Best Cardiothoracic & Vascular Treatment & Surgery

PACE Hospitals provides integrated cardiothoracic and vascular treatment services, combining medical management, interventional procedures, and advanced surgeries for complete patient care. 

Non-Pharmacological Management

These methods help stop disease progression, improve results, and aid recovery:

Lifestyle Modifications

• Smoking cessation: Quitting smoking improves blood vessel function, increases oxygen supply, and lowers the risk of conditions like atherosclerosis and peripheral arterial disease, as well as heart attack and stroke. 
• Regular physical activity: Exercise helps to strengthen the heart, improve circulation, and control blood pressure and cholesterol. It also reduces the risk of coronary artery disease and improves overall fitness.
• Heart-healthy diet: A low-salt, low-fat, high-fiber diet helps manage blood pressure and cholesterol, preventing conditions like Hypertension and reducing cardiovascular risks. 
• Weight management: Maintaining a healthy body mass index (BMI) decreases strain on the heart, lowers the risk of diabetes and high cholesterol, and helps prevent long-term cardiovascular diseases.
  
  

Risk Factor Control

• Blood pressure monitoring: Keeping blood pressure in check helps prevent hypertension. It also reduced the risk of heart disease. 
• Diabetes control: Managing blood sugar levels helps to prevent damage to blood vessels and lowers the risk of peripheral arterial disease (PAD) and coronary artery disease.
• Cholesterol management through diet: A nutritious diet lowers cholesterol and inhibits plaque accumulation, which reduces the risk of atherosclerosis and its effects.
  
  

Respiratory Support 

• Pulmonary Rehabilitation: A designed program of exercise and education that improves lung function and reduces shortness of breath (breathlessness), especially in conditions like COPD.
• Breathing Exercises: Help expand the lungs, strengthen respiratory muscles, and prevent complications like atelectasis, especially after surgery or in lung diseases.
• Oxygen Therapy: Provides extra oxygen to maintain proper levels in the body, reducing strain on the heart and improving breathing in severe lung or heart conditions.
  
  

Compression & Vascular Care 

• Compression Stockings: Improve blood flow and minimize edema to help control varicose veins and avoid DVT.
• Limb Elevation: This involves raising legs above the heart level decreases swelling, improves circulation, and alleviates venous discomfort.
  
  

Patient Education & Monitoring: 

• Regular Follow-ups: Regular check-ups allow doctors to track illness development, assess treatment efficacy, and make timely drug or therapy changes.
• Awareness of Symptoms: Recognising signs like chest pain and breathlessness allows early detection of emergencies.
• Postoperative Rehabilitation: Exercise, breathing methods, and instruction help to speed up recovery following surgery, increasing heart and lung function and overall quality of life.
  

Pharmacological Management 

Medications are used to manage symptoms, prevent complications, and stabilize disease:

Cardiac Medications

• Antiplatelets: Antiplatelet medications help prevent blood platelets from sticking together and forming clots inside blood vessels. This is especially important in conditions where arteries are narrowed. By reducing clot formation, antiplatelets lower the risk of heart attacks and strokes and are commonly used in patients with coronary artery disease or after procedures like stent placement.
• Anticoagulants
•  Anticoagulants, often called blood thinners, work by slowing down the blood clotting process. They are used to prevent and treat conditions where harmful clots can form, such as DVT and pulmonary embolism. These medications help prevent clots from growing larger and reduce the risk of complications.
• Beta-blockers: Beta-blockers are medications that reduce the heart rate and lower blood pressure by blocking the effects of stress hormones on the heart. This reduces the workload on the heart and improves its efficiency. They are commonly used in conditions such as Hypertension, heart failure, and after heart attacks, helping to prevent further cardiac events and improve long-term outcomes.
• ACE inhibitors / Angiotensin II Receptor Blockers (ARBs): These medications help to relax blood vessels and lower blood pressure by affecting the hormonal system that regulates blood pressure (the renin-angiotensin system). By reducing strain on the heart and improving blood flow, these medications are widely used in conditions like hypertension, heart failure, and chronic kidney disease. They also help prevent damage to blood vessels and reduce the risk of complications such as heart attack and stroke.
• Statins: Statins lower cholesterol levels in the blood, particularly low-density lipoprotein (LDL or “bad cholesterol”). High cholesterol contributes to the development of atherosclerosis, where fatty deposits narrow the arteries. By reducing cholesterol levels, statins help prevent plaque formation, stabilise existing plaques, and lower the risk of heart attacks, strokes, and other cardiovascular complications.
• Diuretics: Diuretics help the body to eliminate excess salt and water through urine. This reduces fluid buildup in the body and decreases the workload on the heart. They are widely used in conditions such as heart failure, hypertension, and certain lung-related conditions where fluid accumulation occurs. 
• Antiarrhythmics: These are used to control abnormal heart rhythms (arrhythmias) by regulating the electrical activity of the heart. They help restore a normal heart rhythm or prevent irregular heartbeats from recurring. Antiarrhythmics are used in conditions such as atrial fibrillation, ventricular arrhythmias, and other rhythm disorders. By maintaining a stable heart rhythm, antiarrhythmics reduce symptoms and the risk of serious complications.
  
