Best ECMO Doctors in India

Profile Highlights:

  • Dr. Rajesh Sharma is one of the most experienced and widely acclaimed Cardiothoracic and Vascular surgeons specializing in pediatric cardiac surgery in India.
  • He provides treatment for both adult and pediatric heart diseases and disorders and focuses primarily on complex congenital heart diseases.
  • Dr. Sharma’s expertise lies in infant and Neonatal cardiac surgery, surgery for transposition of the great arteries, Fontan circulation, and acquired heart diseases.
  • His experiences encompass over 3 decades during which he has performed over 20,000 heart surgeries including congenital heart disorders as well as acquired heart defects.
  • Dr. Rajesh Sharma did his fellowship training in pediatric cardiovascular surgery from premier institutes in the USA and has used his knowledge and skills to take up several complex cardiac cases and deliver excellent results.
  • Along with his practice, Dr. Sharma has also been involved in teaching and training undergraduate and postgraduate students and started his career as a faculty with AIIMS, Delhi. He has also mentored cardiac surgery trainees who are now well-established surgeons in various parts of India.
  • Dr. Rajesh Sharma has contributed immensely to the field of pediatric cardiac surgery in India and has various publications to his name in renowned national and international scientific journals.

Profile Highlights:

  • Dr. Krishna Subramony Iyer is one of the best Pediatric Cardiac surgeons in India and specializes in congenital heart diseases.
  • He has been practicing pediatric cardiac surgery for over 4 decades and has performed more than 10,000 surgeries through various procedures like double switch operation TAPVC repairs, Fontan and Fontan, arterial switch, and DORV.
  • Dr. Iyer has been associated with Escorts Heart Institute for a long time and is responsible for establishing the first pediatric cardiac care program in North India in 1995.

Profile Highlights:

  • Dr. Kulbhushan Singh Dagar, a pioneer and an expert in the cardiology field earned his reputation through his exceptional performance in the field of complex congenital heart defects, especially for newborns.
  • With over 21 years of experience, Dr. Dagar has dedicatedly performed complex surgical procedures by implementing innovative techniques and cutting-edge technologies in his procedures and is currently considered an asset to the cardiac industry, not just nationally, but internationally too!

Profile Highlights:

  • Dr. Praveen Chandra is one of the most well-known and respected Interventional Cardiologists in India and performs over 5000 percutaneous and diagnostic interventions every year.
  • He specializes in devising techniques that help minimize open surgeries. Dr. Praveen Chandra performed the first Percutaneous Aortic Valve implantation without surgery in India.
  • He also developed techniques to reduce the number of patients requiring bypass surgeries and has been trying to make angioplasty techniques more accurate to help with the treatment of multiple blocked arteries.

Profile Highlights:

  • Dr. Z S Meharwal is a well-known cardiac surgeon in India who has performed more than 20,000 cardiac surgeries in his career that including some of the most complex and high-risk cardiac procedures.
  • Dr. Meharwal is a member of the founding team that started the Fortis Escorts Heart Institute and has been associated with the hospital since then.
  • His interest lies in Minimally Invasive Cardiac procedures, valve repair, and replacement, and heart transplants among other major vascular and thoracic surgeries.

Profile Highlights:

  • Dr. Bhaba Nanda Das is a well-known cardiovascular and cardiothoracic surgeon and has performed the first Coronary Artery Bypass Grafting (CABG) on a beating heart in India.
  • He has performed over 20,000 cardiac surgeries and does more than 800 cardiac surgeries annually.
  • With a keen interest in cardiovascular and thoracic procedures, Dr. Das is the first cardiac surgeon to use all arterial grafts for multiple coronary revascularizations. He was also the first to use coronary sinus in Fontan’s circulation.

Profile Highlights:

  • Dr. T S Kler is undoubtedly one of the best vascular surgeons not only in India but also abroad. He has performed more than 25,000 Surgeries in his life which makes him stand where he is.
  • He is a pioneer in electrophysiology & he established the first dedicated Electrophysiology department in India at Fortis Escorts Heart Institute.
  • Dr. T S Kler initiated a radio Frequency Ablations programme at Escorts in 1993, one of the first of its kind in India. He was the first doctor in India to implant an ICD, CRT-P & CRT-D.

