15 Frequently Asked Questions : Cardiac Surgery in India for Bangladeshi Patients

Q1 · What is Cardiac Surgery?

Cardiac surgery refers to surgical procedures performed to treat diseases or structural problems involving the heart and, in some cases, major blood vessels connected to the heart.

Depending on the condition, cardiac surgery may be performed to

• Improve blood flow to the heart
• Treat blocked coronary arteries
• Repair or replace damaged heart valves
• Correct congenital heart defects
• Treat selected aortic conditions
• Treat selected rhythm disorders
• Repair structural abnormalities
• Treat certain complications of heart disease

Common cardiac operations include:

Coronary Artery Bypass Grafting

CABG creates a new route for blood to flow around blocked or narrowed coronary arteries using blood vessels taken from another part of the body. CABG may be performed using a heart-lung machine or, in selected cases, without it.

Heart Valve Surgery

Valve surgery may involve repairing an existing valve or replacing it with a mechanical or biological prosthetic valve when repair is not appropriate.

Aortic Surgery

Selected diseases affecting the aorta may require surgical repair or replacement.

Congenital Heart Surgery

Children and adults with congenital heart defects may require procedures to repair structural abnormalities present from birth.

Other Cardiac Procedures

Depending on the condition, cardiac surgery may also involve selected rhythm procedures, minimally invasive cardiac surgery, or procedures performed as part of complex combined operations.

Q2 · How much does Cardiac Surgery cost in Bangladesh compared with India?

Cardiac-surgery costs vary significantly because the final cost depends on the type of operation, complexity of the cardiac condition, number of bypass grafts or valves involved, implant requirements, ICU stay, investigations, medicines, complications and length of hospitalisation.

For planning purposes, this guide uses

• US$1 ≈ BDT 122
• US$1 ≈ INR 96

Potential savings are indicative planning ranges, not guaranteed savings. Actual costs depend on the patient's diagnosis, surgical complexity, surgeon, hospital, valve or implant selected, ICU requirements, medicines, blood products, complications and length of stay.

Patients should ask whether the quotation includes

• Cardiologist consultation
• Cardiac surgeon consultation
• ECG
• Echocardiography
• Cardiac imaging
• Coronary angiography where required
• Blood tests
• Anaesthesia
• Operation-theatre charges
• Bypass surgery charges
• Valve or other prosthetic-device charges
• ICU charges
• Hospital room
• Medicines
• Blood products
• Physiotherapy
• Cardiac rehabilitation
• Additional hospital days
• Follow-up consultations

For cardiac surgery, patients should obtain a detailed written quotation and clarify which investigations, surgical, ICU, implant, medicine and follow-up expenses are included.

Q3 · Which Indian cities can Bangladeshi patients consider for Cardiac Surgery?

The appropriate city should be selected according to the patient's cardiac diagnosis, required procedure, surgeon expertise, ICU facilities and follow-up requirements.

Q4 · Which hospitals in India can Bangladeshi patients consider for Cardiac Surgery?

The following hospitals are part of the broad Indian medical-hospital reference list. Patients should confirm the availability of the required cardiac surgery and specialist service for their individual condition.

Q5 · What types of Cardiac Surgery are available?

Cardiac surgery covers several different categories.

Coronary Artery Bypass Surgery

CABG may be performed for selected patients with significant coronary artery disease. The operation creates new pathways for blood flow around blocked coronary arteries.

CABG may include

• Single bypass
• Double bypass
• Triple bypass
• Multiple bypass
• On-pump CABG
• Off-pump CABG
• Total arterial CABG in selected cases

Valve Surgery

Valve procedures may include

• Mitral valve repair
• Mitral valve replacement
• Aortic valve repair in selected cases
• Aortic valve replacement
• Tricuspid valve repair
• Tricuspid valve replacement
• Pulmonary valve surgery
• Double-valve surgery

Valve repair may be considered when the valve can be suitably repaired; replacement may be required when repair is not appropriate.

