Beauty of Cardio Thoracic Surgery and My Journey

https://www.ctsnet.org/home/slakhotia

I would love to share a bit about my profession and work of our team at Institute of Medical Sciences, BHU, Varanasi a tertiary care 2000 plus bedded university teaching hospital and medical college under Govt of India. I joined here in 2011 after I finished my MBBS in 1998 from Calcutta, MS Gen Surgery in 2003 from Rewa and MCh in cardiovascular and thoracic surgery from Kanpur in 2007. I worked at RML Hospital Delhi, LRS Institute of TB and RD Delhi, BM Birla Heart Research Centre, Calcutta and SSSH Hospital, Rajkot for my further experience in cardio thoracic surgery. During all this period of around 20 years (1992 -20011) I got chance to learn and learn more about medical sciences and then my speciality of heart and lung surgery. I was blessed to have some wonderful teachers , got enormous chances to see and work with some great surgeons of India during studies, residency, job, seminars and workshops. They all shaped my profession and future.

Since last many years working in government sector is like rowing a boat against a mountain stream, but yes at end of day when you see a kid smiling and saying thank u or a mother in joy to see her kid recovering or to see stopped heart beating again after surgery is over or to see a blue baby becoming pink after surgery, these are the moments which heal your all pains and sacrifices you have made in this journey. Getting chance to treat poorest of poor and mentor young bright minds of future doctors is a blessing and it overshadows the poor service conditions and other hardships of working in a government system .

Nothing happens without team , In our team there are around 20 members behind a successful heart surgery... anaesthetics, perfusionist, OT technicians, residents, assistants, ot nurses, icu nurses, paramedics, physiotherapists and many more. And mistake of any can lead to fatal outcome. So we all work as highly coordinated dedicated team where work is not guided by watch but by passion, with cardiac surgeon as team leader.

Sadly we are the only government centre doing these procedures between Lucknow and Patna, a geographical distance of around 500 kms and we roughly cater to a population of around 50 million for their cardiac and lung surgery needs. This results in enormous patient load on us.

Most of times our patients get financial help from prime minister or chief minister relief fund.

It’s a humble beginning and we feel happy that God gave us chance to serve humanity of this region and help in laying down foundations of Open Heart Surgery programme in this part of India.

Our team has now done more than 1000 successful open heart surgeries which includes many complex congenital heart surgeries, valvular replacements and repairs, CABG , cardiac tumours etc. Apart from cardiac, our department is one of very few centres in India where lung surgeries are also being done in large numbers. I am thankful and grateful to all, especially Prof Damyanti Agrawal Madam for giving me enormous opportunities to contribute in the development of our department.

Around 25 years back, in the spring of 1991, idea of becoming a Doctor dawned on me as one of my friends suggested me that if I love helping needy and poor, then I should choose medical profession. Since then after joining medical college in 1992, dream of touching a live human heart fascinated me and my romance with heart came true twelve years after in 2004, when I joined MCh residency. After that God has given me fascinating opportunity to touch, see and feel thousands of human heart , which is core of our life, which if beats we are there and which if stops … we are no more.

A typical day in cardiac surgery is filled with variety of emotions ranging from joy to happiness to grief to frustration and anger to excitement and satisfaction. Training, working and then getting established in field of cardiac surgery is like rowing a boat against a mountain stream, full of uncertainty, frustrations and sacrifices in personal life but at the end of day when you see a kid smiling and saying thank you … or a mother in joy to see her baby recovering or a baby becoming pink from blue … or to see stopped heart beating again after surgery … These are the moments which actually heal all your sacrifices, struggle and pain you have made in this journey.

Opening the sternum, seeing the heart beating, then cannulating, going on Cardio Pulmonary Bypass, arresting the heart, cooling it, operating inside the heart, repairing it, constructing pathways in it, replacing damaged structures , doing various anastomosis, closing it back, removing air from heart chambers, reperfusing the heart, seeing it beat again, weaning from CPB, removing cannulas, hemostasis and closing back the sternum are the various steps involved in Cardiac surgery. And then starts the equally important post operative care which may extend from few hours to many days. There are hardly any U turns, a small error in any step by any of team members can lead to high morbidity or mortality.

Taking a lecture class of Final Year students

PROFESSIONAL CONTRIBUTIONS:

1. Great role in establishing the regular open heart surgery programme along with our team at Institute of Medical sciences, BHU, Varanasi .

2. Construction of state of art cardiac surgery ICU in IMS, BHU 2011-12

3. Starting of MCh in CTVS programme in IMS, BHU 2013

4. Starting of Diploma in Extracorporeal Perfusion Technology in 2015

5. Construction of state of art thoracic surgery ICU in IMS, BHU 2016

6. In charge , planning and designing of CTVS wing in centenary super speciality hospital, BHU

7. Member and/or Chairman of DPC and PPC of department, hospital

PPC and other bodies from time to time.

