Heart & Lung Conditions We Treat

What it is: Coronary artery disease (also called ischaemic heart disease or IHD) occurs when the arteries that supply blood to the heart muscle become narrowed or blocked, usually due to a build-up of fatty deposits (plaque). This restricts blood flow and oxygen to the heart, causing symptoms such as chest pain (angina), breathlessness, or in severe cases, a heart attack.

When surgery is considered: When medications or stenting are not sufficient, coronary artery bypass grafting (CABG) may be recommended. This procedure creates new pathways for blood to flow around the blocked arteries.

Minimally invasive option: Prof. Shahrul is one of the few surgeons in Kuala Lumpur actively performing MICS CABG, bypass surgery through a small keyhole incision between the ribs, without splitting the breastbone.

Coronary Artery Bypass (CABG) MICS CABG Available Triple Vessel Disease LAD Disease

What it is: The mitral valve controls blood flow between the two left chambers of the heart. Mitral stenosis means the valve has become narrowed and does not open properly. Mitral regurgitation means the valve does not close properly, causing blood to leak backwards. Both conditions can cause breathlessness, fatigue, and heart failure if left untreated.

Surgical options: Mitral valve repair (where the existing valve is corrected) is generally preferred over replacement as it preserves natural tissue. When repair is not possible, a mechanical or bioprosthetic replacement valve may be used.

Minimally invasive option: Both mitral valve repair and replacement can be performed through a small keyhole incision between the ribs, avoiding the need to split the sternum.

Mitral Valve Repair Mitral Valve Replacement (MVR) MICS Available

What it is: The aortic valve sits between the heart's main pumping chamber and the aorta (the body's largest artery). Aortic stenosis means the valve has become stiff and narrow, making the heart work harder to pump blood. Aortic regurgitation means the valve leaks. Both can cause chest pain, dizziness, breathlessness, and, if untreated, heart failure.

Surgical option: Aortic valve replacement (AVR) is the standard surgical treatment for severe aortic valve disease. Either a mechanical valve or a tissue (bioprosthetic) valve may be used.

Minimally invasive option: Minimally invasive aortic valve replacement (MIS AVR) can be performed through a small upper chest incision, avoiding a full sternotomy.

Aortic Valve Replacement (AVR) MIS AVR Available

What it is: The tricuspid valve controls blood flow between the right atrium and right ventricle. Tricuspid regurgitation, where the valve does not close properly, is often associated with left-sided heart disease or atrial fibrillation. It can cause fluid retention, leg swelling, and fatigue.

Surgical option: Tricuspid valve repair (annuloplasty) is the standard surgical approach, often performed at the same time as mitral valve surgery.

Tricuspid Valve Repair Combined Valve Procedures MICS Available

What it is: An atrial septal defect (ASD) is a hole in the wall (septum) between the heart's two upper chambers (atria). It is a congenital condition, meaning present from birth. Some ASDs are small and close on their own; larger defects allow abnormal blood flow between the chambers and can lead to breathlessness, fatigue, and in the long term, heart failure or pulmonary hypertension.

Surgical option: Surgical closure of the ASD, including the more complex Sinus Venosus ASD which cannot be closed by catheter device. This can be performed using minimally invasive keyhole techniques.

ASD Closure (Keyhole) Sinus Venosus ASD Adult Congenital MICS Available

What it is: Atrial fibrillation (AF) is the most common heart rhythm disorder, where the heart's upper chambers beat irregularly and rapidly. It can cause palpitations, breathlessness, dizziness, and significantly increases the risk of stroke due to blood clots forming in the left atrial appendage.

Surgical option: The MAZE procedure creates scar tissue patterns in the atria to block the abnormal electrical signals causing AF. It is often performed simultaneously with valve surgery. Left atrial appendage ligation (closure) may be performed at the same time to reduce stroke risk.

