Extracorporeal membrane oxygenation (ECMO)

ECMO is a mechanical circulatory support that temporarily takes over the function of lungs and heart to support person whose heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life.

Generally, it is used either post-cardiopulmonary bypass or in late stage treatment of a person with profound heart and/or lung failure, allowing for treatment of the underlying cause while circulation and oxygenation are supported. It is also used as a bridge to either heart transplant or placement of a ventricular assist device.

CORONARY ANGIOGRAM AND ANGIOPLASTY

Coronary angioplasty is a procedure used to widen blocked or narrowed coronary arteries (the blood vessels supplying the heart).

The procedure includes temporarily inserting a tiny balloon where your artery is clogged to stretch open it and is often combined with the permanent replacement of a small wire mesh tube, called a stent. The stent is left in place permanently to restore the blood supply to the heart and decrease its chance of narrowing again.
When is it done?

Angioplasty is used to treat heart disease known as atherosclerosis (buildup of fatty plaques at in the arteries supplying the heart).
Your doctor might suggest angioplasty as a treatment options when the medication is ineffective to improve your heart health, if you have a worsening chest pain (angina pain), or if you have a heart attack.

ENDOVASCULAR AORTIC ANEURYSM REPAIR (EVAR)

Endovascular Aortic Aneurysm Repair (EVAR) is a procedure done by an interventional cardiologist, used to repair a widened area of the aorta, called aneurysm. An aneurysm occurs due to weakness in the wall of the artery. When used to treat thoracic aortic disease, the procedure is specifically termed TEVAR (Thoracic Endovascular Aortic Aneurysm Repair).

In the EVAR procedure, a stent graft is inserted into the aneurysm through small incisions in the groin, without surgically opening or removing part of the aorta, thereby offering an alternative treatment choice to open surgery. The stent is placed within the patient’s vasculature, thereby excluding the aneurysmal sac from blood flow and preventing the walls of the aneurysm from rupturing.

ELECTROPHYSIOLOGICAL (EP) STUDY AND ABLATION

Electrophysiological (EP) study and ablation is done by a cardiologist specialized in heart rhythm disorders (arrhythmia).
Your doctor may recommend an EP study if you:

• Have an abnormal heart rhythm (arrhythmia), such as simple and complex atrial arrhythmias and ventricular arrhythmias.
• Experience a temporary loss of consciousness (syncope)
• Have a risk of sudden cardiac death

Cardiac ablation works by scarring or destroying heart tissues that triggers or sustains an abnormal heart rhythm. The procedure involves inserting a long, flexible tubes (catheters) through your veins at your groin and threading it to several places within your heart.

Your doctor may inject dye into the catheter, which will reveal your blood vessels and heart using X-ray imaging. The catheters have electrodes at the tips that can be used to send electrical impulses to your heart and record your heart’s electrical activity.

If your doctor determines that cardiac ablation is appropriate, he or she may continue with that procedure during your EP study. Cardiac ablation involves using special catheters to apply heat or cold energy to areas of your heart. The energy creates scar tissue that blocks the erratic electrical signals in your heart.

PACEMAKER IMPLANTATION

A pacemaker is a small electronic device that is placed under the skin on your chest to help regulate electrical problems of the heart to ensure that your heartbeat does not slow to a dangerously low rate. An implanted pacemaker will mimics the action of your natural pacemaker.

• Your doctor might recommend a pacemaker if you have:
  • Bradycardia – This occurs when your heart beats too slowly
  • Tachy-brady syndrome – This is characterized by alternating fast and slow heartbeats
  • Heart block – This occurs when the electrical signals of your heart is delayed or blocked

A pacemaker implantation is done under local anesthesia to numb the area of the incision. It is usually performed while you’re awake and typically takes a few hours.

You will stay in a hospital one day after having a pacemaker implanted. Your pacemaker will be programmed to fit your pacing needs and education regarding the care of the pacemaker will be given before discharged from hospital.

In IJN, we also offer MICRA pacemaker implantation which is the latest and smallest leadless pacemaker. Unlike the conventional pacemaker that is placed under patient’s chest with leads running to the heart, MICRA is implanted directly into patient’s heart via a vein in your leg. Thus, a MICRA is proven to be less invasive procedure with no chest incision, no chest scar and fewer medical complications.

MITRACLIP FOR MITRAL REGURGITATION

MitraClip is a small device that is attached to your mitral valve. It treats mitral regurgitation by allowing your mitral valve to close more completely, helping to restore normal blood flow through your heart. Unlike surgery, the MitraClip procedure does not require opening the chest. Instead, doctors access the mitral valve with a thin tube (catheter) that is guided through a vein in your leg to reach your heart.

Advantages of MitraCLip:

• Less invasive procedure than the conventional open-heart surgery
• Reduction of hospital visits due to heart failure
• Lower length of hospital stay

MICRA

In IJN, we also offer MICRA pacemaker implantation which is the latest and smallest leadless pacemaker. Unlike the conventional pacemaker that is placed under patient’s chest with leads running to the heart, MICRA is implanted directly into patient’s heart via a vein in your leg. Thus, a MICRA is proven to be less invasive procedure with no chest incision, no chest scar and fewer medical complications.

Mechanical Heart Implantation (left ventricular assist device- LVAD)

A left ventricular assist device (LVAD) is an implantable mechanical pump that helps pump blood from the ventricles (lower chambers of your heart) to the rest of your body. A control unit and battery pack are worn outside your body and are connected to the LVAD through a port in your skin.

It is implanted to patients with a failing heart while awaiting for a heart transplant or until the heart is strong enough to efficiently pump on its own. In addition, LVAD is also beneficial for a long-term treatment for patients with heart failure but aren’t good candidates for a heart transplant, to improve their quality of life.

Minimally invasive heart surgery

In minimally invasive heart surgery, our surgeons perform heart surgery through small incisions in the right side of your chest, as an alternative to open heart surgery. They operate between the ribs, which may result in less pain and a quicker recovery for many people

Minimally invasive heart surgery may be performed to treat a variety of heart conditions including coronary artery bypass surgery, valves repair and replacement surgery, atrioventricular septal defect surgery and maze procedure for atrial fibrillation

Minimally invasive heart surgery offers a series of benefits compared to open heart surgery such as less blood loss, lower risk of infection, reduced trauma and pain, shorter hospital stay and less visible scars