Author name: Atul Manori

Mitral valve disease symptoms can be silent for years — and when they do appear, they are often mistaken for fitness issues, age, or general tiredness. By the time breathlessness or palpitations become significant, the heart muscle may already have been strained for a prolonged period. Dr. Ved Prakash, Director of CTVS at Yatharth Super Speciality Hospitals, Greater Noida, explains what the mitral valve does, how it becomes diseased, and what the symptoms mean — so you can act before the condition becomes harder to treat.   What Is the Mitral Valve and What Does It Do? The mitral valve sits between the left atrium and left ventricle — the two chambers on the left side of the heart that receive oxygenated blood from the lungs and pump it to the body. Its job is to open fully when blood flows from the atrium into the ventricle, then close completely to prevent blood flowing backwards when the ventricle pumps. When the mitral valve does not open fully (mitral stenosis) or does not close properly (mitral regurgitation), it disrupts the heart’s pumping efficiency — and over time, places serious strain on the heart and lungs. The Two Types of Mitral Valve Disease Mitral Stenosis — The Narrowed Valve Mitral stenosis is a narrowing of the mitral valve opening, most commonly caused by rheumatic fever in childhood — a complication of untreated streptococcal throat infection. Rheumatic heart disease remains a significant problem across India, particularly in patients now aged 30–60 who had rheumatic fever as children without adequate treatment. As the valve opening narrows, blood backs up into the lungs — causing breathlessness, exercise intolerance, and eventually atrial fibrillation (irregular heartbeat). Mitral Regurgitation — The Leaking Valve Mitral regurgitation occurs when the valve leaflets do not close completely and blood leaks backwards into the left atrium with each heartbeat. Causes include mitral valve prolapse (the leaflets bow backwards), degenerative valve disease (wear over time), and rheumatic heart disease affecting the valve leaflets. The leaking means the heart pumps the same blood twice — forward to the body and backwards into the lungs — causing progressive heart muscle strain. Mitral Valve Disease Symptoms — What to Watch For Breathlessness on exertion — particularly when climbing stairs, walking uphill, or carrying weight. Often the first and most common symptom. Breathlessness lying flat — many patients with mitral disease sleep with extra pillows because lying flat causes fluid to shift to the lungs (orthopnoea). Waking at night short of breath — called paroxysmal nocturnal dyspnoea. The patient wakes gasping or coughing and must sit upright to breathe comfortably. Palpitations — a racing, irregular, or fluttering heartbeat. Mitral stenosis is a major cause of atrial fibrillation, which significantly worsens symptoms and increases stroke risk. Fatigue and reduced exercise capacity — the heart cannot increase its output normally during activity because the diseased valve restricts flow. Swelling of ankles and feet — as the condition advances and right-sided heart pressure increases. Cough — sometimes with blood-tinged sputum — in severe mitral stenosis, elevated lung pressure can cause bleeding into the airways. How Is Mitral Valve Disease Diagnosed? Stethoscope examination: A characteristic murmur is heard — a trained cardiologist or surgeon can identify mitral valve disease from the sound alone Echocardiogram (Echo): The primary investigation — shows the valve structure, opening area, degree of leaking, and the impact on heart chambers ECG: May show atrial fibrillation or signs of left atrial enlargement Chest X-ray: May show an enlarged heart or fluid in the lungs Cardiac catheterisation: Occasionally needed to assess coronary arteries before surgery in older patients When Does Mitral Valve Disease Need Surgery? Surgery is recommended when: Symptoms (breathlessness, palpitations, reduced exercise capacity) are present and moderate-to-severe The echocardiogram shows the heart chambers are enlarging — even before symptoms appear Atrial fibrillation develops as a result of the valve disease The ejection fraction begins to fall — indicating the heart muscle is under strain Waiting too long is the most common mistake. Surgery performed before the left ventricle is significantly enlarged delivers far better long-term results than surgery performed after the heart has been damaged by years of volume overload. Mitral Valve Treatment Options Mitral valve repair: The preferred operation for mitral regurgitation in suitable cases. The patient’s own valve is reconstructed — no prosthetic implanted, no lifelong blood thinners required. Dr. Ved Prakash attempts repair in every anatomically suitable case. Mitral valve replacement: For valves that are too damaged to repair — most commonly severely calcified rheumatic valves. A mechanical or biological prosthetic valve is implanted. Balloon mitral valvotomy: A catheter-based procedure for suitable cases of mitral stenosis — a balloon is used to widen the narrowed valve without surgery. Only applicable when the valve leaflets are pliable and not heavily calcified. Frequently Asked Questions — Mitral Valve Disease Symptoms What are the early symptoms of mitral valve disease? The earliest symptom is usually breathlessness that is mildly worse than expected for your age and fitness level — particularly on exertion. Many patients initially attribute this to being unfit or getting older. A routine echocardiogram prompted by a heart murmur is how many cases