Prince Aly Khan Hospital

Specialised Care Areas

Our specialized care areas include the following.

The advanced digital Cardiovascular imaging system-Cath lab has been installed at the hospital.
The machine provides high quality imaging. The lab is equipped with life saving emergency equipments like defibrillators, intra aortic balloon pump, and anaesthesia machine. The team comprises of cardiologists with exceptional talent & extensive experience.
(national and international).

Services Offered:

    • Coronary Angiography: “Gold standard” for the evaluation of coronary artery disease.
    • Coronary Angioplasty (Single / Multiple Vessels): Angioplasty with or without the use of stents can often be used to relieve blockages in coronary arteries in selected cases.
    • Primary Coronary Angioplasty for heart attack
    • Permanent pacemaker implantation
    • Automatic Implantable Cardiac Defibrillator (AICD)
    • Balloon Valvuloplasty
    • Peripheral Angiography and Angioplasty
    • Cerebral Angiography and Angioplasty
    • Electrophysiology studies and pacemaker implantation

A team of cardiac surgeons is always on standby for all procedures performed in the cath lab.

The Prince Aly Khan Hospital Day Care unit is used extensively for day surgery and day medical care (including chemotherapy for cancer patients). Day care unit chiefly caters to patients undergoing surgeries and procedures that require a day stay in the hospital i.e. a patient can get admitted in the morning and is discharged the same evening.

The department is also equipped with an extra corporeal shockwave lithotripsy machine for non-invasive removal of kidney stones.

Two high-dependency (HDU) beds are also provided in the Day Care area for overnight observation after major surgery.

Daycare surgery offers many benefits for patients, doctors and employers. These include increased convenience, increased safety and lower infection rates. Day care centers, provide high quality health care at lower costs and also because they can focus only on aspect of treating ambulatory patients efficiently. Patients find day care surgery much less stressful, moreover patients do not suffer from separation anxiety. As they not need to be separated from their families overnight, something which is especially helpful for children.

Day care involves less paperwork , little waiting and are more organized compared to crowded and uncomfortable hospital settings. Because the expenses incurred during hospital stay are eliminated, ambulatory surgery usually costs less than the same type of surgery done for a hospital inpatient.

This is a benefit that everyone – business organizations, surgeons and patients greatly
appreciate.

Admission Procedure For Day Care

Admission into day care is decided by the consultant. The consulting doctor’s letter is required
specifying day care.

    • Booking is to be done at least 24 hours in advance.
    • Patient will not be allowed to stay overnight.
    • In case of an exigency where overnight stay is necessitated, the patient would be shifted
      to wards.

Enhanced External Counter Pulsation [EECP] is a non-surgical, non-invasive treatment for certain cases of coronary artery disease and congestive cardiac failure. Prince Aly Khan Hospital is one of only two such facilities in Mumbai. Following bypass surgery, only 75% of patients are symptom free from ischemic events and continue to have symptoms even after maximal surgical and medical intervention. EECP is a boon for patients who are unfit for surgery due to other complicating conditions. Prince Aly Khan Hospital also offers this treatment to patients who prefer not to choose surgical treatment. The treatment is carried out on a comfortable out-patient basis.

Heart failure or Congestive Heart Failure (CHF), another devastating condition, affects millions of lives in India. It is seen at all ages, but is more common among the elderly. Current treatment options just relieve, but never completely eliminate the symptoms. Angina, swelling of extremities, breathlessness and fatigue are the common symptoms. Prince Aly Khan Hospital offers EECP to patients, a more promising treatment that frees patients from the clutches of heart diseases.

EECP potentially treats heart-failure and angina which is chest pain or discomfort that occurs when the heart muscles do not get enough blood. Angina is the most common coronary heart disease and may feel like pressure or a squeezing pain in the patient’s chest. Angina patients complain of chest discomfort provoked by physical, emotional or mental stress. Patients experience shortness of breath, fatigue, indigestion, faintness, or pain in the chest, arm, neck or jaw.