Aortic Surgery

Selected patients may require

• Ascending aortic surgery
• Aortic root surgery
• Aortic valve and aorta combined surgery
• Aortic aneurysm repair
• Other complex aortic procedures

Congenital Heart Surgery

Congenital procedures may include repair of

• Atrial septal defects
• Ventricular septal defects
• Patent ductus arteriosus
• Tetralogy of Fallot
• Transposition of the great arteries
• Complex congenital heart defects

The exact operation and timing depend on the child's anatomy, age, symptoms and clinical condition.

Minimally Invasive Cardiac Surgery

Selected patients may be suitable for minimally invasive approaches depending on anatomy and procedure requirements. Less-invasive approaches are not appropriate for every patient.

Q6 · Who may be suitable for Cardiac Surgery?

Cardiac surgery may be considered for selected patients with

• Significant coronary artery disease
• Severe or symptomatic valve disease
• Certain congenital heart defects
• Selected aortic diseases
• Structural heart problems
• Certain complications of previous cardiac treatment
• Selected rhythm-related conditions
• Other heart conditions requiring surgical treatment

The decision depends on

• Symptoms
• Echocardiography findings
• Coronary anatomy
• Heart function
• Valve severity
• Overall health
• Age
• Kidney and lung function
• Diabetes and other medical conditions
• Previous cardiac procedures
• Surgical risk

Not every patient with heart disease requires surgery. Depending on the diagnosis, treatment may involve medicines, catheter-based procedures, interventional cardiology, minimally invasive treatment or conventional surgery.

Q7 · What tests are required before Cardiac Surgery?

Cardiac-surgery evaluation usually requires detailed assessment.

Depending on the condition, tests may include

• Clinical cardiology examination
• ECG
• Echocardiography
• Chest X-ray
• Blood tests
• Kidney-function tests
• Liver-function tests
• Blood-sugar testing
• Lipid profile
• Coagulation profile
• Cardiac biomarkers where clinically indicated
• Coronary angiography
• CT coronary angiography in selected patients
• Cardiac CT
• Cardiac MRI in selected cases
• Stress testing where appropriate
• Pulmonary-function testing
• Carotid evaluation where indicated
• Dental evaluation before selected valve procedures
• Anaesthesia assessment

For congenital heart disease, additional imaging or cardiac catheterisation may be necessary depending on the anatomy and planned intervention. The exact testing pathway should be determined by the treating cardiologist and cardiac surgeon.

Q8 · What medical records should Bangladeshi patients send before travelling to India?

Bangladeshi patients should send complete cardiac records before travelling whenever possible.

These may include

• Recent cardiologist consultation
• ECG reports
• Echocardiography reports
• Echocardiography images where available
• Coronary angiography report
• Coronary angiography CD or digital images
• CT scan reports
• Cardiac MRI reports where applicable
• Previous cardiac surgery reports
• Previous angioplasty records
• Stent information
• Pacemaker or device information where applicable
• Blood-test reports
• Kidney-function reports
• Diabetes reports
• Current medication list
• Allergy information
• Previous discharge summaries

Patients should also provide a clear history of

• Current symptoms
• When symptoms began
• Previous cardiac events
• Previous surgeries
• Previous angioplasty or stenting
• Current medications
• Any previous complications
• The surgery recommended by the treating doctor

Complete cardiac records can help the Indian cardiac team understand the case before the patient's arrival.

Q9 · How does Cardiac Surgery work?

The exact process varies according to the procedure.

Step 1: Cardiac Evaluation

The cardiologist and cardiac surgeon review the diagnosis, symptoms, investigations and previous treatment.

Step 2: Preoperative Assessment

The patient undergoes the investigations required to assess heart function and general surgical fitness.

Step 3: Surgical Planning

The cardiac team determines the appropriate procedure based on the patient's anatomy and clinical condition.

