Cardiac care at the tertiary level requires more than individual specialist excellence - it requires a configuration of surgical, interventiona...
Cardiac care at the tertiary level requires more than individual specialist excellence - it requires a configuration of surgical, interventional, imaging and clinical cardiology expertise that can function as a coordinated programme. The distinction matters clinically. A patient with severe aortic stenosis, for example, needs a team that can assess surgical versus transcatheter options, perform the chosen intervention, and provide ongoing cardiac management - all within a single institutional framework rather than across multiple referral chains.
Medanta Indore's Cardiac Care department brings together cardiac surgery, interventional cardiology, advanced echocardiography and clinical and preventive cardiology under one programme. The team comprises eight specialists - spanning a Director, three Associate Directors, and four Consultants - trained at Bombay Hospital and Institute of Medical Sciences Mumbai, MGM Medical College Indore, and postgraduate institutions across central India. For patients in Madhya Pradesh and the broader central India region, this concentration of cardiac subspecialty expertise within Indore removes the need to travel to Mumbai, Delhi, or Pune for advanced cardiac procedures.
The department's capability spans cardiac surgery including minimally invasive and paediatric cardiac procedures, percutaneous coronary intervention including primary angioplasty for acute MI, structural heart disease intervention including transcatheter aortic valve replacement and left atrial appendage occlusion, advanced echocardiography including three-dimensional echo and transoesophageal echocardiography and preventive and clinical cardiology including heart failure management.
Cardiac Surgery - Open Heart, Minimally Invasive, and Paediatric
Dr. Vinit Pandey, Director, is a cardiothoracic and vascular surgeon who trained at Bombay Hospital and Institute of Medical Sciences, Mumbai for his MCh in CTVS - one of the few non-Delhi, non-AIIMS institutions in India with a nationally regarded CTVS programme. His MBBS and MS in General Surgery were both completed at MGM Medical College, Indore, giving him a training trajectory that is deeply rooted in the central India region alongside exposure to high volume cardiac surgical practice in Mumbai. His surgical scope covers coronary artery bypass grafting, valve repair and replacement, paediatric and congenital heart surgery, vascular surgery including aneurysm repair and peripheral vascular interventions, minimally invasive cardiac surgery and general thoracic surgery. The inclusion of paediatric and congenital cardiac surgery alongside adult work reflects a breadth of surgical training that is uncommon in a single surgeon's practice.
Interventional Cardiology - Coronary and Structural
Percutaneous coronary intervention including coronary angiography and angioplasty via the radial route, primary angioplasty for acute myocardial infarction, and balloon mitral valvuloplasty is performed by Dr. Alkesh Jain, Dr. Bharat Rawat, Dr. Ashish Sharma and Dr. Yatendra Kumar Porwal. Dr. Jain holds a Fellowship from the Society for Cardiovascular Angiography and Interventions (FSCAI). Pacemaker implantation and paediatric cardiac interventions are also within Dr. Jain's clinical scope.
Structural heart disease intervention at Medanta Indore is managed by Dr. Ritesh Kumar Gupta, who holds a Fellowship in Structural Heart Intervention and Coronary Intervention alongside his DM in Cardiology. His procedural scope covers transcatheter aortic valve replacement (TAVR) for severe aortic stenosis in patients who are high or intermediate surgical risk, left atrial appendage occlusion (LAAO) for patients with atrial fibrillation who require stroke prevention but cannot tolerate long-term anticoagulation, atrial septal defect device closure and heart failure management. LAAO is a procedure available at a limited number of centres in central India; its availability at Medanta Indore reflects the department's structural intervention capability.
Advanced Echocardiography
Dr. C.S. Agarwal, Associate Director, holds a Fellowship in Advanced Echocardiography and focuses his practice on two-dimensional echocardiography, three-dimensional echocardiography and transoesophageal echocardiography. Three-dimensional echocardiography provides volumetric cardiac imaging that allows more accurate quantification of ventricular function and valve morphology than standard two-dimensional assessment. TEE is used for detailed valve assessment, procedural guidance during structural interventions and when transthoracic imaging is technically limited. Dr. Ashish Sharma and Dr. Rajesh Karanjiya also perform echocardiography including TEE within their respective clinical practices.