Narrowed or blocked coronary arteries restrict blood flow to the heart and are the commonest cause of Angina. Angina can be disabling as it restricts ability to work and perform activity.

EECP is an excellent option with long lasting benefits:

    • EECP treatment is a non-invasive outpatient procedure
    • It is a non–traumatic option for Chronic, Refractory Angina. It decreases the pain associated with Angina.
    • EECP decreases the need for medication.
    • EECP reduces chances for Bypass Surgery or Balloon Angioplasty in the future.
    • EECP decreases the amount of Angina attacks Andand pains.
    • EECP increases time to exercise – induced Ischemia.
    • EECP makes it easier for patients to exercise without having chest pain.
    • EECP is a safe and well tolerated therapy
    • EECP demonstrates efficacy and safety in long term follow up studies.
    • EECP may eEliminate or diminish the need for Anti-Angina Drugs.
    • EECP makes good economic sense for patients

EECP PROCEDURES

External Counter pulsation involves the use of EECP Devices to inflate or deflate a series of compressive cuffs wrapped around the patients’ calves, lower thighs and upper thighs. Inflation and deflation of the cuffs are modulated by events in the cardiac cycle via computer-interpreted ECG signals. Patients are treated with EECP one hour daily for a total of 35 hours.

HOW IT WORKS

EECP is believed to create new pathways around blocked arteries in the heart by expanding networks of tiny blood vessels that help increase blood flow to the heart muscle. In CHF patients the benefits are mainly due to decreased left ventricular workload and increased venous return. Cardiac output is raised by as much as 60%.

AEECP enhances blood flow to the heart and coronary arteries by  squeezing blood out of the lower parts of the body up towards the heart. Sometimes referred to as a “natural bypass” as EECP stimulates the growth of new blood vessels around blocked arteries.

EECP therapy has been researched, used and proven since 1995 with over 700 centres in the USA.

EECP FAQs

Some of the common FAQs related to EECP are given below. Incase you have any further
questions please email at info@princealykhanhospital.com

Am I a candidate for EECP treatment?

Ask your physician to evaluate you. You may be a candidate if you:

  • Have chronic, stable angina
  • Are not receiving adequate relief by taking nitrates
  • Do not qualify for invasive procedures
  • Have exhausted invasive treatments without lasting relief of symptoms
  • Are not willing to undergo surgery or angioplasty
  • Wish to explore an alternative treatment with a lower financial burden

Would I feel better after EECP Treatment?

  • Yes, you can walk further, carry heavier packages, and be more active without suffering anginal pain
  • You will need fewer medications
  • You can return to work, travel and exercise without fear of angina
  • Lead a more active and confident life

All these benefits are possible without a single needle puncture or admission to the hospital.

How does EECP work?

  • EECP enhances blood flow to the heart and coronary arteries by squeezing blood out of the lower parts of the body up towards the heart.
  • While EECP is performed, you will be lying on a special treatment table wrapped in three sets of cuffs (like large blood pressure cuffs) around your calves, lower thighs and upper thighs (including the buttocks).
  • The EECP treatment system includes an air compressor that inflates and deflates these cuffs, starting with the calf cuffs, then the lower thigh cuffs, and then the cuffs at the upper thigh and buttocks.
  • The pressure moves the blood from your lower limbs toward your heart. Each wave of pressure is timed to your heartbeat so that the increased blood flow is delivered to your heart at the time that it is relaxed and blood flow to the heart arteries is at its peak.
  • When the heart pumps again, all the cuffs deflate at the same time.
  • This lowers the resistance in the blood vessels of your legs, and decreases the amount of work for your heart to pump blood to your body.

What can I expect during the procedure?

  • The initial course of EECP therapy involves 35 consecutive one-hour sessions, once or twice each day, for approximately 7 weeks.
  • During an EECP clinic visit, you will lie on a bed and the treatment supervisor will wrap blood pressure-type cuffs around your calves and lower and upper thighs.
  • Cardiac monitoring wires will be attached to your chest to record your heartbeat. The cuffs are then inflated and deflated in sequence, placing pressure on your legs.
  • The pumping action helps blood flow from the lower limbs to your heart, while reducing your heart’s workload.