  

Pulmonary Medications

• Bronchodilators: Bronchodilators are medications that relax the muscles around the airways, helping them open up and making breathing easier. They are commonly used in conditions like COPD and asthma, where airway narrowing causes breathlessness.
• Corticosteroids: These are anti-inflammatory medications that reduce swelling and irritation in the airways and lung tissues. They are widely used in inflammatory lung conditions such as asthma, COPD, and interstitial lung diseases. By controlling inflammation, corticosteroids help make breathing easier, lower the number of flare-ups, and stop more lung damage.
• Antibiotics: These treat cardiothoracic and vascular diseases by killing or inhibiting the growth of bacteria responsible for infections affecting the heart, lungs, or blood vessels. They are used for conditions like infective endocarditis, pneumonia, and certain vascular infections. Antibiotics help in controlling the infection, reducing inflammation, preventing further tissue damage, and lowering the likelihood of severe consequences. 
• Antifibrotic drugs: These medications are specialized medications used to slow down the progression of lung scarring (fibrosis), particularly in conditions like pulmonary fibrosis. These medications help lower scar tissue buildup in the lungs. This helps maintain lung function and slows down the disease progression. However, these medications do not cure the disease but play an important role in improving the quality of life and delaying the worsening of symptoms.
  
  

Vascular Medications

• Vasodilators: Vasodilators are medications that relax and widen blood vessels by improving blood flow throughout the body. By reducing resistance in the vessels, they lower blood pressure and decrease the workload on the heart. These drugs are commonly used in conditions like hypertension, heart failure, and angina. Improved blood flow helps deliver more oxygen to tissues and reduces symptoms such as chest pain and shortness of breath.
• Thrombolytics: Thrombolytics are used to dissolve existing blood clots in blood vessels. These are critical in emergency situations such as acute myocardial infarction, stroke, and pulmonary embolism. These medications are used to break down clots quickly, restore blood flow to affected organs, reduce tissue damage, and improve survival outcomes when administered promptly.
• Antihypertensives: These medications helps by lowering high blood pressure, which reduces strain on the heart and blood vessels. When blood pressure is consistently high, it can damage artery walls, lead to narrowing or blockages, and increase the risk of conditions like heart attack, heart failure, stroke, and aortic disease. These medications work through different mechanisms—some relax and widen blood vessels (vasodilators), some reduce the heart's workload by slowing the heart rate (beta-blockers), while others help remove excess salt and water from the body (diuretics), thereby lowering blood volume.

They are essential in managing diseases such as hypertension, coronary artery disease, heart failure, and peripheral artery disease, and also play a key role in preventing disease progression and improving long-term outcomes.

Minimally Invasive Procedures (Endovascular / Catheter-Based / Thoracoscopic)

These procedures offer faster recovery, less pain, and smaller incisions:

Cardiac Procedures

• Angioplasty (PTCA) with Stenting: Angioplasty is performed when the coronary arteries become narrowed or blocked due to plaque buildup. A thin catheter with a small balloon is guided to the blockage, where the balloon is inflated to compress the plaque against the artery walls. A stent is then placed to keep the artery open permanently. This procedure restores proper blood flow to the heart muscle, reduces chest pain, improves exercise tolerance, and significantly lowers the risk of heart attacks and long-term heart damage.
• Transcatheter Aortic Valve Replacement (TAVR/TAVI): TAVR is a minimally invasive procedure used to treat severe aortic stenosis, where the aortic valve becomes stiff and narrowed, restricting blood flow from the heart. A catheter is used to supply a replacement artificial valve, which is typically entered through the femoral artery in the groin and placed inside the damaged valve. Once in place, it starts functioning immediately, improving blood flow throughout the body. This reduces symptoms such as breathlessness, chest pain, and fainting, and is especially beneficial for patients who are not suitable for open-heart surgery.
• Balloon Valvotomy: Balloon valvotomy, also called balloon valvuloplasty, is used to treat narrowed heart valves, particularly the mitral valve. A catheter with a balloon is passed through the blood vessels into the heart and positioned across the narrowed valve. When the balloon is inflated, it stretches and opens the valve leaflets, improving blood flow between heart chambers. This helps relieve symptoms like shortness of breath, fatigue, and palpitations, and can delay or avoid the need for valve replacement surgery.
• Electrophysiology Study & Catheter Ablation: An electrophysiology (EP) study is performed to understand the electrical activity of the heart and detect abnormal pathways causing arrhythmias. Once the exact source of the irregular rhythm is located, catheter ablation is performed using heat (radiofrequency) or cold (cryoablation) energy to destroy the faulty tissue. This procedure helps to restore normal heart rhythm, reduces symptoms like palpitations, dizziness, or fainting, and also eliminates the need for long-term medications.
• Pacemaker / ICD Implantation: Pacemakers and Implantable Cardioverter Defibrillators (ICDs) are tiny electronic devices implanted under the skin, usually near the chest. A pacemaker sends electrical signals to maintain a normal heart rate when the heart beats too slowly. An ICD continuously monitors the heart rhythm and can deliver a life-saving shock if a dangerous fast rhythm is detected. These devices help prevent complications such as fainting, worsening heart failure, and sudden cardiac death, thereby improving both survival and quality of life.
• Minimally invasive coronary artery bypass: This is a surgical procedure is used to treat coronary artery disease without performing a full open-chest surgery. Instead of making a large incision, the surgeon accesses the area through small cuts between the ribs, often without stopping the heart. A healthy blood vessel is grafted to bypass the blocked coronary artery, restoring blood flow to the heart muscle. This method has benefits like less pain, reduced blood loss, shorter hospital stays, and faster recovery. It effectively relieves symptoms such as chest pain and lowers the risk of a heart attack.

Thoracic Procedures

Video-Assisted Thoracoscopic Surgery (VATS): VATS is performed using small incisions, a tiny camera, and specialised instruments. The camera used helps to provide a clear view of the lungs and chest cavity on a monitor, allowing surgeons to operate precisely without opening the chest widely. It is used to treat conditions such as lung tumors, infections, pleural diseases, and pneumothorax. VATS reduces pain, shortens hospital stay, and speeds up recovery.

Thoracoscopic Lung Biopsy /Lobectomy: Thoracoscopic lung biopsy is performed to obtain a small sample of lung tissue for diagnosing conditions like lung infections, interstitial lung disease, or cancer. When a larger diseased portion needs removal, a lobectomy (removal of a lung lobe) is performed, often using a thoracoscopic approach. By removing abnormal or cancerous tissue, these procedures help confirm diagnosis and prevent disease progression. 

Pleural Drainage Procedures: This is a procedure used to remove abnormal air, fluid, blood, or pus from the space between the lungs and the pleural cavity. This is commonly done using a chest tube or catheter. Draining these collections causes the lung to re-expand properly and relieves symptoms such as breathlessness and chest discomfort. These procedures are essential in conditions like pleural effusion, pneumothorax, or empyema, and help restore normal lung function.

Vascular Procedures

• Endovascular Aneurysm Repair: Endovascular Aneurysm Repair (EVAR) and Thoracic Endovascular Aneurysm Repair (TEVAR) are minimally invasive procedures used to treat aneurysms in the abdominal and thoracic aorta. In these procedures, a stent-graft is delivered through a catheter inserted via a small incision in the groin and guided to the weakened portion of the artery. Once positioned, the stent-graft reinforces the vessel wall and creates a new pathway for blood flow, reducing pressure on the aneurysm and preventing rupture. This approach avoids open surgery, leading to faster recovery, less blood loss, and reduced complications while effectively managing life-threatening vascular conditions.
• Peripheral Angioplasty & Stenting: These are used to treat narrowed or blocked arteries in the limbs, commonly due to peripheral artery disease (PAD). During the procedure, a thin catheter with a balloon is inserted into the affected artery and inflated to widen the narrowed segment. In many cases, a stent is placed to keep the artery open and maintain proper blood flow. This procedure relieves symptoms such as leg pain (claudication), improves mobility, and prevents serious complications like tissue damage or limb loss. 
  