8. Purchase of new equipments for continuous up gradation of CTVS department.

9. Administrative responsibility as Head 2017-2020 and May 2024 till date.

10. Starting of new course PDCC in Thoracic Surgery from 2020.

11. Publishing a book first of it's kind showcasing the complete journey of Medicos and Doctors from beginning to end along with the life inside medical colleges and working of hospitals. More than 3000 photos spread over 500 pages. Must have book for lovers of medical sciences and those aspiring for it. https://amzn.eu/d/4Al18pf

Some of the humble contributions which I have been able to make in the Department of CTVS due to grand support from everyone in IMS and BHU are:

1. Starting of M.Ch in CTVS course in 2014 ( LOP )

2. Recognition of M.Ch in CTVS by Medical Council if India in 2019 ( LOR )

3. Organised many cardiac surgery workshops in association with eminent cardiac surgeons from around the India

4. Starting of PDCC in Thoracic Surgery course

5. Starting of Diploma in Extra corporeal perfusion technology course in 2015

6. Recruitment of three faculty members

7. Renovation and Construction of six bedded state of art CTVS ICU in 2011-2012

8. Renovation and Construction of five bedded HDU in 2015-16

9. Modernization of CTVS OT complex and keeping them fully functional.

10. Purchase of some high end modern equipments like Heart Lung machine, ICU ventilat0rs, Heater Cooler machine, Defibrillators, Multipara Monitors, OT Table, Oscillating saw, Echo Machine with Transesophageal probe, Blood gas analyzer etc.

11. MCI visit for increase in MCh seats.

12. Regular Open Heart Surgery programme. Our team has so far done more than 500 major cardiac and thoracic procedures including many complex congenital heart diseases ( like Tetralogy of Fallot, PAPVC, difficult VSDs ), high risk valve replacement surgeries, cardiac tumors, pericardiectomies, lung resections, mediastinal surgeries, peripheral vascular surgeries and much more. Some surgeries like VSD closure, ICR for TOF, PAPVC etc and procedures like deep Hypothermic Circulatory arrest were done for the first time in our Institute. We have been able to do all this with morbidity and mortality that is comparable to any best international centre.

My team has so far done more than 600 major surgeries in IMS with mortality rate of 3.7 %.

13. In this period I also authored more than 25 articles and ten books. https://www.researchgate.net/profile/Siddharth-Lakhotia www.amazon.com/author/siddharthlakhotia

14. I have been also making a popular You Tube series on CTVS Educational Surgical Videos. Till now it has more than 40 videos. https://www.youtube.com/playlist?list=PLe_safEIr_soxeGLRgE65OYDQa 1r_pR36

15. One of the videos on thoracic trauma is now the most watched surgical video from India on You Tube https://youtu.be/QeknY30NvSU It has been watched in over 50 countries.

16. Our teams work has been appreciated widely by local and national media. ( cuttings attached )

17. Our team has been felicitated on various occasions by various dignitaries including Vice Chancellor of BHU, Director of IMS and Medical Superintendent of SSH.

18. Made widely circulated video encouraging young medicos to take CTVS as career. https://youtu.be/6wMs1LGcUSU

Some of my humble contributions to IMS in general have been:

1. Daksh Foundation: To promote extracurricular activities amongst medical, ayush, dental and nursing students. https://www.youtube.com/dakshtrust . It was founded by me in 2018.

a. Musical Programs

b. Debates

c. Poetry recitation

d. Dance classes

e. Heritage walks

f. Drawing Classes

g. Yoga Classes

h. Nature excursions

i. Photography classes

j. Inspirational Lectures

k. Documentary production

l. Skits

m. Regular online competitions

2. Planted around 20 trees in IMS premises and taking care of them

3. Made many movies on IMS on wide range of topics from history to its grandeur, to academics to library, it’s facilities, events, programs etc. They can be seen on following link : https://www.youtube.com/playlist?list=PLe_safEIr_srtTRM1O9UJXz77KZ 9ac_iS

4. I have been making movies and recording lectures on general health awareness. They can be seen at https://www.youtube.com/playlist?list=PLe_safEIr_sppvf39VSwMHGqY WzHvLNyV

5. Published a historical book showcasing the journey of IMS, BHU since 1919, when the idea was first conceived. First of its kind book in its over 500 pages showcases the beautiful world of Medical Sciences and journey of Medicos & a premier government Medical Institute plus University Hospital in India, in the form of live and vibrant 3000 plus photos along with captivating captions & articles. What goes behind making a Doctor and working at a medical college and hospital has been beautifully portrayed in this book. ISBN : 978-93-5406-429-6 Hard Bound. The book IMS BHU : A Legendary Dream https://youtu.be/ kF4BLF8lqG0

6. Regularly organises IMS picnics and get together https://youtube.com/playlist?list=PL1S4HNjf_sFsVpUX3YHffIBFn1MOpY Cz3

Feel Think and Write

Thursday, May 7, 2020

Joy of Becoming a Cardio Thoracic Surgeon

Some of the humble contributions which I have been able to make in the Department of CTVS due to grand support from everyone in IMS and BHU are:

My team has so far done more than 600 major surgeries in IMS with mortality rate of 3.7 %.

Some of my humble contributions to IMS in general have been:

More than 500 videos made by me of general interest on nature, traveling, heritage and education. They can be watched on:

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Happy Healthy Heart

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