How can I prepare for this procedure?

  • During each visit and before the treatment begins, the treatment supervisor will measure and record your blood pressure, pulse and respiratory rates. The supervisor will also look at your legs to check for areas of redness, broken blood vessels, or signs of other vascular problems.
  • Before your treatment, try to urinate so that you won’t experience discomfort during the session. To prevent irritation or skin chafing during the procedure, try to wear tight-fitting, seamless leggings or bicycle pants made of elastic material.
  • If the pulsating sensation from the cuffs becomes uncomfortable, tell the treatment supervisor immediately so that the treatment can be stopped.
  • Your treatment supervisor might recommend that you keep a daily diary of your angina symptoms during the course of your treatment. For example, record each angina attack, its time of occurrence, duration, severity, its relationship to precipitating factors, and the number of nitroglycerin tablets you used to ease the attack.
  • You should continue to take your angina medication at regular prescribed dosages throughout the course of treatment, and talk to your doctor and pharmacist as required.

How will EECP help me?

  • EECP can benefit the heart in two ways: First, the pumping action of the leg cuffs increases the blood flow to the coronary arteries. Because the coronary arteries receive blood from the heart after each heartbeat, the inflation of the cuffs helps more blood flow into the coronary arteries with each heartbeat.
  • Second, just as the heart begins to beat, EECP deflates the cuffs and creates a vacuum-like action in the arteries. This reduces the work of your heart muscle in pumping blood into the arteries.
  • Based on the results of clinical trials, therapy with EECP can help relieve symptoms of angina, reduce the need for angina medications, and reduce the frequency and intensity of chest pain. The procedure can also increase your ability to exercise and give you more independence in daily activities.
  • Because EECP helps reduce the frequency and intensity of chest pain for the short and long-term, many people who undergo treatment experience an improved sense of well-being and overall improvement in their quality of life.
  • Since individual conditions differ, there is no specific time when you might expect to feel better. Most people experience some improvement after 10-12 sessions. Others require a longer period of time to notice a difference in their angina symptoms.

What evidence is there that EECP can be beneficial?

  • Published reports have found that EECP is a relatively safe and effective option for certain people with angina. The Multicenter Study of Enhanced External Counterpulsation (MUST-EECP) randomly assigned 139 people with angina from seven US hospitals to receive either active EECP or a placebo (inactive) procedure for 35 hours over four to seven weeks.
  • About two-thirds of the people receiving EECP benefited from the treatment. Compared with the people who received the placebo procedure, those who completed the active EECP sessions had significantly less angina and tended to need fewer nitroglycerins. Also, people who received the active EECP were able to exercise longer before experiencing chest pain. Ten people dropped out of the study because of adverse events – half of them because of leg pain or chafing. The study was published in the June 1999 issue of the Journal of the American College of Cardiology.
  • EECP appears to have both short-term and long-term benefits. A study published in the April 2000 issue of Clinical Cardiology reported results in 33 patients with coronary heart disease who received EECP. After five years, 64 percent did not need bypass surgery or balloon angioplasty and did not have a major adverse cardiovascular event. This rate is similar to that found in many people who are treated with bypass surgery or angioplasty.
  • A more recent study showed that the procedure relieves angina and improves perfusion (blood flow to the heart) during stress in patients with coronary artery disease. The research was published in the April 1, 2002 issue of the American Journal of Cardiology.
  • Doctors are uncertain exactly how EECP helps ease angina. The procedure may stimulate the growth of tiny blood vessels in the heart and help bypass blocked blood vessels. This would increase blood flow and oxygen to deprived areas of the heart. EECP may also improve the function of existing blood vessels.

What are the risks?

Some patients experience minor skin irritation due to pressure of the cuffs. You should consult your physician regarding any risk and complication factors.