• Carotid Artery Stenting: Carotid artery stenting is used to treat narrowing of the carotid arteries, which supply blood to the brain. This narrowing is usually caused by plaque buildup (atherosclerosis) and increases the risk of stroke. During the procedure, a catheter is inserted through the groin and guided to the affected carotid artery. A small balloon may be inflated to open the narrowed segment, and a stent is placed to keep the artery open. This improves blood flow to the brain and significantly reduces the risk of stroke, especially in patients who are not ideal candidates for open surgery.
• Endovenous Laser Therapy (EVLT) / Radiofrequency Ablation (RFA): Both are used for varicose veins. In these procedures, a thin catheter is inserted into the affected vein, and heat energy (either laser or radiofrequency) is applied to seal the damaged vein from within. Once closed, blood is naturally redirected to healthy veins, which improves blood circulation. This helps relieve symptoms such as pain, swelling, heaviness, and visible vein bulging, while also preventing complications like skin changes or ulcers.
• Sclerotherapy: Sclerotherapy is a non-surgical procedure used to treat small varicose veins and spider veins. This method includes injecting a solution directly into the afflicted veins, causing them to expand and collapse before being absorbed by the body. As treated veins diminish, blood flow is diverted to healthier veins, resulting in better overall circulation. This procedure not only enhances cosmetic appearance but also reduces symptoms. It is a quick outpatient treatment with minimal downtime and high success rates.
• Catheter-directed thrombolysis: This is a minimally invasive procedure that helps dissolve blood clots in arteries or veins. It is often used for conditions like deep vein thrombosis or acute arterial blockage. In this method, a thin catheter is carefully guided to the location of the clot. Clot-dissolving medications, known as thrombolytics, are delivered directly into the clot. This focused approach breaks down the clot more effectively and reduces the chance of side effects throughout the body. By restoring blood flow fastly, the procedure eases symptoms like pain and swelling, helps prevent tissue damage, and decreases the risk of serious complications such as pulmonary embolism (PE) or limb ischemia.
  

Open Surgical Procedures (Major Surgeries)

These are performed for complex or advanced diseases requiring direct surgical correction.

Cardiac Surgeries

• Coronary Artery Bypass Grafting (CABG): Heart bypass surgery is an open-heart surgical procedure used to treat severe coronary artery disease, where the arteries supplying blood to the heart are significantly narrowed or blocked. In this procedure, a healthy blood vessel is grafted to bypass the blocked coronary artery. This creates a new pathway for blood to flow to the heart muscle, improving oxygen supply. CABG helps relieve symptoms like chest pain (angina), improves heart function, and reduces the risk of heart attack and other serious cardiac complications, especially in patients with multiple or complex blockages.
• Heart Valve Repair or Replacement Surgery: Heart valve surgery is performed to treat damaged or diseased heart valves that do not open or close properly, which affects normal blood flow through the heart. In valve repair, the existing valve is preserved and corrected to function normally, while in valve replacement, the damaged valve is replaced with either a mechanical or biological (tissue) valve. These procedures restore correct blood flow, minimise cardiac strain, and alleviate symptoms like shortness of breath, fatigue, and edema. Prompt intervention helps to prevent complications and further structural damage to the heart.
• Congenital Heart Defect Repair: Congenital heart defect repair is performed to correct structural abnormalities of the heart present from birth, such as Atrial Septal Defect (ASD), Ventricular Septal Defect (VSD), and Tetralogy of Fallot (TOF). Surgical repair involves closing holes, reconstructing abnormal pathways, or correcting valve and vessel defects. This surgery restores normal circulation, improves oxygenation, supports normal growth and development, and prevents long-term complications.
  
• Aortic Root Replacement / Aortic Surgery: Aortic root replacement and other aortic surgeries are performed to treat serious conditions affecting the aorta like aortic Aneurysm or aortic dissection. In this procedure, the diseased portion of the aorta is replaced with a synthetic graft to restore the strength and function of the vessel. This prevents life-threatening complications like rupture or impaired blood flow to the vital organs. By stabilising the aorta and ensuring proper circulation, the surgery significantly improves survival and reduces the risk of sudden cardiovascular emergencies.

Thoracic Surgeries

• Thoracotomy (Open Chest Surgery): Thoracotomy is a major surgical procedure in which an incision is made in the chest wall to access organs such as the lungs, heart, esophagus, or major blood vessels. It is performed to treat several conditions such as lung tumors, severe infections, chest trauma, or complex cardiothoracic diseases. This provides direct visualisation and access to the thoracic cavity. Thoracotomy surgery allows surgeons to remove diseased tissue, control bleeding, or repair damaged structures. Although it is more invasive than minimally invasive techniques, but often essential for managing advanced or complicated conditions effectively.
• Lung Resection: Lung resection refers to the surgical removal of a diseased portion or the entire lung, most commonly performed for conditions like lung cancer, severe infections, or damaged lung tissue.
  