Preventive and Clinical Cardiology
Preventive cardiology - cardiovascular risk assessment, management of hypertension, dyslipidaemia, and metabolic risk factors, and the prevention of primary and recurrent cardiac events - is a specific clinical focus of Dr. Rajesh Karanjiya. He holds a Fellowship in Non-Invasive Cardiology alongside an MD in Medicine in which he was a gold medallist. His practice covers heart failure management, non-invasive cardiac investigation including stress testing and Holter monitoring, and general internal medicine alongside his cardiology work. Heart failure management is also within the scope of Dr. Ritesh Kumar Gupta and Dr. Yatendra Kumar Porwal.
Dr. Vinit Pandey, Director, completed his MBBS and MS at MGM Medical College, Indore, and his MCh in Cardiothoracic and Vascular Surgery at Bombay Hospital and Institute of Medical Sciences under Mumbai University - a surgical programme with high operative volume across adult and paediatric cardiac, vascular, and thoracic surgery. He leads the cardiac surgery programme at Medanta Indore.
Dr. Alkesh Jain, Associate Director, holds a DM in Cardiology, an MD in General Medicine, and an FSCAI. His interventional practice covers coronary angioplasty, primary angioplasty, balloon mitral valvuloplasty, pacemaker implantation, and paediatric cardiac interventions. Dr. Bharat Rawat, Associate Director, holds a DM in Cardiology and an MD, and focuses on coronary interventions delivered via the radial route - an approach associated with lower access-site complication rates compared to femoral access - alongside clinical cardiology. Dr. C.S. Agarwal, Associate Director, holds a Fellowship in Advanced Echocardiography and an MD, and manages the department's echocardiographic imaging practice.
Dr. Ashish Sharma, Consultant, holds a DM in Cardiology and an MD, and performs coronary angiography and angioplasty, transoesophageal echocardiography, primary angioplasty, balloon mitral valvuloplasty, and pacemaker implantation. Dr. Rajesh Karanjiya, Consultant, holds a Fellowship in Non-Invasive Cardiology and an MD in Medicine and completed with a gold medal and covers preventive cardiology, heart failure, and the full non-invasive investigation suite. Dr. Ritesh Kumar Gupta, Consultant, holds a Fellowship in Structural Heart Intervention and Coronary Intervention and a DM in Cardiology, with a specific focus on TAVR, LAAO, ASD device closure and heart failure management. Dr. Yatendra Kumar Porwal, Consultant, holds a DM in Cardiology and an MD, and manages complex coronary intervention, structural heart disease, cardiac device implantation, and valvular heart disease.
What is left atrial appendage occlusion and when is it recommended?
The left atrial appendage is a small pouch in the left atrium where approximately 90% of thrombi responsible for embolic stroke in atrial fibrillation patients originate. Left atrial appendage occlusion involves the percutaneous deployment of a plug-like device (delivered via a transseptal catheter) to seal off this structure, reducing the thromboembolic risk. It is indicated in patients with non-valvular atrial fibrillation who have a high stroke risk but cannot tolerate anticoagulation due to bleeding history, bleeding risk, non-compliance or patient preference after informed discussion.
Can paediatric cardiac surgery be performed at Medanta Indore?
Yes. Dr. Vinit Pandey lists paediatric and congenital heart surgery as a specific area of his surgical practice encompassing repair of congenital defects, closed cardiac procedures including patent ductus arteriosus ligation and coarctoplasty, and mitral commissurotomy. Paediatric cardiac interventions (catheter-based procedures in children) are also within Dr. Alkesh Jain's scope. Families in Madhya Pradesh and central India who have a child with a diagnosed or suspected congenital heart condition may consult the cardiac team at Medanta Indore for evaluation and surgical or interventional planning.
What does radial route coronary angioplasty mean, and is it preferable to femoral access?
Coronary angioplasty can be performed by introducing the catheter either through the radial artery in the wrist or through the femoral artery in the groin. The radial approach has become the preferred access route in high-volume contemporary practice because it is associated with significantly lower rates of access-site bleeding and vascular complications, allows the patient to sit up and mobilise soon after the procedure, and reduces hospital stay. Femoral access remains appropriate in certain anatomical situations or when the radial artery is unsuitable. Dr. Bharat Rawat and Dr. Ritesh Kumar Gupta both preferentially use radial access for coronary procedures at Medanta Indore.