Dr Sameer Pagad

Dr Sameer Pagad
Consultant Cardiologist, K J Somaiya Hospital Superspeciality Centre

Technological advances have made todays medical world grow by leaps and bounds. It has made surgeons operate with more precision and safety, writes Dr Sameer Pagad, Consultant Cardiologist, K J Somaiya Hospital Superspeciality Centre, for Elets News Network (ENN).

In my line of work, interventional cardiology; necessity has truly been the mother of intervention. Few other fields in medicine have made such quick progress as interventional cardiology.

Stents when they were introduced around a couple of decades ago were nothing but a metal mesh which helped maintain the patency of the vessel. Such rapid progress has been made with the advancements in technology that today we really have the state of the art stuff, thinner struts, drug elution, biodegradable polymer, to totally biodegradable stents.

The devices used to deliver stents safely have been constantly being upgraded and today we have much superior devices like rotablation (a burr with diamond chips embedded on the top which helps in chiselling our way through tough calcific lesions), cutting balloons (balloon with blades embedded on it which again helps give controlled cuts precisely to soften a tough lesion) and so on. And, all this is being done in an artery about 3 millimetre in diameter!

If not for the technical advances, all this was impossible. All these devices help the procedure of angioplasty to be safer and results to be more rewarding.

Another device, which never fails to fascinate me, is the pacemaker. I am yet to see a more intelligent device in the medical world. Not only does it regulate and drive the electrical impulse needed to generate a contraction in people with diseased electrical circuits of the heart; in todays devices it can detect faulty rhythms, correct them, give a shock if required, detect fluid accumulation in the lungs, synchronise the way the heart contracts, keep a track and record of every heartbeat since its implantation.

And all this happens when the size keeps decreasing with every up gradation. It is interesting to note that the first pacemaker implanted in humans, had the patient to be connected to the huge pacemaker externally and the patient had to literally wheel it with him! Now they are the size of a matchbox, implanted under the skin done in local anaesthesia!

Today, thanks to the technology, we are mimicking all what the surgeon does in an open heart surgery;percutaneously (via small punctures in the groin). Trans cutaneous aortic valve replacements (TAVR), Mitraclip (device which corrects a leaking valve), Watchman device (device which plugs a small chamber in the heart and prevents clot formation) all can be done percutaneously, thus decreasing patient morbidity significantly but with equal efficacy as an open heart surgery. Such is the pace at which advancements in medical technologies are being made, it keeps us doctors continuously on our toes to keep abreast of the very latest, in our eternal quest of giving the best to our patients.

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