are first diagnosed. Can mitral valve disease be treated without surgery? Medications can control heart rate and manage fluid retention (diuretics) — relieving symptoms temporarily. They cannot repair a structurally diseased valve. Surgery or intervention is required for definitive treatment once the disease reaches a moderate-to-severe stage. Is mitral valve disease caused by rheumatic fever common in India? Yes — India carries one of the world’s highest burdens of rheumatic heart disease. Patients now aged 30–60 who had sore throats and joint pains as children (often treated inadequately) frequently present with significant mitral valve disease decades later. Can mitral valve disease cause a stroke? Yes — particularly when mitral stenosis leads to atrial fibrillation. The irregular heartbeat causes blood to pool in the left atrium and form clots, which can travel to the brain. Anticoagulation (blood thinners) is started as soon

Heart valve surgery is an operation to repair or replace a heart valve that is no longer working correctly — either because it has become too narrow and restricts blood flow (stenosis), or because it leaks and allows blood to flow backwards (regurgitation). Understanding what heart valve surgery involves is the first step to making an informed decision about your treatment. Dr. Ved Prakash, Director of CTVS at Yatharth Super Speciality Hospitals, Greater Noida, specialises in all forms of heart valve surgery — with a repair-first approach that preserves the patient’s own valve wherever the anatomy permits.   What Is Heart Valve Surgery — The Basics The heart has four valves — the mitral, aortic, tricuspid, and pulmonary — that open and close with every heartbeat to keep blood flowing in the correct direction. When a valve becomes diseased, it forces the heart to work harder than it should. Over months and years, this extra strain weakens the heart muscle. Heart valve surgery corrects the problem at its source — repairing or replacing the diseased valve so the heart can pump efficiently again. When performed before the heart muscle is significantly weakened, outcomes are excellent and most patients return to full normal life. The Two Types of Heart Valve Surgery Valve Repair The diseased valve is reconstructed using the patient’s own tissue. No artificial valve is implanted. The surgeon reshapes, tightens, or restructures the valve leaflets and supporting apparatus to restore normal function. Why repair is preferred over replacement whenever possible: No lifelong blood thinners (anticoagulation) required Better long-term durability than any prosthetic valve Lower risk of infection on the valve Preserved heart muscle function Dr. Ved Prakash uses intraoperative echocardiography (echo during surgery) to confirm the repair is successful before closing the chest — if not, replacement is performed immediately. Valve Replacement When the valve cannot be repaired — because it is too heavily calcified, severely damaged, or the anatomy is not suitable — it is replaced with a prosthetic valve. Two types are available: Mechanical valve: A durable metal valve that lasts a lifetime. Requires lifelong warfarin (blood thinner) to prevent clotting. Best for younger patients who can reliably manage anticoagulation. Biological (tissue) valve: A natural tissue valve (from pig or cow). Does not require lifelong blood thinners in most patients. Wears out over 15–20 years. Best for patients over 60–65 or those who cannot safely take warfarin. Which Valves Are Most Commonly Operated On? Valve Common Conditions Surgery Type Mitral valve Rheumatic heart disease, prolapse, degeneration Repair preferred; replacement if not feasible Aortic valve Aortic stenosis (calcification), bicuspid valve Replacement (mechanical or biological) or TAVI Tricuspid valve Secondary to mitral disease, rheumatic Repair during mitral surgery if significant Symptoms That Suggest You May Need Heart Valve Surgery Breathlessness on exertion or at rest Fatigue and reduced exercise tolerance Swelling in the legs or ankles Heart palpitations or irregular heartbeat (atrial fibrillation) A heart murmur detected on examination Echocardiogram showing severe valve disease or reduced heart function The timing of heart valve surgery is critical — operating before the heart muscle weakens gives the best results. Waiting too long — even without symptoms — can lead to irreversible heart damage. What Happens During Heart Valve Surgery? General anaesthesia — you are fully asleep The heart is accessed through a chest incision (sternotomy) A heart-lung machine maintains circulation while the heart is stopped The diseased valve is repaired or replaced The heart is restarted and intraoperative echo confirms the result Total operative time: 3–5 hours for valve surgery Recovery After Heart Valve Surgery ICU: 1–2 days for monitoring and breathing tube removal Ward: 7–10 days total hospital stay Home: Rest, walking, no driving for 6 weeks, no lifting for 8 weeks Full recovery: 8–12 weeks Follow-up: Annual echocardiogram to check valve function For patients who are elderly or high-risk for open surgery, TAVI surgery in Delhi NCR offers aortic valve replacement without opening the chest — a catheter-based alternative with significantly faster recovery. Frequently Asked Questions — Heart Valve Surgery What is heart valve surgery and is it always open-heart surgery? Heart valve surgery is traditionally performed through an open-chest incision (open-heart surgery). However, for the aortic valve specifically, TAVI (Transcatheter Aortic Valve Implantation) now offers a catheter-based