By Dr. Apurba Kumar Sarma, MCh CVTS | Cardiac Surgeon, Tulip Mediworld Superspeciality Hospital, Guwahati
Quick Takeaways
- Age, diabetes, and prior surgery are rarely absolute barriers – what matters is a proper individual assessment
- For most cardiac procedures, you no longer need to travel to Delhi or Chennai – Tulip Mediworld, Guwahati handles the full range of complex heart surgery
- Surgery is typically recommended when blockages are severe enough that medicines alone cannot adequately protect the heart
- The fear of surgery is almost always worse than the reality – understanding what actually happens significantly reduces anxiety
- Every patient deserves honest answers before making a decision; if you have been told surgery is impossible, come for a second opinion
In 25+ years as a cardiac surgeon and across more than 7,000 heart operations, the questions families ask me have stayed remarkably consistent. They are not technical questions. They are human ones: Is it safe? Does it hurt? Can we trust someone here? Will my family member actually be okay?
These are the right questions – and they deserve straight answers, not brochure language.
This page brings together the twenty questions I hear most often in my clinic, in the corridors outside the operating theatre, and in the conversations families have while they are waiting and afraid. If you are at that stage right now, I hope this helps.
Age alone is not a reason to say no to surgery. In 25+ years and across 7,000+ heart operations, some of my most rewarding cases have been patients in their 70s and 80s who walked out of the hospital and returned to their lives.
What determines whether surgery is safe is not your birth year – it is your overall condition: heart function, kidney health, lung capacity, and nutritional status. We assess every patient individually. For many older patients, the risk of not operating – of leaving a blocked artery or a failing valve untreated – is far greater than the risk of surgery itself.
If your family member has been told surgery is “too risky because of age,” please come for a second opinion before accepting that answer.
For many years, the honest answer would have been: you probably have to travel. That is no longer true.
I returned to Guwahati in 2017 precisely because I did not want Northeast India families to face that journey – the cost, the distance, the exhaustion of navigating an unfamiliar city at the most frightening moment of their lives. I then founded Tulip Mediworld Superspeciality Hospital to make that commitment permanent.
Today, Tulip Mediworld handles the full range of complex cardiac procedures – bypass surgery, valve replacement, aortic surgery, congenital heart operations, and more – with a Cathlab, CT Coronary Angiogram, 24/7 emergency care, and a full ICU. The care once available only in Delhi or Chennai is now available here, at home, with a team that knows this region.
You don’t have to go anywhere.
Yes. I perform the surgery myself, and I remain personally involved from admission to discharge.
I understand why families ask this. In large institutions, patients sometimes meet their surgeon once and then find themselves in the care of juniors and residents. That is not how I work.
At Tulip Mediworld, I personally assess each patient before surgery, lead the operating team in the theatre, and monitor recovery closely in the post-operative period. If there is a concern – day or night – my team reaches me. Families are kept informed at every stage, not left waiting in a corridor.
This is not a promise I make to attract patients. It is simply how I practise, and how I believe cardiac surgery should be done.
Tulip Mediworld was built specifically to handle what others cannot.
The hospital has 6 operation theatres, 200+ beds, 24/7 emergency and ICU support, a Cathlab, MRI, CT Scan, and the first CT Coronary Angiogram facility in Northeast India. It was designed from the ground up for high-complexity cardiac and multi-specialty care – not retrofitted from a general hospital.
I have operated on patients with triple vessel disease, failed prior surgeries requiring redo bypass, congenital defects in adults, and acute aortic dissections. These are not cases every centre handles. The infrastructure at Tulip was built to match that level of surgical challenge.
If you have been told a case is inoperable or that you must travel far for treatment – come for an assessment. We will give you an honest answer about what is possible.
This is one of the most important questions a family can ask – and there is no single answer that fits every patient.
In general, medicines manage symptoms and slow disease progression. Surgery is recommended when the blockage is severe enough that blood supply to the heart is at significant risk, when medicines are no longer sufficient, or when waiting increases the danger of a heart attack.