Prince Aly Khan Hospital offers you the latest, most sophisticated treatment device. Prince Aly Khan Hospital has the best doctors to provide risk free EECP treatment.

Prince Aly Khan Hospital is one of the best-equipped centres of its kind in Mumbai, complete with the latest technology and an internationally recognized team of specialists. Prince Aly Khan Hospital offers gastrointestinal endoscopy, a procedure which enables the specialists to see the inside lining of digestive tract. This examination is performed using the most intricate endoscopes (videoscopes). The department is also equipped with latest digital C-ARM machine and image archival system. Doctors use a flexible tube with a tiny TV camera at the end that displays the images on a colour TV. The Prince Aly Khan Hospital endoscopes not only allow diagnosis of gastrointestinal (GI) disease but treatment as well. Besides gastroscopy and colonoscopy, ERCP and stenting are routinely done.

The Prince Aly Khan Hospital Centre consists of various speciality divisions that include Endoscopy, Clinical Gastroenterology, GI Cancer Detection and Staging, Hepatology, Pancreatology and Interventional Radiology. It offers comprehensive medical care to any patient suffering from a gastrointestinal problem. Interventional endoscopists at the centre perform wide range of procedures to diagnose and treat gastrointestinal disorders.

Prince Aly Khan Hospital treats patients intuitively; hence, the centre is conveniently located on the ground floor of the main building of the hospital. This Centre functions as an OPD /Day Care facility that is functional from Monday through Saturday from 8 am to 5 pm. The Centre caters to appointments to the patients for endoscopic procedure or GI consultation.

ERCP

Endoscopic retrograde cholangiopancreatography (ERCP) enables the physician to diagnose problems in the liver, gallbladder, bile ducts, and pancreas.

Gastroscopy is an examination of the inside of the oesophagus, stomach and duodenum. It is performed by using a thin, flexible fibre-optic instrument that is passed through the mouth and allows the doctor to see whether there is any damage to the lining of the oesophagus or stomach, and whether there are any ulcers in the stomach or duodenum.

Colonoscopy is a screening test to view the interior lining of the large intestine (rectum and colon) through a thin, flexible tube fixed with a fibre optic camera called a colonoscope. This test is used to detect problems or diseases of the anus, rectum, or large intestine. This test is usually performed for evaluating the causes of abdominal pain, bleeding or pus in the stool, anemia, prolonged constipation or diarrhea and as a screen test for colon cancer or polyps. By colonoscopy, tissue samples can be collected and abnormal growths can be removed.