alternative without a chest incision for suitable patients. How long does heart valve surgery take? Between 3 and 5 hours depending on which valve is being repaired or replaced and whether additional procedures (such as tricuspid repair or coronary bypass) are needed simultaneously. Will I need blood thinners for life after heart valve surgery? Only if you receive a mechanical valve replacement. Biological valve recipients and patients who undergo valve repair do not require lifelong anticoagulation in most cases — though short-term anticoagulation may be prescribed during healing. Can valve surgery be avoided with medication? Medications manage symptoms but cannot repair a structurally damaged valve. Once valve disease reaches a moderate-to-severe stage with symptoms or evidence of heart muscle impact on echocardiogram, surgery delivers better outcomes than continued medical management. What is the success rate of heart valve surgery? For elective valve repair or replacement at an experienced centre, success rates exceed 98%. Dr. Ved Prakash performs heart valve surgery in Delhi NCR with extensive experience in repair-first techniques from Medanta and Narayana Hospitals. Is Heart Valve Surgery Right for You? If an echocardiogram has shown valve disease — or if a murmur has been detected — book a heart valve surgery consultation in Delhi NCR with Dr. Ved Prakash at Yatharth Super Speciality Hospitals, Greater Noida. Online consultation is available — share your echo report via WhatsApp. Dr. Ved Prakash | Director CTVS — Yatharth Super Speciality Hospitals, Greater Noida 📞 +91-9355255106  | Book Appointment →

Triple vessel disease means all three of your major coronary arteries have significant blockages — and it is the diagnosis that most consistently points toward bypass surgery as the right treatment. If your cardiologist has just told you that you have triple vessel disease, this article explains what it means, why it is more serious than single or double vessel disease, and what the evidence says about treatment. Dr. Ved Prakash, Director of CTVS at Yatharth Super Speciality Hospitals, Greater Noida, treats triple vessel disease patients referred from across Delhi NCR, UP, and Uttarakhand.   Triple vessel disease means all three of these arteries have a stenosis of 70% or more — significant enough to restrict blood flow, cause symptoms on exertion, and put the heart at risk of heart attack. When your cardiologist says you have triple vessel disease, they mean blockages are present across the entire coronary circulation — not just one section of the heart. Why Triple Vessel Disease Is More Dangerous Than Single or Double Vessel Disease With single vessel disease, a blockage in one artery threatens one region of the heart muscle. The other two arteries can partially compensate. With triple vessel disease, all three territories are simultaneously at risk. There is no compensatory reserve. A plaque rupture in any of the three arteries can cause a large heart attack — and the cumulative burden of reduced blood flow to the entire heart progressively damages the left ventricular muscle over time, leading to heart failure. Additionally, triple vessel disease is strongly associated with: Reduced ejection fraction— the heart’s pumping function declines as all three territories are chronically under-supplied Higher risk of ventricular arrhythmia — from widespread ischaemia affecting the heart’s electrical stability More rapid symptom progression — angina that is difficult to control with medication alone Why Bypass Surgery Is the Recommended Treatment for Triple Vessel Disease This is the most critical piece of information for patients who have just received this diagnosis. Multiple large randomised trials have compared bypass surgery against angioplasty specifically in triple vessel disease. The consistent finding across the SYNTAX trial, the FREEDOM trial (in diabetics), and the NOBLE trial is that bypass surgery delivers significantly better outcomes at 5 and 10 years — lower rates of heart attack, lower mortality, and dramatically fewer repeat procedures. The reason is anatomical and mechanical. Bypass surgery creates new blood vessel routes that bypass all three blockages simultaneously — restoring near-normal blood supply to the entire heart muscle. The LIMA graft to the LAD alone has a 90%+ patency rate at 15 years. Angioplasty places metal stents inside the diseased vessels — which remain in place and are subject to restenosis (re-blockage) at higher rates, particularly in diabetics. In triple vessel disease, the cumulative restenosis risk across multiple stents is unacceptably high. When Bypass Surgery Is Most Strongly Preferred Factor Why It Strengthens the Case for Bypass Diabetes FREEDOM trial: bypass reduced death and heart attack by 51% vs angioplasty in diabetic triple vessel disease at 5 years High SYNTAX score (≥33) Complex anatomy — angioplasty outcomes are markedly inferior at high SYNTAX scores Reduced ejection fraction (<50%) Bypass achieves more complete revascularisation — particularly important when the heart muscle is already struggling LAD involvement LIMA-to-LAD graft lasts 15–20 years — stents in LAD have significantly higher restenosis rates Age under 70 Younger patients benefit most from the graft durability of bypass — fewer re-procedures over their lifetime Can Angioplasty Treat Triple Vessel Disease? Angioplasty is technically feasible in triple vessel disease and is appropriate in a small subset of patients — specifically those with low SYNTAX scores, non-diabetics, and those with very high surgical risk