Profile Highlights:

  • Dr. Ashutosh Marwah is one of the best child heart specialists in India, having experience of over 26 years.
  • He was the former Assistant Director of Jaypee Hospital and is now practicing at Indraprastha Apollo Hospital in New Delhi.
  • Dr. Ashutosh Marwah has expertise in treating complex cardiac defects, Interventional & perioperative cardiac catheterizations, dilatation stenting, fetal echocardiography, Aortic Aneurysm, and Stent implantation.
  • He has Fellowships in Pediatric Cardiology from reputed hospitals like Escorts Heart Institute, Delhi, and Royal Children’s Hospital, Melbourne, improvised his skills.
  • Dr. Marwah published multiple research papers and articles in reputed medical journals of India and abroad. He is also a member of the Lions Club of Dar Es Salaam.

Profile Highlights:

  • Dr. Sandeep Attawar is a highly recognized Heart and Lung transplant surgeon in India who has over 2 decades of experience as a cardiac surgeon and has performed more than 10,000 cardiac surgeries on adult and pediatric patients.
  • Dr. Attawar specializes in all types of surgeries for adults as well as pediatric heart patients and finds interest in heart and lung transplant surgery, congenital heart surgery, Aortic aneurysm repair, and implantation of heart failure devices.

Profile Highlights:

  • Dr. Ajay Kaul is a leading name in the field of Cardiothoracic and Vascular Surgery in India with over 3 decades of experience.
  • He specializes in Coronary Bypass surgery and is one of the best with the highest number of total arterial coronary bypass surgery (4000+) by using two internal mammary arteries from the chest and without any cuts on arms and legs.
  • He is also an expert in minimally invasive cardiac surgeries (MICS) and has performed more than 4000 MICS which is the highest by any cardiac surgeon in India.

Best ECMO Hospitals in India

Indraprastha Apollo Hospital, New Delhi

Hospital Highlights:

  • Indraprastha Apollo Hospital is a 700-bedded multispecialty hospital in the heart of the capital of India. It is a part of Apollo Hospital group, one of India’s most reputed healthcare chains. Indraprastha Apollo Hospital has been accredited by Joint Commission International, making it the first internationally accredited hospital in the country in 2005.
  • There are 52 specialties in the hospital with one of the best cardiology centers in the country. The hospital is also equipped with State of the art infrastructure facilities with the largest Sleep Lab in Asia and the largest number of ICU bed facilities in India.
  • The hospital also has one of the largest dialysis units in India along with a dedicated Bone Marrow Transplant unit.
  • The latest and highly advanced technologies that are installed in the hospital include Da Vinci Robotic Surgery System, PET-MR, PET-CT, Cobalt-based HDR Brachytherapy, Brain Lab Navigation System, Tilting MRI, Portable CT scanner, 3 Tesla MRI, 128 Slice CT scanner, DSA Lab, Endosonography, Hyperbaric Chamber and Fibro scan.

Fortis Memorial Research Institute, Gurugram

Hospital Highlights:

  • Fortis Memorial Research Institute is a multi-super-specialty, quaternary care hospital with 1000 beds. The hospital comprises reputed clinicians, and international faculty and is also equipped with cutting-edge technology. The hospital is a part of Fortis Healthcare Limited, a reputed chain of private hospitals in India.
  • It is a NABH-accredited hospital that is spread across 11 acres of land and has a capacity of 1000 beds. The hospital has 55 specialties and is one of the premier health care centers in the Asia Pacific region popularly known as “the Mecca of Healthcare”.
  • The hospital has 260 diagnostic centers and is also equipped with the latest and advanced techniques that include 3 Telsa which is the world’s first Digital MRI technology. The hospital also has world-class Radiation Therapy techniques which have been developed by leading technology experts from Elekta and Brain Lab.

