In-patient Department (IPD) services:

How many beds are there totally in the department?

There are 6 ICU beds, 2 step-down ICU beds and 26 general ward beds in the department to cater in-patient services. All these beds are almost hundred percent full on all days due to the long waitlist of patients and many emergency cross referral cases. Each consultant is provisionally allotted 5 beds in the general ward for admitting the patients. All wards are centrally airconditioned with infrastructural facilities complying with fire safety and patient-safety norms.
The general ward consists of 3 cubicles with each cubicle having 8 to 10 beds and a common toilet and bath room facilty.

Is there any private / special ward isolated rooms availabe for admitting the patients in the CTVS wards?

No. not available. As there are no nursing officers specifically posted for looking after the patients in such areas, the CTVS department has the practice of not admitting the patient in specail rooms considering the patient safety policy as most of the patients admitted in the department are sick heart patients requiring frequent nursing attention and monitoring. Hoever in special circumstances for very stable patients, if the special rooms are available in the neighboring departments such as Cardiology, Neurology or Neurosurgery – serving in the same floor the request may be considered for admitting in these rooms.

What is the basis of admission into the CTVS ward?

Admission of patients in the ward follows one of the 4 patterns:

1. From the list of OPD patients who are already worked up for surgery – each consultant will maintian his regular waiting list and will call them for admission.
2. Patients with utmost severity of the disease requiring urgent treatment will be prioritized out of turn from the regular waiting list.
3. Patients also may be prioritized from the regular waiting list based on the special conditions based on the logistics when some facilities are limited availability of rare blood group in the blood bank, focussed workshops inviting guest faculty for a particular type of operations, surgery requiring coordination at multiple levels such as Robotic surgery, etc.
4. Patients also may be admitted from the cross referrals arriving as emergencies from Emergency Department or other specialities such as Pediatrics, Medicine,etc. Admissio of these cases are decided by the faculty on duty on the day of referral.

Operation theatres and operations:

• There are two modular operation theatres in the multispecailty theatre-complex fitted with HEPA filter, laminar flow, state-of-the art operative video recording facilities in each of these theatres for performing major operations and a minor operation theatre for performing bronchoscopy and other minor procedures.

• Elective major operation theatres are functional for 6 days in a week from Monday to Saturday and for 24 hours in any day for emergency operation subjected to the priority set by the duty anesthesiologist based on the urgency levels queued up in the general emergency list for the whole hospital.

• The cardiac operations performed include a wide spectrum such as CABG (coronary artery bypass graft) – both on pump and off pump, heart valve repair or replacement, redo and re-redo open heart operations, complex aortic operations such as aortic root replacement (Bentall and David operations), repair of aortic dissecting aneurysms, aortic arch replacement, repair of thoracoabdominal aortic aneurysms, hybrid aortic branch bypass operations with endovascular aortic stent, excision of cardiac tumors, pediatric cardiac operations including arterial switch, Senning’s operation, repair of total anomalous pulmonary venous connection (TAPVC), repair of atrioventricular canal defects, bidirectional Glenn shunt, Blalock-Taussig shunt, Fontan’s operation, Rastelli operation, repair of tetralogy of Fallot (TOF), Correction of double outlet right ventricle (DORV), correction of aorto-pulmonary window (APW), repair of rupture or aneurysm of sinus of Valsalva (RSOV/ASOV), repair of anomalous origin of left coronary artery from pulmomnary artery (ALCAPA), closure of atrial septal defect (ASD), ventricular septal defect (VSD) and persistent ductus arteriosus (PDA), pulmonary arterial banding,