Step 4: Anaesthesia

Cardiac surgery is generally performed under general anaesthesia.

Step 5: Surgical Procedure

Depending on the diagnosis, the procedure may involve

• Coronary artery bypass grafting
• Valve repair
• Valve replacement
• Aortic repair
• Congenital heart repair
• Other cardiac reconstruction

Step 6: Intensive Care

Following major cardiac surgery, the patient is generally monitored closely in a cardiac intensive-care setting.

Monitoring may include

• Heart rhythm
• Blood pressure
• Oxygen levels
• Urine output
• Heart function
• Drain output
• Blood tests

Step 7: Hospital Recovery

Once the patient is stable, they are transferred from intensive care to a regular hospital room.

Step 8: Physiotherapy and Mobilisation

Gradual movement, breathing exercises and physical rehabilitation are introduced according to the patient's condition.

Step 9: Discharge Planning

Before discharge, the medical team provides medication, wound-care, activity and follow-up instructions.

Step 10: Cardiac Rehabilitation

Structured cardiac rehabilitation may be recommended after surgery. Cardiac rehabilitation can continue after the patient returns home, including supervised or home-based programmes in suitable circumstances.

Q10 · What are the alternatives to Cardiac Surgery?

Cardiac surgery is not the only treatment option for every heart condition. Depending on the diagnosis, alternatives may include:

Medicines

Medicines may be used to manage

• Blood pressure
• Cholesterol
• Heart rhythm
• Fluid retention
• Blood clot risk
• Angina
• Heart failure

Angioplasty and Stenting

Selected patients with coronary artery disease may be treated with catheter-based angioplasty and stent placement rather than bypass surgery.

Transcatheter Valve Procedures

Selected patients with valve disease may be evaluated for catheter-based valve procedures depending on valve anatomy, age, surgical risk and other factors.

Catheter-Based Congenital Procedures

Certain congenital heart defects may be treated through catheter-based interventions in selected patients.

Lifestyle and Rehabilitation

Depending on the condition, treatment may also include

• Cardiac rehabilitation
• Smoking cessation
• Diet modification
• Exercise under medical guidance
• Weight management
• Diabetes control
• Blood-pressure management

The appropriate alternative depends on the exact cardiac diagnosis and should be determined by the cardiology and cardiac-surgery team.

Q11 · What should Bangladeshi patients ask before accepting a Cardiac Surgery quotation?

Patients and families should ask

• What is the exact cardiac diagnosis?
• Why is surgery being recommended?
• Is surgery urgent or can it be planned?
• What specific operation is being proposed?
• Is CABG, valve surgery or another procedure required?
• How many bypass grafts are expected?
• Can the valve be repaired or does it require replacement?
• What type of valve or implant is proposed?
• Is minimally invasive surgery appropriate?
• What are the major surgical risks?
• What complications could increase the cost?
• How long is the expected ICU stay?
• How long is the expected hospital stay?
• Are ICU charges included in the quotation?
• Are the valve or other implants included?
• Are blood products included?
• Are medicines included?
• Are investigations included?
• What happens if additional surgery is required?
• How long should the patient stay in India?
• When can the patient travel back to Bangladesh?
• What cardiac rehabilitation will be required?
• What follow-up will be required after returning to Bangladesh?
• What medications will be required after surgery?
• What documents will be provided at discharge?

Patients should request a detailed written medical and financial plan before travelling.

Q12 · How long should Bangladeshi cardiac-surgery patients stay in India?

The required duration depends on the type of cardiac surgery, patient's medical condition and postoperative recovery.

Initial Evaluation

Approximately 3–7 days may be required for specialist consultation, investigations and treatment planning.

CABG

Hospitalisation following CABG commonly extends for several days, while international patients may need additional time in India for postoperative assessment and recovery. Some patient resources describe hospital stays of up to around 10 days after CABG, although individual requirements vary.

