India: Super power in heart health care

By Dr. Ramakanta Panda 
For over a month now, the nation's attention has been anxiously transfixed on a figure who is a VVIP, scholar and leader of a vast sub-continent. No prize for guessing - everyone knows about him. He has been constantly making headlines in print and on electronic media ever since he was wheeled into the operation theater of the All India Institute of Medical Sciences, New Delhi, on January 23 until his full recovery and return to high office in early March. He is none other than our very own Prime Minister Manmohan Singh who underwent redo bypass heart surgery.
A message to the nation
However, during that short but critical period in our country's history, it sent out a positive message of hope to the people of India, which made them proud to be Indians. The message was that, unlike in the past when politicians and celebrities preferred medical treatment abroad, we need not travel to the West for medical treatment when we have the world's best hospitals and doctors.
A new health trend
The health sector in India is on a roll. The purchasing power of the Indian middle-class is rising very rapidly. So they can afford quality healthcare. It is estimated that by 2012 the health care sector will shoot up to $40 billion. Today, since most Indians can afford Western medicines, the heath sector is rapidly growing.
The Prime Minister himself, with his most distinguished rank and the many options he had, chose a team of Indian doctors, Indian medical staff and Indian medical institutes for his redo bypass surgery. By doing so, he manifested absolute faith in the ability and skills of Indian doctors. Moreover, other VIPs like actors Shah Rukh Khan and Amitabh Bachchan, and politicians like Atal Bihari Vajpayee have also preferred Indian hospitals and doctors.
Cardiology in India
Cardiovascular disease is among the world's leading causes of death, and nearly 80 per cent deaths occur in India and China. The disease is becoming a major health problem in our country where life expectancy has increased with decrease in contagious diseases and infant mortality. It is well established that our population experiences coronary artery disease at a younger age than in other countries. There is a clear progression towards degenerative and lifestyle-related diseases such as cardiovascular disease as a result of current social and economic changes. A lack of patient-awareness and inadequate medical facility were other factors which contributed to a large number deaths in the past. Earlier it was perceived that cardiovascular dieses prevails more in urban cities. But recently, we at the Asian Heart Institute have seen influx of patients coming from small town and villages. In spite of the surge in cardiovascular disease, I still believe that we as a nation are well-equipped to handle the epidemic, provided we see more investment in setting up more specialized hospitals like the Asian Heart Institute.
Infrastructure for complex surgeries
At present, premium hospitals in India with world-class medical facilities have been providing cardiac care of the highest nature under the expertise of leading cardiac surgeons of our country. While being offered a full range of cardiology services - from prevention of heart disease to early detection of complex heart problems, the team of cardiologists has been regularly performing angioplasties, aneurysm, valvuloplasties, closure of congenital heart defects and other high-risk cases.
Last year more than 65000 operations were done in India. Not only that, even the quality of healthcare provided in India is now of International standards. For eg: At AHI, 99% of the patients are operated on "beating heart". Ninety-five per cent bypass surgeries are performed using arterial grafts which result in long term success. In the premium heart care hospitals like Asian Heart Institute, the surgical teams have pioneered techniques of LESS (Lower End Sterner Split) in India, which entails only a 2-inch incision in the chest for coronary bypass surgery. This just goes to prove the world class technical expertise being provided to the patients.
Achievements in cardiology
Following facts makes it clear that the Indian heart healthcare sector has not only attained high success rate, but is also credible:
As per the study conducted recently, Indian specialists have performed over 5,00,000 complex surgeries such as cardio-thoracic, neurological and cancer. The success attained in these surgeries is at a par with international standards.
The success of cardiac bypass in India is 98.7 per cent, higher than in USA. In the Asian Heart Institute, over 70,000 patients were treated; one of the lowest surgical mortality rates in the world; over 8,000 cardiac surgeries performed; over 10,000 angioplasties, and over 4,000 interventional procedures; and zero deaths in redo bypass surgeries in the past two years.
80 per cent cardiovascular diseases related deaths now globally occur in low- and middle-income nations, which cover most countries in Asia. And India has come out as the best medical facility hub with one-tenth of the cost compared to Western countries.