due to other medical conditions. In these patients, a Heart Team discussion determines whether angioplasty’s lower procedural risk outweighs bypass surgery’s better long-term outcomes. <span”>For the majority of triple vessel disease patients — particularly diabetics, those with high SYNTAX scores, or those with any degree of impaired heart function — angioplasty is not the guideline-recommended treatment. If you have been offered angioplasty for triple vessel disease and you are diabetic or have a high SYNTAX score, you are entitled to ask for a cardiac surgeon’s opinion before proceeding. What Happens If Triple Vessel Disease Is Not Treated Medical therapy alone (aspirin, statins, beta-blockers, blood pressure medications) reduces heart attack risk but does not provide the survival benefit of revascularisation in symptomatic triple vessel disease. Untreated, progressive triple vessel disease leads to: Increasing angina frequency and severity — until medication can no longer control symptoms Progressive decline in ejection fraction — from chronic ischaemia starving the heart muscle Heart attack — which in triple vessel disease often involves a large territory of heart muscle Heart failure — requiring hospitalisation and long-term management </ul ong>The evidence for revascularisation improving survival in triple vessel disease is unambiguous — which is why the diagnosis triggers an urgent cardiac surgical consultation in every guideline-based cardiac programme. For a detailed explanation of how the decision between bypass surgery and angioplasty is made — including the SYNTAX score and Heart Team process — read the complete guide on why bypass surgery is preferred over angioplasty in triple vessel disease. To book a consultation for bypass surgery in Delhi NCR, share your angiogram report via WhatsApp at +91-9355255106 for a pre-assessment before visiting. Frequently Asked Questions — Triple Vessel Disease Heart Bypass What is triple vessel disease of the heart? Significant blockages (typically 70% or more) in all three major coronary arteries — the LAD, LCx, and RCA. The most advanced form of multi-vessel coronary artery disease, carrying the highest risk of heart attack and heart failure without treatment. Is bypass surgery always necessary for triple vessel disease? For most patients — especially diabetics, those with high SYNTAX scores, and those with any degree of impaired heart function — bypass surgery is strongly recommended over angioplasty. The SYNTAX, FREEDOM, and NOBLE trials all confirm superior long-term outcomes with bypass in this setting. What happens if

Haridwar and Rishikesh have cardiology services — angiography, stenting, and pacemakers — but no dedicated full-service CTVS cardiac surgery centre. For bypass surgery, valve replacement, aortic surgery, or paediatric heart surgery, patients from this region have two realistic options: Centre Distance from Haridwar Elective Wait Cost AIIMS Rishikesh 35 km — 40 min 6–12 weeks Government rates Yatharth Hospital, Greater Noida ~240 km — 3 hrs No waiting list Mid-tier, accessible   Route from Haridwar and Rishikesh to Yatharth Hospital From Haridwar: NH-58 → Roorkee → Muzaffarnagar → Meerut bypass → Ghaziabad → Noida-Greater Noida Expressway → Sector 110 From Rishikesh: NH-58 toward Haridwar → then as above From Roorkee: NH-58 → 2.5 hours Distance: 230–250 km from Haridwar | 3–3.5 hours drive This is the same route used by Dehradun patients — Dehradun patients choosing Yatharth Hospital pass through Haridwar en route Cardiac Surgery Available Bypass Surgery On-pump · Off-pump · Redo · Arterial grafting Heart Valve Surgery Mitral repair and replacement · Aortic replacement · Rheumatic double valve TAVI For elderly / high-risk aortic stenosis Paediatric Heart Surgery ASD · VSD · TOF · TGA · Coarctation · TAPVC Aortic Surgery Aneurysm · EVAR · TEVAR · Emergency dissection Vascular Surgery Varicose vein EVLT · DVT · Peripheral disease Your Surgeon — Dr. Ved Prakash Director, CTVS — Yatharth Super Speciality Hospitals, Greater Noida. MCh CTVS. 8+ years at Medanta, Narayana, and Sarvodaya. Every patient seen and operated on personally. Ayushman Bharat, CGHS, ECHS, and all major insurance accepted. Uttarakhand state health scheme — confirm empanelment at time of booking. Start Without Travelling WhatsApp angiogram / echo / CT to +91-9355255106 — pre-assessment provided Online cardiac consultation available before making the trip Call to confirm OPD slot before travelling Frequently Asked Questions Is there a cardiac surgeon near Haridwar for bypass surgery? AIIMS Rishikesh is nearby but has 6–12 week elective waiting times. Yatharth Hospital, Greater Noida is 3 hours via NH-58 — full CTVS surgery with no waiting list and a senior named surgeon performing every operation. How far is Yatharth Hospital from Haridwar? 230–250 km via NH-58, approximately 3–3.5 hours. The same national highway used by Dehradun patients travelling to Greater Noida. Why choose Yatharth over AIIMS Rishikesh? When the waiting list at AIIMS is 6–12 weeks for an elective procedure and the patient’s condition or insurance allows a private hospital — no waiting list, named senior surgeon, comparable clinical outcomes, and mid-tier accessible cost. Dr. Ved Prakash | Director, CTVS — Yatharth Super Speciality Hospitals, Greater Noida 📞 +91-9355255106  | 📧 drvedprakash@gmail.com  | Book a Consultation →