Renal or kidney dialysis is an artificial method of maintaining the chemical balance of the blood when the kidneys have failed. Prince Aly Khan Hospital is equipped with five machines; the department offers real value for money, with high quality dialysis at very reasonable costs. It offers a lease of life to more than 2500 patients of renal failure annually. The Prince Aly Khan Hospital reverse osmosis water treatment plant assures a high degree of safety and adherence to international standards. FAQs
    • Is kidney failure permanent? Not always. Some kinds of acute kidney failure get better after treatment. In some cases of acute kidney failure, dialysis may only be needed for a short time until the kidneys get better. In chronic or end stage kidney failure, your kidneys do not get better and you will need dialysis for the rest of your life. If your doctor says you are a candidate, you may choose to be placed on a waiting list for a new kidney.
    • Where is dialysis done? Dialysis can be done in a hospital, in a dialysis unit that is not part of a hospital, or at home. You and your doctor will decide which place is best, based on your medical condition and your wishes.
    • Are there different types of dialysis? Yes, there are two types of dialysis –haemodialysis and peritoneal dialysis.
    • What is hemodialysis? In haemodialysis, an artificial kidney (hemodialyzer) is used to remove waste and extra chemicals and fluid from your blood. To get your blood into the artificial kidney, the doctor needs to make an access (entrance) into your blood vessels. This is done by minor surgery to your arm or leg. Sometimes, an access is made by joining an artery to a vein under your skin to make a bigger blood vessel called a fistula. However, if your blood vessels are not adequate for a fistula, the doctor may use a soft plastic tube to join an artery and a vein under your skin. This is called a graft. Occasionally, an access is made by means of a narrow plastic tube, called a catheter, which is inserted into a large vein in your neck. This type of access may be temporary, but is sometimes used for long-term treatment.
    • How long do hemodialysis treatments last? The time needed for your dialysis depends on:
      • How well your kidneys work
      • How much fluid weight you gain between treatments
      • How much waste you have in your body
      • How big you are
      • The type of artificial kidney used
      Usually, each haemodialysis treatment lasts about four hours and is done three times a week. A type of haemodialysis called high-flux dialysis may take less time. You can speak to your doctor to see if this is an appropriate treatment for you.
    • What is peritoneal dialysis and how does it work? In this type of dialysis, your blood is cleaned inside your body. The doctor will do surgery to place a plastic tube called a catheter into your abdomen (belly) to make an access. During the treatment, your abdominal area (called the peritoneal cavity) is slowly filled with dialysate through the catheter. The blood stays in the arteries and veins that line your peritoneal cavity. Extra fluid and waste products are drawn out of your blood and into the dialysate. There are two major kinds of peritoneal dialysis.
    • What are the different kinds of peritoneal dialysis and how do they work? There are several kinds of peritoneal dialysis but two major ones are: Continuous Ambulatory Peritoneal Dialysis (CAPD) and Continuous Cycling Peritoneal Dialysis (CCPD). Continuous Ambulatory Peritoneal Dialysis (CAPD) is the only type of peritoneal dialysis that is done without machines. You do this yourself, usually four or five times a day at home and/or at work. You put a bag of dialysate (about two quarts) into your peritoneal cavity through the catheter. The dialysate stays there for about four or five hours before it is drained back into the bag and thrown away. This is called an exchange. You use a new bag of dialysate each time you do an exchange. While the dialysate is in your peritoneal cavity, you can go about your usual activities at work, at school or at home. Continuous Cycling Peritoneal Dialysis (CCPD) usually is done at home using a special machine called a cycler. This is similar to CAPD except that a number of cycles (exchanges) occur. Each cycle usually lasts 1-1/2 hours and exchanges are done throughout the night while you sleep.
    • Will dialysis help cure the kidney disease? No. Dialysis does some of the work of healthy kidneys, but it does not cure your kidney disease. You will need to have dialysis treatments for your whole life unless you are able to get a kidney transplant.
    • Is dialysis uncomfortable? You may have some discomfort when the needles are put into your fistula or graft, but most Prince Aly Khan Hospital patients have no other problems. The dialysis treatment itself is painless. However, some patients may have a drop in their blood pressure. If this happens, you may feel sick to your stomach, vomit, have a headache or cramps. With frequent treatments, those problems usually go away.
    • How long has dialysis been available? Haemodialysis and peritoneal dialysis have been done since the mid-1940’s.
    • How long can you live on dialysis? We do not yet know how long patients on dialysis will live. We think that some dialysis patients may live as long as people without kidney failure.
    • Do dialysis patients feel normal? Many patients live normal lives except for the time needed for treatments. Dialysis usually makes you feel better because it helps many of the problems caused by kidney failure. You and your family will need time to get used to dialysis.
    • Do dialysis patients have to control their diets? Yes. You may be on a special diet. You may not be able to eat everything you like, and you may need to limit how much you drink. Your diet may vary according to the type of dialysis.
    • Can dialysis patients continue to work? Many dialysis patients can go back to work after they have gotten used to dialysis. If your job has a lot of physical labour (heavy lifting, digging, etc.), you may need to get a different job.

Lithotripsy is the glistening technology adopted at Prince Aly Khan Hospital. The word “litho,” means stone, and the word “tripsy,” means to “break.”

