hard material as calcific plaque. Normal healthy tissue is elastic and is deflected out of the way. The mechanism of action is similar to shaving, in which the razor cuts the hard inelastic beard, while not damaging the soft, elastic surrounding skin. However it requires rigorous training to handle the equipment.

Is it routinely used device?
It is not a routinely used device, and only a handful of interventional cardiologists in the country are trained to operate this device. Dr Ganesh Kumar, consultant interventional cardiologist at the Dr L H Hiranandani hospital is one amongst them. The rotablator is marketed only by one company (Boston Scientific, USA), and to obtain their device, you need to be a certified operator to handle such complex cases. However, with the increasing number of complex cases that are being treated by Dr Ganesh Kumar, Dr L H Hiranandani hospital is the first hospital in Mumbai to permanently obtain this machine, so as to benefit the select group of highly complex coronary interventions that are being done routinely in this hospital.

What is IVUS?
Intravascular Ultrasound (or IVUS) allows us to see a coronary artery from the inside-out. This unique point-of-view picture, generated in real time, yields information that goes beyond what is possible with routine imaging methods, such as coronary angiography, performed in the cath lab, or even non-invasive Multislice CT scans.

This cross-section view can aid in stent sizing, and in confirmation that the stent has been placed optimally, is fully expanded and hugging the vessel wall. A growing number of cardiologists feel that the new information yielded by IVUS can make a significant difference in how a patient is treated, and can provide for more accurate stent placement, reducing complications and the incidence of stent thrombosis.

How Does IVUS Work?
IVUS uses ULTRASOUND: the same technology as the ultrasound imaging used echocardiography and many other medical exams. Very high frequency sound waves, called ultrasound, are emitted by a transducer. These ultrasound waves, which are beyond the range of human hearing, bounce off the various types of tissue structures in the body and the echo of these waves is then converted into a picture.

In the case of Intravascular Ultrasound, the transducers have been miniaturized to less than four hundredths of an inch and placed on the tip of a catheter. This catheter can be slipped into the coronary arteries over the same guide wire that is used to position angioplasty balloons or stents. It becomes, in effect, a tiny camera that gives us a cross-sectional view of the artery, a view that shows distinct circular layers, using shades of gray or colors, the major ones being:

When is IVUS Done?
Intravascular ultrasound is done in the catheterization laboratory in conjunction with angiography. Some cardiologists use it occasionally, in difficult cases, or to assist in the selection and sizing of stents and balloons. Others use it routinely, to confirm accurate stent placement and optimal stent deployment.

How Can IVUS Make Stenting More Accurate?
With the accurate measurements of both the true diameter of the artery and the diameter of the open lumen channel provided by IVUS, the guesswork is taken out of choosing the correct size balloon and stent. Using only angiography, a cardiologist may underestimate the size of a diseased artery.

IVUS can also measure the length of the diseased area, so the precise length of the stent needed can be determined ahead of time, reducing the need for overlapping stents which are known to increase the risk of thrombosis.

Once the stent has been implanted, IVUS can clearly show the stent struts in relation to the arterial wall and plaque. If the stent has been undersized or if there is any area that needs "touching up", a larger balloon can be directed to it and expanded to fit the stent optimally.

FFR (Fractional Flow reserve)
Fractional Flow Reserve, or FFR, is a guide wire-based procedure that can accurately measure blood pressure and flow through a specific part of the coronary artery. FFR is done through a standard diagnostic catheter at the time of a coronary angiogram. The measurement of Fractional Flow Reserve has been shown useful in assessing whether or not to perform angioplasty or stenting on "intermediate" blockages (50-70%blocks)

Both these technologies will help tremendously in improving the outcomes of angioplasties and better patient care.

Our Team

Full Time Consultant
Name Designation Qualification Availability
a. Dr. Ganesh Kumar AV Senior Consultant Interventional Cardiologist and Head of Department MD (General Medicine), DNB (Internal Medicine), DNB (Cardiology), DM (Cardiology), Fellowship in Interventional Cardiology (Rambam Medical Center, Haifa), FACC

Monday to Saturday :  8.00 am - 8.00 pm

b. Dr. Rushikesh Sambhaji Patil Full Time Consultant Cardiology DM (Cardiology), MD (General Medicine), MBBS

Monday to Saturday : 8.00 am - 8.00 pm

c. Dr. Irfan Khan Hamid Full Time Consultant Cardiology MBBS, MD (General Medicine), DM (Cardiology)

Monday to Saturday : 8.00 am - 8.00 pm

Visiting Consultant
Name Designation Qualification Availability
Honorary Consultant Interventional Cardiology ONLY IPD
Visiting Consultant Cardiology ONLY IPD
Visiting Consultant Cardiology

 Tuesday :  2.00 pm - 4.00 pm

Visiting Consultant Interventional Cardiology


Dr. Deepak P. Turakhia Honorary Consultant Cardiology MD (Medicine), DM (Cardiology), DNB (Cardiology)