Agra’s hospitals offer cardiology — angiography and stenting — but not full CTVS cardiac surgery. For bypass surgery, valve replacement, TAVI, or paediatric heart surgery, Agra patients have traditionally travelled to Delhi — through Mathura and Faridabad, or via NH-19 into the city. The Yamuna Expressway changes that entirely. Yatharth Super Speciality Hospitals, Greater Noida is 2.5–3 hours from Agra — no Delhi traffic, direct expressway, same-day arrival.   Route from Agra to Yatharth Hospital Route: Agra → Yamuna Expressway → Greater Noida exit → Sector 110, Yatharth Hospital Distance: 200–220 km Drive time: 2.5–3 hours — expressway all the way, no city traffic Toll: Yamuna Expressway toll applicable — carry exact change or FASTag Better than Delhi route: No NH-19 congestion, no Faridabad bypass delays, no city entry issues Heart Surgery Available for Agra Patients Bypass Surgery (CABG) On-pump · Off-pump · Redo bypass · Triple and quadruple bypass Heart Valve Surgery Mitral repair and replacement · Aortic valve replacement · Rheumatic double valve TAVI For elderly / high-risk aortic stenosis — no open chest required Paediatric Heart Surgery ASD · VSD · TOF · TGA · Coarctation · TAPVC Aortic Surgery Aneurysm repair · EVAR · TEVAR · Emergency dissection surgery Vascular Surgery Varicose vein EVLT · DVT · Peripheral arterial disease · Diabetic foot Your Surgeon — Dr. Ved Prakash Dr. Ved Prakash, Director of CTVS, brings 8+ years of cardiac surgical experience from Medanta The Medicity, Narayana, and Sarvodaya Hospital. He personally performs every operation and sees every patient in OPD. Agra patients receive the same surgical expertise previously only accessible in central Delhi — via a 2.5 hour expressway drive. Insurance Accepted Ayushman Bharat PM-JAY — eligible patients CGHS and ECHS All major cashless insurance companies UP state health scheme — confirm empanelment at time of booking Start Without Travelling WhatsApp reports — angiogram / echo / CT to +91-9355255106 — pre-assessment before the drive Online cardiac consultation — video discussion to assess urgency and plan Call to book OPD — confirm slot before the 2.5 hour journey For information on the most common procedure for Agra referrals — bypass surgery — visit the dedicated page. Frequently Asked Questions — Heart Surgery Agra Where do Agra patients go for heart surgery? Yatharth Hospital, Greater Noida is 2.5–3 hours from Agra via Yamuna Expressway — a fast, direct route bypassing Delhi entirely. Full CTVS cardiac surgery available with no waiting list. How do I reach Yatharth Hospital from Agra? Yamuna Expressway from Agra → Greater Noida exit → Sector 110. Approximately 200–220 km, 2.5–3 hours. No Delhi traffic on this route. Can I get a cardiac opinion without travelling from Agra? Yes — WhatsApp reports to +91-9355255106 for a pre-assessment, or book an online cardiac consultation before making the journey. Dr. Ved Prakash | Director, CTVS — Yatharth Super Speciality Hospitals, Greater Noida 📞 +91-9355255106  | 📧 drvedprakash@gmail.com  | Book a Consultation →

For heart surgery, Dehradun patients have traditionally needed to travel to AIIMS Rishikesh, Delhi, or Chandigarh — journeys of 5–7 hours that are stressful for cardiac patients and costly for families. Dr. Ved Prakash, Director of CTVS at Yatharth Super Speciality Hospitals, Greater Noida — approximately 4 hours from Dehradun via NH-334 and NH-58 — provides full-service cardiac surgery for Dehradun and Uttarakhand patients with the quality of Delhi’s best hospitals and significantly more accessible costs.   Why Dehradun Patients Choose Yatharth Hospital for Heart Surgery Dehradun’s cardiac facilities are limited to cardiology — coronary angiography, angioplasty, and pacemaker implantation are available. But bypass surgery, valve repair and replacement, aortic surgery, and paediatric heart surgery for Dehradun patients require travel. The options are: AIIMS Rishikesh: Excellent institution but long waiting lists for elective CTVS surgery — often 6–12 weeks for non-emergency cases Delhi (AIIMS, Apollo, Max, Fortis): 5–6 hours from Dehradun by road — feasible but exhausting for cardiac patients Yatharth Hospital, Greater Noida: 3.5–4 hours from Dehradun via NH-334/NH-58 — closer than central Delhi, with shorter waiting times and more accessible costs Chandigarh (PGI, Fortis Mohali): 5 hours from Dehradun What Heart Surgery Is Available for Dehradun Patients at Yatharth Hospital? Bypass surgery (CABG): For Dehradun patients referred after angiography — on-pump and off-pump bypass surgery available. No waiting list for referred urgent cases. Mitral and aortic valve surgery: Repair and replacement for rheumatic and degenerative valve disease — significant in the Uttarakhand hill district population TAVI: For elderly Dehradun patients with aortic stenosis too frail for open surgery — available without the journey to AIIMS Delhi Paediatric heart surgery: ASD, VSD, TOF repair for children from Dehradun and Uttarakhand Aortic aneurysm and EVAR/TEVAR Varicose vein laser treatment (EVLT) Getting Started From Dehradun WhatsApp pre-assessment: Send angiogram/echo/CT report to +91-9355255106. Dr. Ved Prakash reviews and advises on urgency, surgical plan, and cost estimate before travel. Online consultation: Available for initial assessment without travel — particularly useful for Dehradun patients to determine urgency before committing to the journey. Insurance: Ayushman Bharat PM-JAY, CGHS, ECHS, and major insurance accepted. Uttarakhand state government health scheme patients should confirm empanelment before visiting. Frequently Asked Questions — Heart Surgery Dehradun How far is Yatharth Hospital from Dehradun? Yatharth Super Speciality Hospitals, Greater Noida is approximately 280–300 km from Dehradun via NH-334 (Haridwar) and NH-58 — a drive of 3.5–4 hours. The route is well maintained and manageable for a family travelling with a cardiac patient. Is bypass surgery available near Dehradun? Full-service CTVS (bypass surgery, valve surgery, aortic surgery) is not available in Dehradun city as of 2026. The nearest cardiac surgery centres are Yatharth Hospital Greater Noida (3.5–4 hours), AIIMS Rishikesh (35 minutes but long waiting lists), and hospitals in Delhi (5–6 hours). Can I get a second opinion for heart surgery from Dehradun without travelling? Yes — Dr. Ved Prakash provides online cardiac second opinion consultations for Dehradun patients. Share your angiogram, echocardiogram, and any clinical reports via WhatsApp at +91-9355255106. A video consultation is arranged and a full clinical opinion is provided before you travel for surgery. Dr. Ved Prakash | Director CTVS — Yatharth Super Speciality Hospitals, Greater Noida 📞 +91-9355255106  | Book Appointment → Tetralogy of Fallot — TOF — is the most common cyanotic congenital heart defect, and tetralogy of Fallot symptoms include the bluish colouration of the skin (cyanosis) that gives this condition its most well-known description: the “blue baby.” With timely surgery, children with tetralogy of Fallot grow up to live full, active lives — but the journey from diagnosis to long-term follow-up requires parents to be well informed. Dr. Ved Prakash, Director of CTVS at Yatharth Super Speciality Hospitals, Greater Noida, explains tetralogy of Fallot symptoms, what surgery involves, and what long-term care is needed.   What Is Tetralogy of Fallot? Tetralogy of Fallot is a combination of four structural heart defects present from birth: A large VSD (Ventricular Septal Defect) — a large hole between the two lower heart chambers Pulmonary stenosis — narrowing of the outflow from the right ventricle to the pulmonary artery (the vessel taking blood to the lungs), sometimes involving the pulmonary valve itself Overriding aorta — the aorta is positioned directly over the VSD, receiving blue (deoxygenated) blood from the right ventricle as well as oxygenated blood from the left Right ventricular hypertrophy — the right ventricle thickens because it is working against the obstructed pulmonary outflow The combination of these four defects means that oxygen-depleted blood bypasses the lungs and is pumped to the body through the aorta — causing the characteristic cyanosis (blue discolouration) that defines tetralogy of Fallot symptoms. Tetralogy of Fallot Symptoms — What Parents Notice Cyanosis (bluish skin): The most characteristic tetralogy of Fallot symptom — blue or purple discolouration of the lips, tongue, fingernails, and toenails. Cyanosis may be present at birth or appear in the first weeks of life as the ductus arteriosus (a fetal blood vessel) closes. “Tet spells” — hypercyanotic episodes: Episodes of sudden, intense cyanosis — the baby turns very blue, becomes irritable or inconsolable, breathes very fast, and may briefly lose consciousness. Tet spells are caused by spasm of the right ventricular outflow tract that suddenly reduces blood flow to the lungs. They are a medical emergency. Squatting in older children: Older children with unrepaired TOF instinctively squat after physical activity — squatting increases systemic vascular resistance and reduces the right-to-left shunting, providing temporary symptom relief Poor growth and feeding difficulties in untreated infants Exercise intolerance in older children with partial defects Clubbing of fingers and toes — in children with long-standing cyanosis How Is Tetralogy of Fallot Diagnosed? Foetal echocardiogram: TOF can often be detected at the 18–20 week anomaly scan — allowing planned delivery at a centre with paediatric cardiac surgery Neonatal echocardiogram: Confirms the diagnosis and anatomical details after birth Pulse oximetry screening: Low oxygen saturation detected at birth routine screening CT cardiac angiography: For detailed assessment of the pulmonary artery anatomy before surgical

Bulandshahr is one of the closest western UP districts to Greater Noida — and that makes Yatharth Super Speciality Hospitals one of the most accessible full-service cardiac surgery centres for patients from this region. The drive is 40–50 minutes via NH-34. No Delhi crossing, no Expressway toll, straight road to the hospital.   Route from Bulandshahr to Yatharth Hospital Route: Bulandshahr → NH-34 → Dadri → Greater Noida → Sector 110, Yatharth Hospital Distance: 50–60 km Drive time: 40–50 minutes No Delhi crossing required. No toll on this route. Cardiac Surgery Available for Bulandshahr Patients Bypass Surgery On-pump · Off-pump · Redo · Single to quadruple bypass Heart Valve Surgery Mitral repair and replacement · Aortic valve replacement · Rheumatic double valve TAVI For high-risk elderly aortic stenosis patients Paediatric Heart Surgery ASD · VSD · TOF · TGA · Coarctation · TAPVC Vascular Surgery Varicose vein EVLT · DVT · Peripheral arterial disease Surgeon and Hospital Dr. Ved Prakash — Director, CTVS, Yatharth Super Speciality Hospitals, Greater Noida. MCh CTVS. 8+ years at Medanta, Narayana, and Sarvodaya. Personally operates every case. Full surgeon profile at cardiac surgeon in Greater Noida. Ayushman Bharat PM-JAY, CGHS, ECHS, and all major insurance accepted. UP health scheme — confirm empanelment at time of booking. Start Without Travelling WhatsApp angiogram / echo / CT to +91-9355255106 — pre-assessment provided Call to confirm OPD before making the 45-minute trip Frequently Asked Questions — Cardiac Surgeon Bulandshahr Is there a cardiac surgeon near Bulandshahr? No dedicated CTVS centre in Bulandshahr. Yatharth Hospital, Greater Noida is 40–50 minutes away via NH-34 — the nearest full-service cardiac surgery centre for Bulandshahr patients. How far is Yatharth Hospital from Bulandshahr? 50–60 km via NH-34 — 40–50 minutes. No Delhi crossing, no toll. Dr. Ved Prakash | Director, CTVS — Yatharth Super Speciality Hospitals, Greater Noida 📞 +91-9355255106  | 📧 drvedprakash@gmail.com  | Book a Consultation →