Valve Surgery

Patients may require approximately 10–14 days or longer in India depending on the procedure and recovery.

Complex Cardiac Surgery

Patients undergoing combined procedures, aortic surgery or complicated cardiac operations may require approximately 14–21 days or longer.

Congenital Heart Surgery

The duration varies significantly according to

• Patient age
• Type of congenital defect
• Procedure performed
• ICU requirements
• Recovery
• Complications

Patients should not book a fixed return flight before receiving postoperative clearance from the treating team.

Q13 · What is recovery like after Cardiac Surgery?

Recovery depends on the type of cardiac surgery and the patient's overall health.

Early recovery may involve

• ICU monitoring
• Pain management
• Breathing exercises
• Wound care
• Gradual mobilisation
• Medication adjustment
• Nutritional support
• Physiotherapy
• Cardiac rehabilitation

After major cardiac surgery, patients may initially experience

• Tiredness
• Reduced physical strength
• Appetite changes
• Sleep disturbances
• Chest discomfort around the surgical area
• Reduced exercise tolerance

Recovery should be gradual.

Patients may be advised to

• Walk progressively
• Perform breathing exercises
• Follow medication instructions
• Attend follow-up appointments
• Follow dietary recommendations
• Avoid strenuous activity until cleared
• Participate in cardiac rehabilitation where recommended

Recovery timelines vary significantly. Some patient resources describe approximately 4–8 weeks for recovery after CABG, while more complex procedures can require longer. The treating team should determine when the patient can resume work, driving, exercise and other activities.

Q14 · How can Cardiac Surgery follow-up be managed after returning to Bangladesh?

Cardiac-surgery patients should have a clear follow-up plan before leaving India.

Before returning to Bangladesh, patients should obtain

• Final discharge summary
• Detailed operation report
• Diagnosis
• Procedure details
• Echocardiography report
• Relevant imaging
• ECG where applicable
• Medication list
• Anticoagulation instructions where applicable
• Wound-care instructions
• Activity restrictions
• Cardiac rehabilitation plan
• Follow-up schedule

After returning to Bangladesh, follow-up may include

• Cardiologist consultation
• ECG
• Echocardiography
• Blood tests
• Blood-pressure monitoring
• Medication adjustment
• Anticoagulation monitoring where applicable
• Wound assessment
• Cardiac rehabilitation
• Gradual activity progression

Patients who have undergone valve replacement may require specific long-term medication and monitoring depending on the type of valve used.

Patients should seek urgent medical attention for

• Severe chest pain
• Severe breathing difficulty
• Fainting
• New severe palpitations
• High fever
• Wound discharge
• Significant wound redness
• Sudden weakness
• Significant leg swelling
• Other serious or rapidly worsening symptoms

Q15 · Should a Bangladeshi patient travel to India for Cardiac Surgery?

India can be considered by Bangladeshi patients seeking

• A cardiac-surgery second opinion
• CABG evaluation
• Valve repair or replacement
• Complex cardiac surgery
• Aortic surgery
• Selected congenital heart surgery
• Minimally invasive cardiac surgery
• Combined cardiac procedures
• Postoperative cardiac rehabilitation

However, overseas treatment is not automatically required for every patient with heart disease.

A Bangladeshi patient considering cardiac surgery in India should compare

• Exact cardiac diagnosis
• Severity of disease
• Urgency of surgery
• Proposed procedure
• Cardiologist and cardiac-surgeon evaluation
• Hospital cardiac and ICU facilities
• Expected treatment cost
• Valve or implant requirements
• Expected hospital stay
• Total duration in India
• Travel requirements
• Rehabilitation arrangements
• Follow-up arrangements in Bangladesh

For many patients, obtaining an Indian cardiac-surgery opinion based on complete cardiac records before travelling can help determine whether surgery is appropriate, what procedure may be required, what investigations are still necessary and what the estimated treatment pathway and cost may be.