Advances in Bypass Surgery - What’s New

Beating Heart Surgery:

Traditionally Bypass surgery used to be done by Connecting the Patient to the Heart Lung Machine (Cardio-pulmonary Bypass Machine) and the Heart is stopped while the Surgeons perform the Bypass Operation.

Nowadays Surgeons perform what’s called the Beating Heart surgery where we work as the Heart is beating normally and we perform the Bypass Operation. Avoiding Heart lung Machine in majority of patients helps in faster recovery and has a more economical impact for the patient.

Multi-Arterial Bypass Surgery:

Bypass surgery usually is done with One Artery ( Internal Mammary Artery) and Multiple Veins harvested from the legs and thighs.

India being the World’s capital of Diabetes Mellitus, we have a lot of young patients coming up for Bypass Surgeries, in the Forties and Fifties.

The veins harvested from the legs get usually blocked in 8 to 12 years after surgery. In case of young patients, using multiple Arterial grafts are used like the Right Internal Mammary Artery (RIMA)and Left Radial Artery (RA) to improve long term results and  survival.

The Right Internal Mammary Artery (RIMA) and Radial Artery stay open for many more years compared to the Veins taken from the leg and helps in giving many more years of life and symptom free survival for patients.

In the academic front the team headed by Dr Anbarasu Mohanraj is also a part of an ICMR funded Multi-centric trial which looks into the long term patency of multiple arterial   grafts in diabetic patients. This Multi-centric Trial is named PREDICT Study.

Minimal Invasive Bypass Surgery.

Conventional Heart surgery is done by making a cut in the chest in the middle and cutting across the chest bone (Sternum)

A select group of patients can be operated through a small cut which is 2.5 - 3.0 inches in the side and    performing the surgery. With time, more and more patients can be operated through the side (Minimally Invasive surgery)

Right now we perform this surgery in a select subset of patients without compromising the results. We will soon be performing more of these surgeries even in patients needing triple or quadruple bypass.

Endoscopic Vein Harvest (EVH)

Veins were also being harvested from the leg with a long cut on the leg. This causes significant pain and issues related to healing. Veins are being harvested now with Endoscopes with a small 2 cms incision. This reduces the chances of getting infection in the leg and patients hardly have any pain related to this. Recovery becomes much faster. Patients can return to work much faster.