The decision is based on tests – typically an angiogram or CT Coronary Angiogram – that show the location and severity of blockages. A coronary angiogram is the definitive map of the heart’s blood supply.
What I tell families: do not delay the investigation. Once we have a clear picture, the decision about surgery versus medicine becomes much easier to explain – and to understand.
→ For a detailed explanation of when surgery becomes necessary, read: When Do You Need Bypass Surgery? 7 Signs Your Cardiologist Should Refer You to a Surgeon
Not necessarily immediately – but a heart attack is always a signal that something must be investigated and addressed without delay.
After a heart attack, we need to assess the extent of the damage and whether the underlying blockage has been treated adequately. Sometimes an angioplasty (a stent inserted by a cardiologist) is sufficient. In other cases – particularly when multiple arteries are blocked, or when the blockage is in a critical location – bypass surgery gives the heart a more durable, long-term solution.
The key is not to wait and hope things settle. A heart attack is the heart’s way of saying: the situation is serious. Please come in, let us do the appropriate investigations, and we will advise clearly on the next step.
→ Read: Heart Attack Symptoms Every Indian Should Know – And What to Do in the First 5 Minutes
Bypass surgery – CABG, or Coronary Artery Bypass Grafting – is one of the most studied and well-established operations in the history of modern medicine. In experienced hands and with appropriate patient selection, outcomes are consistently very good.
I am careful about quoting statistics in isolation because every patient is different – a 55-year-old with one blocked artery is a very different case from a 70-year-old with three blocked arteries and a prior heart attack. What I can say is that across my 7,000+ surgeries over 25+ years, including many high-risk and complex cases, the vast majority of patients have gone home and returned to their normal lives.
The most meaningful measure is not a statistic – it is an honest conversation with your surgeon about your specific case, your risks, and what success looks like for you.
→ Read: Bypass Surgery (CABG) in Guwahati: A Complete Patient Guide
For most patients undergoing bypass surgery or valve surgery, the hospital stay is typically 7 to 10 days after the operation – sometimes shorter if recovery is smooth, occasionally longer if there are complications or if the patient needs additional monitoring.
The first 24–48 hours are spent in the cardiac ICU, where the team monitors heart function, breathing, and blood pressure closely. Once stable, the patient moves to a regular ward and begins gentle recovery – sitting up, walking short distances, eating normally.
Discharge does not mean the end of care. We send patients home with a clear recovery plan, medications, and follow-up appointments. The weeks after surgery are just as important as the surgery itself, and we stay involved through that period.
→ For a full week-by-week recovery guide, read: Life After Heart Surgery: Your Complete Recovery Guide
Yes – with careful preparation and monitoring. Diabetes is common in our patient population in Northeast India, and the majority of patients I operate on have some degree of diabetes or blood sugar irregularity.
Diabetes does increase certain surgical risks – primarily around wound healing and infection – but these risks are manageable. Before surgery, we optimise blood sugar control. During the operation, the anaesthesia and surgical team monitor glucose levels closely. After surgery, the nursing and medical team continues that monitoring in the ICU and ward.
Uncontrolled diabetes that has been ignored for years does add complexity. That is why early assessment matters – the better-managed a patient’s diabetes is before surgery, the smoother the recovery.
Diabetes alone is not a reason to avoid surgery. It is a reason to prepare properly.
This is one of the most common fears patients and families bring to me, and I want to answer it honestly.
During surgery, you are under general anaesthesia – you feel nothing. In the first 24–48 hours after surgery, there is discomfort – a tightness in the chest, soreness at the incision site, some discomfort when breathing deeply or coughing. This is expected, and it is managed with appropriate pain medication throughout the hospital stay.
Most patients describe the pain as manageable – not the unbearable experience they imagined. By day 3 or 4, many patients are surprised at how much better they feel than they expected. Within a few weeks, the discomfort fades significantly.
The anticipation of pain is almost always worse than the reality. What matters most is that you are in experienced, attentive hands.