Apollo Hospital, Chennai

Hospital Highlights:

  • Apollo Hospitals, Chennai, is one of the best hospitals for heart care in India. Over the years, Apollo has expanded all over India, as a healthcare chain.
  • India’s first ‘Only Pancreas’ transplant was performed in Apollo Hospital. The hospital is known for successfully performing Asia’s first en-bloc combined heart and liver transplant, and over the years, it has attained a remarkable achievement in the global healthcare space. Around 3-4 organ transplants are performed in the hospital per day.
  • Equipped with over 500 beds, this hospital in Chennai was established in 1983 and since then has been among the most preferred hospital for patients from all over the world.
  • The hospital holds accreditation of the NABH and JCI and is the first hospital in India to be ISO 9001 and ISO 14001 certified. It is also the first South Indian Hospital to receive subsequent reaccreditation from the JCI USA 4 times.

Medanta-The Medicity, Gurgaon

Hospital Highlights:

  • One of India’s best and largest multi-specialty hospitals, Medanta was built with the aim to bring India to the highest standards of medical care. The hospital has been providing the best medical services to its patients, since its inception, with care, commitment, and compassion.
  • Equipped with 1250 beds, the hospital was founded by Dr. Naresh Trehan in the year 2009 with an aim to provide the best medical care at affordable costs. The hospital is spread across 43 acres and includes 45 operation theatres and 350 beds dedicated solely to ICU. The hospital includes over 800 doctors, and more than 22 specialty departments and has a dedicated floor for individual specialty in order to offer the best services under one roof.
  • The hospital is considered one of the premier institutes in India for Cardiac Care and includes staffs and members of high caliber. The hospital has 6 distinct centers of excellence.

Max Super Specialty Hospital, New Delhi

Hospital Highlights:

  • One of the well-regarded providers in India committed to the highest standards of clinical excellence and patient care, Max Super Specialty Hospital is a part of Max Healthcare, which is the second-largest healthcare chain in India. Regarded as one of the most well-regarded healthcare providers in the country, Max Super Specialty Hospital is committed to the highest standards of clinical excellence as well as patient care. The hospital is also equipped with the latest technology as well as cutting-edge research. The hospital is known to deliver and ensure the highest level of patient care.
  • The hospital has more than 500 beds and offers treatment for over 35 specialties. The hospital also holds the credit of having installed the first Brain Suite in Asia. This is a highly advanced Neurosurgical machine that allows MRI to be taken while surgery is ongoing.
  • Other advanced and latest technologies are also installed in the hospital such as the 1.5 Tesla MRI machine, 64 Slice CT Angiography, 4D ECHO, LINAC, and 3.5T MRI machine.

Artemis Hospital, Gurugram

Hospital Highlights:

  • One of the most well-known hospitals in the Delhi NCR, Artemis Hospital is the first hospital in Gurugram to get accredited by the Joint Commission International.
  • With more than 40 specialties, the hospital has been designed to be one of the most technically advanced hospitals in the country, with the best medical and surgical health care. The hospital has eleven special and dedicated centers, for Heart, Cancer, Neurosciences, etc.
  • The latest technologies in the hospital include Endovascular Hybrid Operating Suite and Flat panel Cath Labs for the cardiovascular department, 3 Tesla MRI, 16 slice PET CT, 64 Slice Cardiac CT Scan, HDR Brachytherapy, and highly advanced Image Guided Radiation Therapy techniques (LINAC) are installed in the hospital.
  • The hospital has won several awards as well, since its inception.

BLK Max Super Specialty Hospital, New Delhi

Hospital Highlights:

  • Equipped with 650 beds, BLK Superspecialty Hospital is the largest stand-alone private sector hospital in Delhi.
  • With over 1500 healthcare providers and 150 globally renowned super specialists, the hospital is one of Asia’s largest Bone Marrow Transplant Centres. The hospital is known for having some of the best cancer doctors in the country.
  • The hospital is NABH and NABL accredited and was inaugurated by the first Prime Minister of India. Pt. Jawahar Lal Nehru.