MAZE Procedure Left Atrial Appendage Ligation Combined with Valve Surgery

What it is: The aorta is the body's main artery carrying blood from the heart. An ascending aortic aneurysm is an abnormal bulge in the aorta near the heart, which can rupture if untreated. An aortic dissection is a tear in the inner layer of the aortic wall, a life-threatening emergency requiring urgent surgical intervention.

Surgical options: Elective or emergency replacement of the ascending aorta and aortic arch. The Bentall procedure replaces both the aortic valve and the aortic root. Prof. Shahrul's team handles both elective cases and emergency presentations at DSH2.

Bentall Procedure Ascending Aorta Replacement Emergency Surgery Available Hemiarch Replacement

What it is: Congenital heart defects are structural abnormalities of the heart present from birth. Some are diagnosed in childhood; others are not detected until adulthood. They range from septal defects (holes in the heart) to abnormal coronary artery connections.

Surgical options: Prof. Shahrul manages a range of congenital procedures in both adult and paediatric patients, including ASD closure, VSD repair, and coronary fistula ligation, using minimally invasive techniques wherever appropriate.

VSD Repair ASD Closure Coronary Fistula Ligation Adult & Paediatric

What it is: A pericardial effusion is an abnormal accumulation of fluid in the sac (pericardium) surrounding the heart. In large quantities, this fluid can compress the heart, a life-threatening condition called cardiac tamponade. Causes include infection, inflammatory conditions, cancer, or following cardiac surgery.

Surgical option: Drainage of the fluid and, if necessary, surgical management of the pericardium (pericardiectomy) to prevent recurrence.

Pericardial Drainage Cardiac Tamponade

What it is: Lung cancer is one of the most common cancers worldwide. Early-stage lung cancer, particularly non-small cell lung cancer (NSCLC), may be suitable for surgical removal, which offers the best chance of long-term cure.

Minimally invasive option: VATS (Video-Assisted Thoracoscopic Surgery) lobectomy allows removal of the affected lobe of the lung through small keyhole incisions using a camera, avoiding the need for a large open chest incision (thoracotomy). Recovery is typically faster and less painful.

VATS Lobectomy Minimally Invasive Lung Cancer Surgery

What it is: A spontaneous pneumothorax occurs when air leaks into the space between the lung and chest wall, causing the lung to partially or fully collapse. It may occur in young, tall individuals (primary spontaneous pneumothorax) or in those with underlying lung disease. Recurrent episodes often require surgical treatment.

Minimally invasive option: VATS bullectomy (removal of the air-filled blisters, called bullae or blebs, that caused the air leak) combined with pleurectomy (roughening the lung surface to encourage it to adhere to the chest wall) is performed through small keyhole incisions.

VATS Bullectomy Pleurectomy Keyhole Surgery

What it is: A thymoma is a tumour of the thymus gland, located in the front of the chest. Thymomas are often associated with myasthenia gravis (an autoimmune condition causing muscle weakness). Surgical removal of the thymus (thymectomy) is the standard treatment.

Minimally invasive option: VATS thymectomy allows removal of the thymus through small keyhole incisions, avoiding the need to split the sternum. This is particularly beneficial for patients also undergoing treatment for myasthenia gravis.

VATS Thymectomy Keyhole Surgery Myasthenia Gravis

What it is: Lung metastases are secondary cancers that have spread to the lungs from a primary tumour elsewhere in the body (e.g., colorectal cancer, sarcoma, melanoma). In selected patients with limited metastatic disease, surgical removal of lung metastases (metastasectomy) may be appropriate as part of a multidisciplinary treatment plan.

Minimally invasive option: VATS metastasectomy allows removal of accessible lung metastases through keyhole incisions.

Metastasectomy VATS Secondary Lung Cancer

What it is: Pulmonary sequestration is a rare congenital abnormality where a section of lung tissue has no connection to the normal airway and receives blood supply from an abnormal vessel. It can cause recurrent infections and breathlessness. Surgical removal is the standard treatment.

Minimally invasive option: VATS lobectomy allows removal of the sequestered lung tissue through keyhole incisions.

VATS Lobectomy Congenital Lung