Heart surgery and cardiac care in India, from the UK

Often the patient is a parent in India, not the person calling

That triangle (patient in India, payer in the UK, hospital in a third city) is one of the shapes this corridor takes, and the process is built to handle it rather than bent to fit. Your parent's own consent comes first, and it is theirs to give. After that the angiogram, the echo and the clinic letters are gathered at the Indian end, and the video consultation is scheduled so that both of you are on the same call and nobody has to relay a cardiologist's words down a phone line afterwards. Written messaging carries a time difference far better than a hospital switchboard does, which is why one named coordinator holds the thread instead of a rota. Two questions are worth deciding inside the family before an admission rather than during one: who has the final word if the surgical plan changes, and who will be at the hospital. They are yours to answer, not ours, and answering them early costs a great deal less than answering them at three in the morning.

Ask for the angiogram images, not only the report

A cardiac second opinion turns on what the images show, and a report only summarises them for the doctor who ordered it. If a coronary angiogram has been done, ask the cardiology department to release the images themselves, on disc or through a download link (a copy of your own record is yours to ask for), and send the echocardiogram and a recent ECG alongside them. With those in front of them, a cardiologist can give a considered view on the questions people lose sleep over: whether stenting or surgery suits the anatomy described, whether a valve procedure is being proposed at the right point, whether a device decision can reasonably wait. Dates matter here more than most people expect, since an angiogram from two years ago and an echo from last month describe different hearts; send what you have with the dates visible and say what has changed since. A $50 remote consultation covers the conversation, or $150 for a written opinion you can hand to someone.

Comparing a quote from home with a quote from India, line by line

The mistake is comparing two totals that do not contain the same things. In UK private practice the fees can stack, since the consultant, the anaesthetist and the hospital may each bill separately, so the figure you were given may be only one of several. Before comparing anything, write down what your quote at home includes and what it leaves out. Then ask India for the same detail: the procedure itself; the stents, valve or device identified by make and model with its own price against it; how many nights of intensive care are included and what one more costs; and the drugs you will be discharged on, which is the line people forget until they are paying for it. Then ask what is excluded, in writing. A single-line package is a number rather than a quote, and we do not pass those on. Treatment money goes straight from you to the hospital at rates locked before travel, our fee arrives on a separate invoice, and every figure in the comparison is one you can put in front of whoever else in the family is helping to pay.

Fitness to fly, the return leg, and the file your GP receives

No return flight should be booked for a cardiac patient before the treating team has given a date, and the same caution applies to the outbound leg. Fitness to make the journey at all is a question for the doctors who have examined the patient, never for us. Put it to them explicitly instead of assuming, and treat a negative answer as the end of the matter. Where this corridor helps is the shape of the journey: the Delhi route out of London is flown nonstop several times a day, and Mumbai and Bengaluru can also be reached without a change of plane, so an unwell passenger need not be walked through a connecting terminal; treatment elsewhere in India usually adds one short domestic hop, planned around the admission date. Coming home, the surgeon sets the date and we keep the booking flexible around it. Before discharge, ask for the discharge summary, the operation or catheter-lab report, the medicines with doses, and, if a device has been implanted, the device identification card and its programmed settings in writing.

What to prepare

• The coronary angiogram images on disc or via a download link, together with the report rather than instead of it
• The most recent echocardiogram and ECG, with the date clearly visible on each of them
• The clinic letter stating what has been advised (stent, bypass, valve or device) and who advised it
• A complete list of medicines and doses, anticoagulants included, plus any allergy or previous reaction worth recording
• If the patient is a relative in India: their reports, and a clear answer on who decides and who pays
• The device identification card, if a pacemaker, ICD or CRT device has already been implanted