Medical tourism (heart)
In the past few years, India has emerged as the first choice destination for cardiac surgery and health care, with rapidly expanding infrastructure and clinical expertise; the country is servicing health care needs of international patients. The most affordable surgery cost, and internationally-trained medical professionals are major facts why foreign patients select India. We are now highly regarded worldwide as a quality provider of medical facilities, and our cost advantage is a leading contender. The costs are nearly one-fifth to that in the West. A heart surgery in US costs $30,000, whereas in India a top-of-the-line health care facility is a mere $6,000. The combination of high quality, affordable surgery is attracting a regular stream of foreign patients to India. Moreover, the competence and skills of Indian doctors are being acknowledged abroad. 
It's not just cost savings or the high standard of medical care, the waiting list is much less for any treatment in India than anywhere else in the world. While you might have to wait several months to get a surgery done in US, in India it can be arranged within a week. Our fluent English-speaking ability is another major reason for medical tourists to seek healing in India.
I feel as you read this, you will sense some excitement as we surgeons ourselves feel when we discover some new secret of the human body and apply new methods of conquering heart disease. What is required most in men who want to become surgeons are a steady hand and a mind that reacts quickly and calmly in emergencies. The art of operating has to be hand-taught; each man must actually use the knife himself; he will have to do hundreds of operations before he is any good. And that takes a lifetime of patience and understanding. 

 About the writer: Dr. Ramakanta Panda, Cardio thoracic surgeon, Asian Heart Institute, Mumbai 
It takes exceptional aptitude, daring, perseverance of spirit and mastery over one's emotions to perform over 8,000 heart surgeries, even with a team of able assistants.
Perhaps that's why Dr. Ramakanta Panda has been hailed by his contemporaries as one of the highest-volume surgeons in the world.
Moreover, he has also been acknowledged for executing more than 700 repeat (re-do) bypass surgeries, as well as over 1,500 high-risk surgeries on patients given up as 'inoperable.'
It's small wonder then that Dr. Panda, Vice Chairman & Cardio Vascular Thoracic Surgeon at the Asian Heart Institute, Mumbai, is held in high esteem as being among the first surgeons in India to bring into operation the concept of 'total arterial revascularization.'
A pioneer in medical operations, he uses arterial conduits for bypass grafting, re-do coronary artery bypass, damaged hearts and cardiac remodeling.  He beats heart technique to achieve more than 99 per cent bypass surgeries, and uses only arterial conduits for bypass surgeries. His reputation as the safest and one of the most trusted cardiac surgeons in the world is testified by a mortality rate of 0.5 per cent in isolated bypass surgeries and the lowest complication rate in the country.
As Chief Cardiovascular Surgeon and Vice Chairmen of the Asian Heart Institute, his team is conducting the highest number of cardiac surgeries in Mumbai. Over the past 13 years, he is acting as consultant cardiovascular surgeon and has operated in most major hospitals in Mumbai - Jaslok, Breach Candy, Lilavati and Nanavati, to name just a few.
Dr. Panda was trained in cardiac surgery at the All India Institute of Medical Sciences, New Delhi, and concluded Fellowship training at the Cleveland Clinic, Ohio, in the United States. During his stint overseas, he worked as Registrar at the Harefield Hospital in England for a year, where he received training under Professor Magdi Yacoub, one of the world's foremost cardiac surgeons.
When it comes to winning awards, Dr Panda is at the forefront, too. The Government of India's Central Board of Taxes recently conferred on him the prestigious 'Rashtriya Sanman' (National Honour) award for being one of the highest taxpayers during 1994-95 and 1998-99 assessment years.
The renowned surgeon has been frequently profiled among the Top 5 cardiac surgeons in the country, and is a popular speaker at national and international seminars where he has presented papers and chaired sessions. As a writer, he has shared his vast medical knowledge and experiences in Indian and foreign publications.
Engrossed as he is in his professional duties, his heart and mind is never far removed from the cravings of the poor and needy. As a supporter of good causes and his concern for the welfare of fellow human beings, he has helped many poverty-stricken patients by waiving his professional charge.
He has also founded the Asian Heart Charitable Trust (where? name the town), and in his home state of Orissa, he has established the Sarla Madan Charitable Trust (where? name the town). A surgeon-cum-philanthropist, Dr. Panda's got his 'Heart' in the right place!