• Lobectomy: This involves the removal of one lobe of the lung (the lungs are divided into lobes). It is the most common type of lung resection, especially for early-stage lung cancer. By removing only the affected lobe, the procedure preserves as much healthy lung tissue as possible while effectively eliminating the diseased area, helping improve breathing and preventing the spread of disease.
  
• Pneumonectomy: A pneumonectomy is a major surgical procedure to remove an entire lung. It is most commonly performed to treat lung cancer, but it may also be necessary for severe lung damage caused by injury or chronic infections like tuberculosis. This surgery reduces overall lung capacity, but it can be life-saving by completely removing the diseased lung and preventing further complications or spread of disease.
  
• Mediastinal Tumor Surgery: This is performed to remove abnormal growths located in the mediastinum, which is the central compartment of the chest between the lungs that contains the heart, trachea, esophagus, and major blood vessels. These tumors may be benign or malignant, such as thymoma, lymphomas, or germ cell tumors. Surgical removal relieves pressure on surrounding important tissues, improves breathing and swallowing problems, and prevents tumor spread. Depending on the size and location, the surgery may be performed through open techniques or a minimally invasive technique.
  
• Esophagectomy: Esophagectomy is a major surgical procedure used to treat diseases of the esophagus, most commonly esophageal cancer or severe, non-functioning esophageal conditions. In this procedure, a part or the entire esophagus is removed, and the stomach (or sometimes a section of the intestine) is used to reconstruct the food passage. This eliminates cancerous or diseased tissue, restores the ability to swallow, and improves nutrition. Esophagectomy surgery plays an essential role in managing advanced esophageal diseases and can significantly improve survival and quality of life.

Vascular Surgeries

• Open Aortic Aneurysm Repair: Open aortic aneurysm surgery is a major surgical procedure used to treat a weakened and bulging section of the aorta, known as an aortic aneurysm. In this procedure, the surgeon makes an incision in the chest or abdomen to directly access the affected part of the aorta. The damaged segment is then replaced with a synthetic graft, which restores the strength and normal function of the blood vessel. This surgery prevents life-threatening complications and ensures proper blood flow to vital organs, making it a definitive treatment for large or high-risk aneurysms.
  
• Carotid Endarterectomy: This is a procedure performed to remove plaque buildup from the carotid arteries, which are the arteries that supply blood to the brain. This condition, known as carotid artery disease, increases the risk of stroke. During the procedure, an incision is made in the neck and the inner lining of the artery, as well as the plaque, is carefully removed to restore normal blood flow. This procedure greatly reduces the risk of stroke and improves blood flow to the brain, particularly in patients with severe narrowing or symptoms such as transient ischemic episodes (TIAs).
  
• Peripheral Bypass Surgery (e.g., femoral-popliteal bypass): Peripheral bypass surgery is performed to treat severe blockages in the arteries of the limbs, commonly caused by peripheral artery disease. In this procedure, a healthy blood vessel (from the patient or a synthetic graft) is used to create a new pathway around the blocked artery, restoring blood flow to the affected limb. For example, in a femoral-popliteal bypass, blood is rerouted from the thigh artery to the artery behind the knee. This improves oxygen supply to tissues, relieves symptoms like leg pain and non-healing wounds, and helps prevent serious complications such as tissue loss or amputation.
  
• Embolectomy / Thrombectomy: These are emergency procedures performed to remove a blood clot (embolus or thrombus) that is obstructing a blood vessel. Such blockages can occur in either arteries or veins and may lead to conditions like deep vein thrombosis or acute limb ischemia. During the procedure, the surgeon gains access to the affected vessel and removes the clot using specialized instruments or catheters, restoring normal blood flow. Prompt treatment helps prevent tissue damage, relieves pain and swelling, and reduces the risk of serious or life-threatening complications.
  
• Vascular Graft Surgeries: Vascular graft surgeries involves replacing or bypassing damaged or blocked blood vessels using artificial grafts or natural vessels. These operations are employed in cases of severe arterial blockages, aneurysms, or traumatic vascular injury. The graft serves as a new conduit for blood flow, ensuring adequate circulation to important organs and tissues. Vascular graft procedure help to relieve symptoms, prevent complications like organ damage or ischemia, and improve overall vascular health, especially in advanced or complex cardiovascular diseases.

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Consult us for a free second opinion on treatment.

At PACE Hospitals, we are committed to providing our patients with the best possible care, and that includes offering second medical opinions with super specialists for treatment or surgery. We recommend everyone to get an expert advance medical second opinion, before taking decision for your treatment or surgery.