Lithotripsy is a non-invasive method i.e it does not require surgery. Unlike painful methods like open surgery or extraction, shockwaves are used to break up stones inside the kidney, Ureter and Urinary Bladder. The latest ultrasound lithotripter is available for the purpose. Both x-ray & Ultrasound controls are available on this machine. The positioning, focusing and delivery of shock waves are all controlled by advanced computerized system with safety cut-offs to prevent damage by human error.

Patients does not need any hospital stay and can go home same day.

With lithotripsy, the stones are simply crushed into sand-like particles, which pass out, harmlessly, in urine. Hence, the patient recovers painlessly, which is of utmost priority at Prince Aly Khan Hospital.

An anesthetic is given once the patient in the lithotripsy treatment room. The stone can be viewed on a screen in the control booth. The actual treatment, conducted by a urologist, takes 20 minutes, but the whole process lasts for about 45 minutes. The patient is conscious throughout the entire procedure. Afterwards, the patient is brought back to lithotripsy day care where recovery room nurses monitor and care for the patient awhile they are in the lithotripsy unit 30 minutes after the procedure.

Laser lithotripsy is a procedure where pulses of intense laser light are used to break up urinary calculi or “stones” that have formed in the urinary tract, including the bladder or kidney. When these stones grow so large that they cannot be passed out of the body easily, they obstruct the normal flow of urine and can cause extreme pain, infection or kidney damage. Laser lithotripsy is most often used in very large or difficult to reach stones where other treatments have failed and/or major surgery may be the only other option. The stones are simply crushed into sand-like particles, which pass out, harmlessly in urine & the patient recovers painlessly.

The Operation Theatre is equipped with the latest medical technology and infrastructure for surgical procedure.

The preoperative and postoperative areas include technologies that help our nurses meet each patient’s needs. We have an experienced team of theatre technicians / nurses to assist the surgeons carry out all types or surgeries and procedures with greater efficiency.

The Operation Theater is designed on internationally accepted sterility norms. Each theater has an independent air-conditioner system with laminar airflow wherein air cycle change 25 times per hour. This ensures a minimal risk of infection for the patient.

Prince Aly Khan Hospital has an operating room complex with well-equipped operating rooms and facilities for sophisticated surgical procedure like cardio-thoracic, open heart or coronary by-pass surgeries, joint replacement, Gynecology & Obstetrics Surgery, neurosurgery, surgical procedures for all kind of cancers, paediatric, reconstructive and cosmetic surgery, advanced ophthalmic (including vitreo-retinal) ENT procedures, bariatric surgery (performed on morbidly obese), the laser guided prostatic surgery, the minimal invasive endoscopic spinal surgeries, microvascular surgeries. The team of full-time Cardio Thoracic & Vascular Surgeons and Cardiac Anaesthetists is geared up to perform both, adult and paediatric cardiac surgery.

Special precautions for infection control are being taken by microbiological surveillance of O.Ts and central sterilization supply department. It has the latest versions of the image intensifier (C-ARM) and Telescopic, Endoscopic and Laproscopic instruments. There ate three operation theatres which are equipped with modern and sophisticated apparatus.

The OT Units comprise Recovery Rooms, a pre-operative room and a central sterilization supply department.

Equipment

The latest models of operating microscopes, steretactic, equipment, ultrasonic aspirators and image intensifiers are accoutered in the Operation Theaters. Further, all theaters have international brand Anesthesia Machines, Anesthesia Ventilators and continuous patient monitoring equipments. The O.Ts is equipped with state-of-the-art equipment like C-arms operating microscopes, blood gas analysers, thermoelastrography, anaesthesia machines. Solar monitors, Cuza machines for GI/ Transplant/ Neuro etc., phacoemulsification and vitrectomy machines, ultracisors, Argons lasers etc.

Training

Consultants regularly keep on updating themselves in their respective specialities and equipment handling through regular CMEs held in various parts of the country and abroad.

O.T. personnel are also regularly trained on various aspects like use of disinfectant, sterilants. Handling equipment, preparation of medication, infection control practices, waste management, patient management and universal precaution etc.