Dr. Anil Bhan

Consultant in cardiac surgery, the operative treatment of heart disease — coronary bypass grafting, valve repair and replacement, and correction of structural defects. A surgical opinion usually follows an angiogram or echocardiogram, and the consultation covers which procedure is being recommended, why it is preferred to a stent or to medication, and what recovery realistically involves.

What a cardiac surgeon treats

Blocked coronary arteries, damaged or narrowed heart valves, aneurysms of the aorta and structural defects of the heart. The common operations are coronary bypass grafting, valve repair and valve replacement, and increasingly these are done through smaller incisions than the full sternotomy most people picture.

When you would be referred

Usually after an angiogram or an echocardiogram has shown something a cardiologist cannot fix with medication or a stent — disease in several arteries at once, disease of the left main artery, or a valve that has become tight or leaky enough to strain the heart. A surgical opinion is not a commitment to surgery; it is the point at which somebody who operates looks at your images and tells you whether operating is the better option.

At the first consultation

Expect the images to be reviewed in front of you, the recommended procedure named, and the alternative explained — stenting, or continuing on medication, and why it is or is not the better choice in your case. You should also be told what recovery involves week by week, because that is the part patients are least prepared for.

What to bring, and what to ask

Your angiogram or echocardiogram images and reports, a current list of medication, and any previous cardiac procedure notes. Worth asking: how many grafts are planned, what your ejection fraction is, whether the operation is on-pump or off-pump and why, and what happens if something is found during surgery that was not visible on the images.