Welcome to the website of Mr. Kulvinder Lall, one of the London’s leading cardiac surgeons in with expertise in coronary bypass surgery, aortic valve replacement and repair, mitral valve repair and keyhole heart surgery.
Mr. Lall also acts as an expert witness for medico-legal matters.
Mr. Lall is listed on the General Medical Council Specialist Register as a specialist in Cardiothoracic Surgery.
Will my insurance cover this type of surgery?
The majority of medical insurance plans will cover cardiac surgery, however, this question is best answered by contacting our office at 020 7234 2288
What are your office hours?
Our hours are 8:00 am - 4:30 pm Monday through Friday.
Who do I contact if I have a billing question?
If you have any billing inquiries, please call our office at 020 7234 2288
What can I do before surgery to decrease my risk?
There are a number of things that patients can do before surgery to improve their chances of doing well. Most importantly, do not smoke! The nicotine and other drugs in cigarette and cigar smoke can cause blood vessels in the heart or legs to constrict (get smaller) and can even cause a heart attack. Stopping smoking is the most important thing you can do to improve your health, even if you have smoked for many years. Another very important thing to do is to increase your activity, even if it is just going for a walk every day. In your visit to your surgeon before surgery, you may be given a breathing exercise device (called an inspirometer) - use it often to improve your breathing - you will be doing these breathing exercises after surgery to help clear your lungs and prevent pneumonia. Be sure to follow your doctor's orders to control other diseases you may have, such as diabetes or high blood pressure.
How is surgery accomplished?
Mr Lall will meet with you and explain the operation and its risks and benefits. You will have the opportunity to ask any questions you or your family may have. After we receive your signed consent form, your surgery will proceed. You will be transported to a sterile operating room, sedated and placed under anesthesia by the cardiac anesthesiology team.To operate on the heart, the surgeon opens the chest by dividing the breastbone(sternum) and connects you to the heart-lung machine. By performing the functions of the heart and lungs, this machine allows the surgeon to operate directly on the heart. When the operation is finished, the heart resumes beating on its own and the heart-lung machine is disconnected. Then the divided breastbone is wired together so it can heal, which requires at least six to eight weeks. Finally, the skin is closed by stitches, staples or a special glue, depending on the surgeon's preference. The sternal wires will remain in the chest bone and are not removed.
How long will the operation take?
The length of your operation will depend on the type of surgery that you are having. Most surgeries take at least four to five hours. Included in this time is the preparation for surgery, which requires approximately 45 to 60 minutes
What is the risk of something bad happening to me?
While the great majority of patients have no problems related to surgery and the risks of anesthesia are very low, cardiac, thoracic, or vascular surgery carries more risk to you than many other surgeries. First of all, patients needing these types of surgery either do have heart disease or are at high risk of having heart disease. The risk of having a heart attack during or right after surgery is higher in cardiac, thoracic, and vascular patients than for patients without heart disease undergoing other types of surgery. The risk of a very bad outcome, such as death or stroke, will be different for each patient. Your surgeon and anesthesiologist can advise you of your risk profile for the particular procedure you are scheduled to undergo. While it is important to understand the risks associated with cardiac, thoracic, and vascular surgery, these should be weighed against the risks of alternative therapies. In nearly all cases, you would not be referred for surgery unless your doctors felt that the benefits of surgery outweighed the risks.
Will there be any limitations after my surgery?
The most important restriction is limiting upper body use to allow your sternal bone to heal. This means no pushing, pulling or lifting more than five pounds for two months after surgery. Your nurse will teach you techniques to accomplish this. Exercise that strengthens stomach muscles will help you become independent sooner.
What is the average length of hospital stay?
Many patients are able to leave the hospital in three to four days after surgery. Our team will discuss your discharge plans with you postoperatively.
What type of care will I need after I return home?
If you are able to go directly home, you will need someone there 24 hours per day for the first week. The key responsibilities are:
Grocery shopping and meal preparation.
Obtaining medications and dispensing as ordered.
Monitoring patient’s weight, blood pressure, temperature and keeping a record for the surgeon.
Assisting with the walking program as necessary.
Helping with daily activities such as bathing, assisting in and out of bed as needed.
Providing transportation to doctor appointments.
When can I drive?
Usually three to five weeks after surgery. Your doctor will tell you when this is appropriate.
When can I return to work?
Most individuals who perform desk or sitting activities are able to resume limited or part-time work at three to four weeks after surgery. Those with physically active jobs may be restricted for two months. Your return to work should be discussed with your surgeon usually two to three weeks after surgery.
What about exercise?
After an open heart operation we encourage exercise, however, we feel that lower body exercises are superior. We, therefore, encourage walking, use of a treadmill at low speed and an exercise bicycle. We do not allow returning to weight lifting or heavy straining with the upper body. With regard to playing golf, we limit the patients in the following way: For the first month following surgery no golf whatsoever, or if they are feeling well they may practice putting. During the second and third months we progressively allow the patient to increase the distance from the hole, allowing pitching and chipping during the second month, and approach shots in the third month. After three months if the patient is doing well he may play a full round of golf.
When can I travel in an airplane, car or train?
We suggest limited travel in the first few weeks after an open heart operation. We prefer, if possible, that the patient be seen in follow up by both their surgeon and their cardiologist prior to travelling long distances, but the majority of our patients can travel quite soon.
When will I return to see my doctor?
You will return to see Mr Lall for a postoperative visit six weeks from the date of your discharge.