NewZNew (Shimla) : As many as 100 doctors from multiple specialities of region attended an annual continued medical education (CME) on ‘ Cardiac Sciences’ at Hotel Holiday Home, Shimla last night. The CME was organised by Max Super Speciality Hospital (MSSH), Mohali and Indira Gandhi Medical College Alumni Association, Shimla.
Dr. Virendar Sarwal, Director & Head, Department of Cardio Thoracic & Vascular Surgery , and Dr Amit Gupta, Sr Consultant, Cardiology from MSSH were the keynote speakers during event. Where Dr. Sarwal spoke on ‘Advances in treating Coronary Artery Disease’, Dr. Gupta talked on ‘Vulnerable plaque : the Dilemma’.
Dr. Sarwal said that even as there was a significant scientifically advancements in treating coronary artery disease, yet it would often become difficult in choosing between bypass surgery and angioplasty the two treatments available for disease. Fortunately, the last few years have witnessed lot of scientific debate and analysis leading to a clear picture on concept of formation of Heart Team.
He said that ‘Heart Team’ consisted of a cardiac surgeon, cardiologist and a non interventional cardiologist. It would evaluate each and every case based on the reports and give a scientific intervention. He explained further as per American Heart Association guidelines 2012 based on two scientific trials “Syntax” and “Freedom” the class I indication for all coronary artery disease except single vessel mid LAD disease was bypass surgery if we have to see the durability, economics and the best procedure.
Talking about modern bypass surgery process , Dr Sarwal said that it was now more safer, less stressful and early recovery too as most of situations were handled with off-pump or beating heart surgery. The ICU and hospital stay, blood usage, back to work days were less as compared to conventional surgery. The outcomes were excellent even in very high risk situations, he asserted.
Dr. Amit Gupta, Sr. Consultant, Cardiology at MSSH said that atherosclerotic cardiovascular disease resulted in millions of sudden deaths annually. The coronary artery disease accounted for the majority of this toll. However the most worrying factor was that the despite major advances in the treatment, a large number of victims of disease would die suddenly without any prior symptom.
Unlike general perception, many heart attack victims did not have severely narrowed arteries caused by plaque. What they found was that inflammation would lead to the development of soft or vulnerable plaque that were not severely stenotic but prone to rupture thus leading to instant formation of blood clot and heart attacks .These plaques have different morphology with high lipid core and cell content that was highly inflammatory with a thin fibrous cap that would rupture easily. Lot of techniques including thermography ,radiofrequency IVUS, optical coherence tomography, and near-infrared spectroscopy were being used for detection of vulnerable plaque, pointed out Dr Gupta.