Choosing a cardiac surgeon in Greater Noida is one of the most consequential decisions your family will make — and yet most patients make it based on a single referral, a hospital name, or a Google search. Dr. Ved Prakash, Director of CTVS at Yatharth Super Speciality Hospitals, Greater Noida, explains the five things every patient should verify before choosing a cardiac surgeon in Greater Noida.   Why Choosing the Right Cardiac Surgeon in Greater Noida Matters Greater Noida and the broader NCR region have seen significant growth in cardiac surgery facilities over the past decade. But not all cardiac surgery programmes are equal — and for a major operation like bypass surgery, valve replacement, or aortic surgery, the experience of the specific cardiac surgeon in Greater Noida performing your case directly affects your outcome. 5 Things to Check Before Choosing a Cardiac Surgeon in Greater Noida 1. The Surgeon’s Specific Subspecialty Training Cardiothoracic and Vascular Surgery (CTVS) is a distinct MCh superspecialty. Verify that your cardiac surgeon in Greater Noida has completed an MCh in CTVS — not just MBBS + MS Surgery. Ask specifically about fellowship training if the surgeon was trained after 2010, as CTVS training programmes have become more specialised. 2. Annual Volume — How Many Operations Per Year? A cardiac surgeon in Greater Noida performing 50+ bypass surgeries per year delivers consistently better outcomes than one performing 10–15. Ask the hospital how many CABG and valve operations are performed annually — and specifically how many the surgeon whose hands will be on your case performs personally. 3. The Hospital’s Cardiac ICU Post-operative cardiac ICU care determines outcome as much as the surgery itself. Before choosing a cardiac surgeon in Greater Noida, confirm: Is there a dedicated cardiac ICU? Is a cardiac anaesthetist available 24 hours? Is the cardiac surgery team available for emergency redo surgery overnight? A well-equipped cardiac surgery programme has affirmative answers to all three. 4. Will Your Surgeon Personally Perform the Operation? In some teaching hospitals, senior cardiac surgeons in Greater Noida and across Delhi NCR have fellows or registrars perform significant portions of the operation under supervision. Ask your surgeon directly: “Will you personally perform this surgery from start to finish?” You deserve a direct answer. 5. Does the Surgeon Encourage a Second Opinion? A confident, ethical cardiac surgeon in Greater Noida will never discourage a second opinion. If surgery has been recommended, a second opinion is your right — and a good surgeon will support it. If a surgeon makes you feel that delaying for a second opinion is dangerous (when clinically it is not), reconsider. About Dr. Ved Prakash — Cardiac Surgeon in Greater Noida Dr. Ved Prakash is the Director of Cardiothoracic and Vascular Surgery at Yatharth Super Speciality Hospitals, Greater Noida — the only dedicated CTVS surgeon at a full-service cardiac surgery centre in Greater Noida NCR. With 8+ years of experience including positions at Medanta (2017–2022), Narayana, and Sarvodaya Hospitals, Dr. Ved Prakash performs bypass surgery, valve repair and replacement, aortic surgery, paediatric heart surgery, TAVI, and vascular procedures. As the lead cardiac surgeon in Greater Noida at Yatharth Hospital, Dr. Ved Prakash personally operates on every case. Patients from Noida, Ghaziabad, Meerut, Agra, Dehradun, and Moradabad travel to Yatharth Hospital for cardiac surgery that previously required a trip to central Delhi. Frequently Asked Questions — Cardiac Surgeon in Greater Noida Is there a CTVS cardiac surgeon in Greater Noida? Yes — Dr. Ved Prakash is the Director of CTVS at Yatharth Super Speciality Hospitals, Greater Noida — a full-service cardiac surgery centre with a dedicated cardiac ICU, hybrid cath lab, and 24-hour cardiac surgical capability. How far is Yatharth Hospital from central Noida? Yatharth Super Speciality Hospitals is located in Sector 110, Greater Noida West — approximately 25–30 minutes from Noida City Centre via the Noida-Greater Noida Expressway, and 45–60 minutes from central Delhi. Can patients from Meerut or Ghaziabad access cardiac surgery in Greater Noida? Yes — Yatharth Hospital, Greater Noida is 60–75 minutes from Meerut and 30–40 minutes from Ghaziabad. Many patients from these cities choose cardiac surgery in Greater Noida over travelling to central Delhi, given the comparable expertise and shorter travel time. Book a consultation with cardiac surgeon Dr. Ved Prakash in Greater Noida. Dr. Ved Prakash | Director CTVS — Yatharth Super Speciality Hospitals, Greater Noida 📞 +91-9355255106  | Book Appointment →

