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Heart and Double Transplant – Indian experience


Dr.T Sundar

Sr.Consultant Cardiothoracic, Heart & Lung Transplant Surgeon

Apollo Hospital, Chennai


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Dr. Sunny Chinchansur

A very good evening to all of you. I am Dr. Sunny Chinchansur and you are watching me live on WCC ICC TV sponsored by Emcure and driven by therightdoctors.com. We are witnessing increasing number of heart transplant in India lately and to elaborate more onto the subject, we are very pleased to have with us Dr. T. Sunder, senior consultant cardiothoracic and heart and lung transplant surgeon, Apollo Hospitals, Chennai, adjunct professor of the Tamil Nadu, Dr. M.G.R. Medical University. Sir, welcome to the show it is an honor to have you here.

Dr. T Sunder

Thank you.

Dr. Sunny Chinchansur

Sir has recently delivered a beautiful talk on heart and lung transplant Indian scenario. Sir, my first question to you is when does one need a heart transplant?

Dr. T Sunder

Transplant usually is the last option. When the heart fails, it does not do its job. It does not pump blood well. A lot of options are available. You have got medications. You have got stents. You have got bypass surgeries (0:01:00.0) may be valve operations. At one point, when all these devices do not help the patient and the patient is symptomatic despite all options, one thinks about a transplant.

Dr. Sunny Chinchansur

Sir what are the results of heart transplant?

Dr. T Sunder

We have standarized our heart transplant procedures in our hospital in Apollo Hospital in Chennai. We do have survival of 90% in one year which is at par with the international standards. So, yes, the results of heart transplants are very good and the patient returns back to normal quality of life after the operation.

Dr. Sunny Chinchansur

So having said that it is last option for any patient with heart failure. Do you find any specific challenges in India as such for heart transplantation?

Dr. T Sunder

That is right. When I said it is a last option what I meant was we need to exhaust all options at an optimal time. The main challenge that we find in India, which is quite (0:02:00.4) different from the western population is that the patient is being referred late. So they wait either it is the patient’s factor where they have an eversion or scare to have surgery or sometimes it is decreased awareness among the physicians that transplant is an option. They get ended up treated very long time. At which point, the failing heart has the effect on other organs, lungs for example, the pressure in the lung based up to an extent where heart transplant cannot be done. When the pressure in the lung gets high, the right ventricle fails and the liver fails. In other words, the heart failure, which was first affecting only the heart, ends up affecting all the organs. At which point, the patient is too sick to have a transplant. So the Indian challenges are the late referral, initially there were problems with cultural believes where there are some people who were concerned that the loved ones if the last rights are not performed with the heart in place may not reach heaven (0:03:00.7), but those things with increasing awareness in the public there is a large amount of donations particularly in the state of Tamil Nadu who come forward to donate the organs.

Dr. Sunny Chinchansur

Sir, any one specific take home message for our viewers that could help overcome these specific challenges in India that we face today.

Dr. T Sunder

1. As far as end-stage heart failure is concerned, as of now heart transplant remains to be the goal standard. 2. The timing of referral for heart transplant needs to be at the right time quite early if the disease and if the patients are referred too late. Well, centers like ours have the infrastructure to do more complex operation like heart and double lung transplant. Now, lets see the patient comes a little late when the lung failure sets in we can do heart and double lung. In fact, we have done the largest in the country. We have done 24 heart and double lung transplants.

Dr. Sunny Chinchansur

Thank you very much sir for (0:04:00.1) that quite narrative Indian scenario of heart failure and indian scenario of heart transplant and also the methods or the steps that we need to take to overcome the specific challenges that we are facing today. Thank you once again, sir. It was a privilege to have you on this show.

Dr. T Sunder

Thank you. Pleasure is mine.

Tags:
  • CT Angio
  • STEMI
  • CAD
  • Myocardial Perfusion
  • PET Imaging
  • CTA
  • TAVI
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