Gleneagles Global Hospitals, Chennai

Hospital Highlights:

  • Established in 1999, Gleneagles Global Hospital, Chennai, is one of the top healthcare facilities in Southern India. It is part of the Gleneagles Hospital Chain, which is the fourth largest healthcare chain in the country. The hospital specializes in multi-organ transplants of kidneys, liver, lungs, heart, etc.
  • The hospital has an excellent infrastructure and state-of-the-art lab and equipment set-up. The hospital boasts cutting-edge technologies, a highly skilled team of doctors and surgeons, and trained support staff. Located in Perumbakam, Chennai, it is one of India’s premier health care destinations. The hospital has performed some of the most complex surgical and clinical procedures in India including multi-organ transplantations.
  • The hospital’s lung transplantation program is one of the best in the country. The hospital is known for having performed India’s first single lung transplant and first minimal invasive lung transplant. It is also the only Indian hospital to be associated with King’s College Hospital, London, United Kingdom for liver transplantations.

Fortis Hospital, Mulund, Mumbai

Hospital Highlights:

  • Fortis Hospital in Mulund is a 315-bed multi-speciality tertiary care hospital with five JCI accreditations that offers a wide variety of diagnostic and therapeutic services. The Fortis Hospital in Mulund delivers patient-centred treatment with cutting-edge technology, highly skilled and experienced surgeons, and paramedical staff.
  • This institution houses Maharashtra’s largest multi-organ transplant centre. It is also the first heart transplant centre in western India to conduct 100 or more consecutive heart transplants in under four years. It is the only hospital in the city to have multi-organ transplants and has handled the youngest patient for angioplasty. Fortis Hospital Mulund now boasts the first advanced surgical robot in central Mumbai.
  • Cardiology and heart surgery, urology, nephrology, neurosciences, orthopaedics, digestive care, emergency and critical care, and maternity care are among the services provided by the hospital.

Kokilaben Dhirubhai Ambani Hospital, Mumbai

Hospital Highlights:

  • Kokilaben Dhirubhai Ambani Hospital, Named after the wife of Indian industrialist Dhirubhai Ambani, the founder of Reliance Industries, this is one of the top hospitals in Mumbai. This 750-bed multi-specialty hospital became operational in 2009. Known as one of India’s most advanced tertiary care facilities, the hospital is designed to raise India’s global standing as a healthcare hub, with an emphasis on excellence in clinical services.
  • Kokilaben Dhirubhai Ambani Hospital uses Protocol and Care Pathway based treatment models to ensure the best outcomes for patients.
  • The hospital represents a confluence of top-notch talent, cutting-edge technology, state-of-the-art infrastructure, and, most importantly commitment.
  • The hospital also holds the accreditation of the NABH, NABL, CAP, and JCI.
  • The hospital has been recognized as the No. 1 Multispecialty Hospital in Mumbai and the West Zone for the fifth year in a row in 2020 by The Week.

Extracorporeal Membrane Oxygenation (ECMO)

ECMO or extracorporeal membrane oxygenation involves pumping the blood outside from your body into a heart-lung machine. The machine removes carbon dioxide and pumps back oxygen-filled blood into your body tissues. The flow of the blood is from the right side of your heart to the membrane oxygenator of the heart-lung machine that rewards and sends it back to your body. The procedure allows the organs to rest and heal while the blood bypasses your heart and your lungs. Usually used in infants with critical disorders of the heart and the lungs, you may also find its use for some other infections.

The method involves the use of a membrane oxygenator (acting as an artificial lung) that oxygenates the blood. It supplies oxygen to the blood and returns it to your body by combining with a warmer and a filter. Used for providing oxygenation while your doctor treats the disorder, it also benefits adults and older children.

Types and parts of ECMO

ECMO is of two types:

  • Veno-venous ECMO (VV ECMO)- It takes blood from the veins and returns the blood to the vein. This type of ECMO finds its application in supporting lung function.
  • Veno-arterial ECMO (VA ECMO)- It takes up the blood from one of the veins and returns the blood back to the artery. It supports the lungs as well as your heart. Being more invasive than veno-venous ECMO, there might be a need to close off the carotid artery (carotid artery is the main artery that extends from the heart to the brain).

 

Parts of ECMO include:

  • Cannulae- They are large tubes (catheters) that your doctor will insert into your blood vessels for taking up and returning the blood back to the body.
  • Membrane oxygenator- Used for oxygenating the blood, it is an artificial lung.
  • Warmer and filter- Its purpose is to warm and filter your blood before the cannulae or catheters return the blood back to your body.