→ For a step-by-step account of what surgery day actually involves, read: What to Expect on the Day of Your Bypass Surgery
Recovery varies by patient, but here is a general picture for bypass surgery:
| Timeframe | What to expect |
|---|---|
| First 2 weeks | Rest at home, short walks, no lifting or strain – wound healing |
| 4–6 weeks | Most patients feel significantly stronger; light daily activity resumes |
| 6–8 weeks | Driving can typically resume; many patients return to desk work |
| 3 months | Most patients are back to a full, active life – often more active than before surgery |
The patients who recover best are those who follow their rehabilitation plan, take their medications regularly, make the lifestyle adjustments we discuss, and attend their follow-up appointments. Recovery is not passive – it is a partnership between the patient and the surgical team.
→ Full recovery roadmap, diet, exercise, and emotional recovery: Life After Heart Surgery: Your Complete Recovery Guide
In some cases, yes. Catheter-based procedures – such as TAVI (Transcatheter Aortic Valve Implantation) for aortic valve disease – allow valve replacement without opening the chest, and are appropriate for certain high-risk or elderly patients.
However, for the majority of patients – particularly younger patients, those with specific valve anatomy, or those who need repair rather than replacement – open surgery remains the gold standard. It allows the surgeon to see the valve directly, repair it precisely, and address any related problems at the same time.
The decision between open surgery and a catheter-based approach depends on the type of valve affected, the severity of the disease, the patient’s age and overall condition, and the specific anatomy. This is a nuanced decision that requires a proper assessment – not a one-size answer.
Redo bypass surgery – operating on a patient who has had a previous heart operation – is technically more complex, and not every centre offers it. I do.
The main challenges with redo surgery involve scar tissue from the prior operation, which alters the anatomy and requires careful, experienced technique. The risks are higher than a first-time bypass, which is why patient selection, pre-operative planning, and surgical experience matter enormously.
Across my career, I have performed redo bypass surgeries on patients who were told by other hospitals that a second operation was not possible or too dangerous. In the right hands, with the right preparation, redo surgery is a viable and often life-extending option.
If your family member has been told a second operation is not possible, please come for an evaluation before accepting that conclusion.
These are the signs that should prompt an immediate evaluation – do not wait and see:
Many patients in Northeast India wait too long – managing symptoms with home remedies or assuming rest will fix things. Heart disease rarely reverses on its own. The earlier a problem is detected and treated, the more options we have and the better the outcome.
When in doubt, come in. The assessment itself will give you clarity – and peace of mind is worth more than the cost of a consultation.
→ Read: Heart Attack Symptoms Every Indian Should Know | Coronary Artery Disease: Symptoms, Causes and When to See a Surgeon
Yes – and this is an area where many patients carry a diagnosis for years, sometimes decades, without realising that surgery can help.
Congenital heart defects – structural problems present from birth, such as holes in the heart (ASD, VSD), abnormal valves, or unusual blood vessel connections – are often diagnosed in childhood but sometimes go undetected until adulthood. Some adults have lived with a defect their whole life and only discover it when symptoms worsen or a scan is done for another reason.
Adult congenital heart surgery requires specific expertise. I have performed these operations across my career, including complex cases where the defect had gone untreated for many years.
If you or a family member has a known congenital heart condition and has been told surgery is needed – or if you have unexplained symptoms and a history of heart murmur – please come for an assessment.
A CT Coronary Angiogram is a non-invasive heart scan that produces detailed images of the coronary arteries – the blood vessels that supply the heart – to detect blockages, narrowings, or calcium deposits.
Unlike a conventional angiogram (which involves inserting a catheter into an artery), a CT Coronary Angiogram is performed as an outpatient procedure. No incision, no hospital admission, no sedation in most cases. You come in, the scan is done, and you go home – usually within a few hours.
What makes this significant for Northeast India is that until Tulip Mediworld introduced this facility, it was not available anywhere in the region. Patients had to travel to major cities for what is now an accessible, early-detection tool.
For anyone with risk factors – family history, diabetes, hypertension, high cholesterol, or chest discomfort – this scan can catch disease before a heart attack happens. That is the shift from reactive to preventive care.