• The thoracic operations include tracheal repair procedures including resection and anastamosis, tracheal stent placement, pulmonary resections (segmentectomy, lobectomy, pneumonectomy), decortication of lungs mediastianl tumor excision, cervical rib excision and decompression of thoracic outlet syndrome, correction of dysphagia lusoria, thymectomy, chest wall tumor excision and reconstruction, correction of chest wall deformities, repair of diaphragm, empyectomy, VATS (Video Assisted Thoracic Surgery) procedures, rigid and flexible bronchoscopy, etc.
• The vascular operations include procedures such as open aortic embolectomy, balloon embolectomy of peripheral arteries, repair of arterial injuries, aortobifemoral bypass, iliofeomral bypass, femoro-femoral crossover bypass, femoropopliteal bypass, infrapopliteal bypass, hepatic, splenic, renal and mesenteric arterial bypass, carotid to subclavian bypass, aorto-subclavian bypass, carotid endarterectomy, carotid tumor excision, excision or exclusion of arteriovenous malformation of limbs, repair of aneurysm of peripheral arteries, creation of arteriovenous fistula (AVF) for hemodialysis and take down of aneurysmal AVF, and venous procedures like venovenous bypass, reconstruction of venacava, etc.
• Minimally invasive Cardiac Operations (MICS) 
• Robotic Surgery

Who operates on the admitted patients?

The faculty who admits the patient usually operates. However in unusual circunstances the faculty may hand over the case to other faculty to operate. Some of the realively simple and straigtforward cases may be operated by the senior residents under the direct supervision of faculty.

Who manages the postoperative patients?

As most of the cardiothoracic operations are long hour procedures, the postoperative patients are usually managed by the senior residents who are trained well and posted around the clock in ICU in shifts and on rotation; however they will be informing the faculty in-charge of the patient time to time based on the needds.

How are the patients in the ward selected for operation for a particular day?

As each faculty is allotted operating tables for particular number of days in a month, accordingly he posts the patients for surgery from his list of cases waiting in the ward. Apart from the surgeon’s chosen list, as multiple other factors such as fitness given by the anesthesiologists, blood availability, other emergency cases arrived in the previous night, availability of ICU beds, etc also have the role to modify the list, the final confirmation of the patients moved into the operation room is know only on the day of surgery. As there may be last minute cancellation due to some unexpected events such as fever occuring on the day of operation, epileptic attack, etc. Hence mostly the daily operative list for an operation room will have the name of 2 or 3 patients out of which only one or two may be operated on the day.

What is expected from the relatives / attendants of the patients prepared for operations?

1. Blood donors:
   They are expected to mobilize blood donors sufficiently for their patients and donate in the blood bank of JIPMER during worrking hours. The number of donors required varies from case to case for example : less than four donors for straightforward open heart operations, more than eight donors for complex aortic procedures or redo open heart operations. They can bring donors of any group but in special circumstances sich as non-availability of rare blood groups, they may have to bring group specific donors.
2. Not to bring food or eatables from outside:
   As JIPMER provides quality tested hygeinically prepared healthyu diet for all the admitted patients, the relatives or attendants are advised not to bring any eatables or food from the outside shops or hotels as the salt content, hygienic standards are questionable and uncertain with poor package techniques, they may harm the patients causing diarrhoea, food poisoning, elevation of blood pressure, water logging due to high salt content , etc. However in exceptional circumstances, the nursing officer will give the directions based on the doctor treating patient to bring specific items such as peanuts, fruits, etc.

Out-patient Department (OPD) services:

OPD runs on all days except Sundays and other Government holidays.

Registration will be limited to 130 patients per day considering the quality care, patient safety and crowd management. In view of limited OPD hall capacity batches of 50 patients will be seated at a time and the rest of the patients will be given tokens and will be allowed inside only after the previous batch of patients left the hall.

OPD timings :

• Registration time: 8 to 10 am.
• Consulting time : Morning - 8.30 am to 1 pm and afternoon – 2 to 3 pm
• Lunch time : 1pm to 2 pm.

Senior residents of the department start the OPD at 8.30 am and the faculty start consultation at 9 am

Weekly time table of OPD days:

NB: The faculty may interchange their OPD days in some circumstances such as

When they happen to take leave or held up in long operations on the previous day or previous night and also when engaged in unavoidable important office Work or meetings or academic classes.

* This Heart Valve Clinic program on Wednesdays is a common day for all the Faculty such that each of them will get a specific Wednesday in a month in rotation in the following pattern :