 

The cannulae take up blood with less oxygen from your body and send it to the oxygenator during ECMO. The membrane oxygenator will then pump oxygen into your blood and send this oxygenated blood through the warmer & filter to finally return the blood to your body.

Reasons for ECMO

ECMO is for the people suffering from critically ill conditions of the heart and the lungs or recovering from a heart transplant and when other life support procedures didn’t work. If you are suffering from serious but reversible lung or heart disorders, then your doctor will place you on ECMO. For the newborns, it is beneficial as it allows their heart and lungs to develop. There is a substantial increase in the survival rates with ECMO. It helps your body by providing oxygen to your body tissues. You may need to go for ECMO during conditions enlisted here.

For infants:

  • ARDS (Acute Respiratory Distress Syndrome)
  • Congenital diaphragmatic hernia (if there is a defect in the diaphragm)
  • Pulmonary hypertension (high blood pressure present in the lungs)
  • Respiratory failure
  • Sepsis (an infection that can be life-threatening)
  • Pneumonia

 

For older children:

  • Severe pneumonia
  • Cardiac surgery
  • Toxic materials present in the lungs because of aspiration
  • Infections
  • Trauma
  • Asthma
  • Congenital heart defects

 

For adults:

  • Decompensated cardiomyopathy (heart muscle disease)
  • Severe hypothermia (low body temperature)
  • Acute myocardial infection (heart attack)
  • Carcinogenic shock (shock caused when the heart is unable to pump enough blood)
  • Myocarditis (presence of inflammation in the muscles of the heart)
  • Post-transplant complications
  • Pulmonary embolism (blockage in the pulmonary artery of the lungs)
  • Hantavirus pulmonary syndrome
  • Influenza (flu)

Preparation for ECMO

Your doctor will first check you before placing you on ECMO. He or she will perform a cranial ultrasound of your brain to ensure that there’s no bleeding. It will also determine if your heart is working. You might need to undergo a chest x-ray daily while on ECMO. Your doctor will prepare the equipment after determining if you need ECMO. A trained team will perform your ECMO. The team will include respiratory therapists, ICU registered nurses, consultants & support personnel, rehab specialists, perfusionists who specialize in performing ECMO and a 24/7 transport team.

What to expect?

During ECMO

During ECMO, your doctor will first discuss all the details of the procedure with you and/or your family. Your doctor will place the cannulae in your chest, neck or groin region depending on your age after giving you general anesthesia (sleep medicine). You will be sleeping due to the sedation while being on ECMO. ECMO will perform the function of the lungs or heart. Your doctor will monitor you closely during ECMO with the help of daily X-rays. Apart from this, the doctor will also be monitoring your:

  • Blood pressure
  • Heart rate
  • Oxygen levels
  • Respiratory rate

 

With the help of a ventilator and a breathing tube, your lungs will continue to work and remove the secretions from your body. You will continuously receive all the medications through intravenous catheters including heparin. Heparin prevents the clotting of blood while it travels during ECMO as it is a blood thinner. Your doctor will place you on ECMO for a minimum of three days to even a month, depending on your condition. However, the higher you are on ECMO, the higher is the risk associated with ECMO.

After ECMO

After noticing the improvements in your condition, your doctor will slowly reduce the amount of oxygenated blood that you receive through the ECMO and then wean you off from ECMO. Once you get off from this, your doctor will place you on a ventilator for a certain period of time. However, you will still require a regular follow-up for monitoring the underlying condition.

Results of ECMO

The severity of your underlying condition will determine the outcomes at large. Depending on your condition because of which you require ECMO, your doctor will explain to you how much helpful will the procedure be for you.

Risks of ECMO

The most common risks associated with ECMO are:

  • Coagulopathy (blood clotting disorder)
  • Seizures
  • Bleeding
  • Infection
  • Stroke (damage to the brain because of the bursting of blood vessels or blood loss)
  • Thromboembolism (blood clot)
  • Limb ischemia (loss of blood in the limbs)

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