→ Read: CT Coronary Angiogram vs Traditional Angiogram: Which One Do You Need? | CT Coronary Angiogram in Guwahati: Now at Tulip Mediworld
Tell them their fear is completely understandable – and that it is also worth having a real conversation with a surgeon before letting that fear make the decision.
Fear of surgery is one of the most common reasons people delay care that could save their lives. I have seen patients who waited two or three years after being advised to have surgery, and who came back in a much worse condition than if they had come earlier.
What I ask of families is this: bring your loved one in. Sit with me. Ask every question that is keeping them awake at night. Understanding what surgery actually involves – what happens before, during, and after – almost always reduces the fear, not increases it.
The unknown is always more frightening than the known. Let us replace the uncertainty with information, and then make a calm decision together.
→ Read: What to Expect on the Day of Your Bypass Surgery
This is a fair and important question – and I want to give you an honest answer, not a promotional one.
Here is what to look for in any cardiac centre: the surgical team’s training and experience, the volume of procedures performed, the infrastructure available for emergencies and post-operative care, and – perhaps most importantly – whether the surgeon is transparent with you about risks and outcomes.
At Tulip Mediworld, I can tell you: the hospital was built specifically for cardiac and complex surgery, not as an add-on to a general hospital. I trained at Sree Chitra Tirunal Institute, one of India’s premier cardiac centres, and have performed 7,000+ surgeries across 25+ years. The infrastructure – 6 OTs, Cathlab, 24/7 ICU, CT Coronary Angiogram – is not marketing language. It exists and it functions.
Come and see it. Talk to us. Ask the hard questions. That is the only way to build genuine trust – not from a brochure.
Yes – and this is a relationship that goes back many years.
From 2004 to 2017, I worked in Bangladesh – helping establish the ZH Sikder Cardiac Care and Research Centre and Square Hospital in Dhaka. I trained surgeons, built cardiac programmes, and operated on thousands of Bangladeshi patients during that period. The trust I built there was not institutional. It was personal.
Today, Bangladeshi patients continue to travel to Guwahati for cardiac surgery – for second opinions, for complex cases, and for follow-up care. Guwahati is geographically close to Bangladesh, the cultural and linguistic connections are strong, and the standard of care at Tulip Mediworld matches what patients would find in Dhaka’s leading hospitals.
If you are in Bangladesh and considering cardiac surgery, please reach out to us directly. We will help coordinate your visit, assessment, and care.
This is a question I genuinely appreciate – it tells me a family is engaged and thinking carefully. Here are the questions every patient or family should ask:
A good cardiac surgeon will answer every one of these questions clearly, without rushing you and without making you feel that asking is a sign of distrust. If a surgeon cannot or will not answer them – that is itself important information.
→ Read: When Do You Need Bypass Surgery? 7 Signs Your Cardiologist Should Refer You to a Surgeon
If reading this has brought up questions about your own family member’s condition – or if you have been sitting with a diagnosis and are not sure what to do next – the most useful thing you can do is come in and have a conversation.
At Tulip Mediworld Superspeciality Hospital, we see patients and families at every stage: before a diagnosis, after a heart attack, before surgery, and through recovery. There is no question too small and no case too complex to discuss.
Book a consultation with Dr. Apurba Kumar Sarma at drapurbasarma.in or call Tulip Mediworld at 1800 890 4655.
Tulip Mediworld Superspeciality Hospital, GS Road, Rukmini Gaon, Guwahati, Assam – 781022.
About the Author
Dr. Apurba Kumar Sarma, MBBS, MS (General Surgery), MCh (CVTS) is a cardiovascular and thoracic surgeon with over 25 years of experience and 7,000+ successful heart surgeries. He is the Founder, Chairman and Managing Director of Tulip Mediworld Superspeciality Hospital, GS Road, Rukmini Gaon, Guwahati, Assam – 781022. He is a Fellow of the Indian Association of Cardiovascular-Thoracic Surgeons and a Life Member of the Indian Medical Association.
This article is for informational purposes only and does not constitute medical advice. Please consult a qualified cardiac surgeon for evaluation and treatment specific to your condition.
