Given his childhood, it’s no surprise Dr. Emmanuel Amulraj became a cardiac surgeon.
He grew up in Kuwait where his father was a perfusionist (he operated the heart-lung machine during cardiac surgeries) with the World Health Organization and his mother was a scrub nurse. Amulraj became fascinated with hearts and witnessed his first open heart surgery at age 6.
“The dome room was a special viewing platform right above the operating room and was a great way to observe surgeries,” explained Amulraj. “My parents let me do my homework there so I’d hang out after school and watch. My dad’s job was to run the heart-lung machine, which is an artificial blood pump that takes on the functions of the heart and lungs while the surgeon operates on the heart. He would explain how they worked and the anatomy of the heart.”
His fascination with the human heart continues to this day. After medical school in India and a residency at State University of New York, Amulraj had advanced training in cardiac surgery, including a fellowship at Stanford University’s Heart Transplant Program where he trained under the mentorship of Dr. Philip Oyer, a pioneer in the field. In July 2014, he joined the faculty at UTMB as assistant professor of surgery in the Division of Cardiothoracic Surgery.
“I was interested in academics because I didn’t want to lose my skills for heart transplants, so that brought my search down to just a few academic institutions that dealt with transplants and devices,” he said. “Texas is one of the fastest growing states in the United States and that means more people who need health care. I looked at this as a great opportunity. A lot has changed at UTMB since Hurricane Ike in 2008, and I think my vision is in line with the administrative vision, as well.”
Within four months of arriving in Galveston, Amulraj had already completed more than 40 cardiac surgeries, including three heart transplants. He specializes in complex valve repair and minimally invasive cardiac surgery as well as heart and lung transplantation. In minimally invasive surgery, surgeons operate on the heart through small incisions in the right side of the chest.
“The nice thing about minimally invasive surgery is patient recovery is cut in half,” said Amulraj. “Patients like that they can now recover in two days, instead of five, and there is hardly any blood loss.”
One of the most common problems he sees is heart failure, a condition in which the heart can't pump enough oxygenated blood to meet the body's needs. It affects nearly five million adults in the United States, but can be difficult to diagnose. In most cases, a patient may have felt symptoms such as shortness of breath or fatigue for quite some time, but either ignored it or didn’t realize something was wrong with their heart until they suffered an acute heart attack. He compares it to driving a car.
“It’s like your tire pressure is low in the car for a long time; it doesn’t really affect you until it goes flat. But if the check engine light comes on, you can either ignore it or keep going — but at some point, something is going to blow up.”
He recommends getting an echocardiograph if a person starts recognizing symptoms such as shortness of breath, fatigue, persistent cough/wheezing, or swelling in the legs, ankles and feet.
“If I see a 23-year-old man who has no history of asthma but is short of breath, tired and has been gaining weight, I would suggest getting an echo,” he said. “Let’s check him out and make sure it’s not a diet issue. It could be something to do with his lungs or heart. Taking a quick look in the window does more benefit than harm.”
Surgery may be needed for patients with severe heart failure. Some may be candidates for a heart transplant, but donor hearts are not always available and their condition may worsen as they wait. Mechanical circulatory support is a way to improve the circulation of blood throughout the body with a heart pump called a ventricular assist device (VAD).
“The development of pumps has been refined so much now that we can put this little device in the heart that decreases the work of the heart and accentuates the amount of blood it pumps,” said Amulraj.
Heart failure is a chronic, progressive condition. In some cases, it can be managed through lifestyle changes such as diet or through the use of medications. As far as tips for a healthy heart, he says it comes down to three basic things: staying active, eating well and getting enough sleep. He points to the surplus of processed foods as one of the largest problems in the modern world.
“If we as humans could go back to our roots and try to eat sugar in its most natural form, that would make us all a lot healthier,” he said. “For example, eat a piece of fruit instead of a processed fruit bar. Fruit in its natural form has fiber and it’s good for you.”
While avoiding processed foods is nearly impossible, he says moderation is key. Getting your heart rate up with moderate exercise for about 30 minutes a day will also help keep your heart in good shape. Amulraj points to new smartphone fitness apps and activity trackers as something that could possibly help pick up heart rhythm issues.
“This new technology has potential to help with today’s medicine. All of these new apps that track heart rhythms and rates could catch potential problems before it becomes a major issue.”
While Amulraj encourages patients to make healthy lifestyle choices, it’s comforting to know that he is there when serious problems arise. Extraordinary progress has occurred in every aspect of cardiac surgery and Amulraj is dedicated to continuing those advancements.
“I love what I do. Cardiac surgery is something that I believe in. It is something that if done correctly, at the right time, in the right way, gives people hope. It gives a second chance at life.”