  VSD in babies — Ventricular Septal Defect — is the most common congenital heart defect, occurring in approximately 3–4 of every 1,000 live births. If your baby has been diagnosed with VSD, this article by Dr. Ved Prakash, Director of CTVS at Yatharth Super Speciality Hospitals, Greater Noida, explains what VSD in babies means, how to recognise the signs, when VSD treatment is needed, and what surgery or device closure involves.   What Is VSD in Babies? VSD in babies is a hole in the muscular wall (septum) dividing the two lower chambers (ventricles) of the heart. A large VSD in babies allows blood to flow from the left ventricle (higher pressure) to the right ventricle — sending too much blood to the lungs. Over months, this extra blood flow causes the lungs to be overloaded, the heart to work harder, and if uncorrected, the pulmonary arteries to develop irreversible high blood pressure (Eisenmenger syndrome). Small VSD in babies often close on their own in the first 2–3 years of life. Moderate and large VSDs require treatment — but the results are excellent and most babies treated for VSD go on to live completely normal lives. Signs of VSD in Babies — What Parents Notice The signs of VSD in babies are related to the size of the defect: Small VSD in Babies Often detected only as a heart murmur during routine examination — the baby appears completely well Normal feeding and weight gain No symptoms — the small VSD in babies causes minimal left-to-right shunting Moderate to Large VSD in Babies Poor feeding — the most important sign: Babies with significant VSD in babies tire during feeding, take very long to finish feeds, fall asleep before completing, or sweat profusely during feeds. The heart is working so hard to compensate for the VSD that feeding — which demands significant physical effort — overwhelms the baby. Poor weight gain: Despite adequate feeding attempts, babies with large VSD in babies often fail to gain weight normally. The heart’s extra workload consumes enormous energy — leaving little for growth. Rapid breathing: Increased lung blood flow from VSD in babies causes the respiratory rate to be faster than normal — particularly visible when the baby is resting or asleep Recurrent chest infections: Overloaded pulmonary blood flow makes the lungs more susceptible to respiratory infections Excessive sweating: Particularly on the forehead and scalp during feeds — a classic VSD in babies symptom reflecting the heart’s excessive effort When Does VSD in Babies Close on Its Own? The probability of spontaneous closure depends on VSD type and size: Muscular VSD in babies (holes in the muscular part of the septum): Up to 80% of small muscular VSDs close spontaneously by age 3. These are monitored with echocardiograms every 6 months until closure is confirmed. Perimembranous VSD in babies (near the aortic valve — most common type): Approximately 30–40% close spontaneously. Moderate and large perimembranous VSDs are unlikely to close and usually require treatment by age 1–2 years. Outlet (subarterial) VSD: Does not close spontaneously and may cause progressive aortic valve damage — early treatment is recommended. When Does VSD in Babies Need Treatment? VSD treatment is recommended for babies with VSD when: The baby is failing to thrive despite adequate nutritional support Breathlessness and feeding difficulties significantly impair quality of life and growth The echocardiogram shows significant left heart enlargement from volume overload Pulmonary artery pressure is elevated The VSD is an outlet type — regardless of symptoms Age 1–2 years for significant moderate-to-large VSDs that have not shown signs of spontaneous closure VSD Treatment Options in Delhi NCR Surgical VSD Closure Open-heart surgery is performed under general anaesthesia and cardiopulmonary bypass. The VSD is closed with a patch of pericardium (the heart’s own lining) or a synthetic patch sewn directly over the hole. VSD surgical closure is performed in babies as small as 3–4 kg when needed. Success rates at experienced centres exceed 98–99%. The child is typically in ICU for 1–2 days and hospital for 7–10 days total. Device Closure For some VSD types — particularly muscular VSDs and some perimembranous VSDs with suitable anatomy — a device (such as an Amplatzer VSD occluder) is delivered through a catheter in the femoral vein to close the VSD without surgery. No chest incision. Hospital stay 2–3 days. Not all VSDs are suitable for device closure — anatomy determines eligibility. Frequently Asked Questions — VSD in Babies Treatment What is VSD in babies and is it serious? VSD in babies is a hole between the two lower chambers of the heart. Small VSDs are often not serious and may close on their own. Large VSDs cause significant heart strain and require treatment — but the results of VSD surgery or device closure are excellent, with most children living completely normal lives after treatment. How do I know if my baby’s VSD is large or small? The size is assessed on echocardiogram — measured in millimetres and also by the degree of left heart enlargement on the scan. Your paediatric cardiologist will classify the VSD as small, moderate, or large and advise whether monitoring or treatment is appropriate. At what age is VSD surgery performed in babies? If VSD treatment is urgently needed — due to failure to thrive or very high pulmonary pressure — surgery can be safely performed from 3–4 months of age. For less urgent cases, surgery is typically planned between 6 and 12 months of age, or up to 2 years if the baby is growing adequately and the VSD shows no sign of spontaneous closure. What is the success rate of VSD surgery in Delhi NCR? For VSD surgical closure at experienced paediatric cardiac surgery centres in Delhi NCR, success rates exceed 98–99%. Dr. Ved Prakash has performed paediatric heart surgery including VSD closure since 2017 across Medanta, Narayana, and Yatharth Hospital. Book a paediatric heart surgery consultation for VSD in Delhi NCR. Echo reports can be shared via