Heart lung machine (hlm) and heart surgery in india

The cost of surgery at India’s top heart hospitals has been scaling new heights. Most of the costs in open heart surgery are accounted for by the consumables, surgical equipments that are disposed of after single use. Being imported, the consumables can be bought only at the prevailing international price.

The import content of cardiac operation is dramatically raised by the all-important Heart Lung Machine (HLM), which temporarily takes over the functions of the heart and the lung during operation. The HLM is the key equipment, performing two functions: to oxygenate blood drawn out from the right heart through an oxygenator, and then to pump the oxygenated blood into the body through aorta. The HLM is indispensable in all open heart surgeries, be it coronary bypass surgery, a valve replacement or the correction of congenital heart defect in babies.

It has a complex array of disposables, which cost nearly Rs 24,000 now. It was Rs 18,000 in March. The oxygenator itself is worth between Rs 7000 and Rs 12,000. It pumps blood through a polyurethane mesh which is so fine that a single pore allows no more than one blood corpuscle at a time.

In extreme cases, when the body refuses to accept the HLM, surgeons take recourse to an artificial heart support system called intraortic balloon pumps. Leading manufacturers- Datascope, Mansfield or Abco-all in the US makes the balloon, which is disposable. Its cost has spiraled from Rs 22,000 a year ago to Rs 32,900.