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Bypass surgery with beating heart safe bet in India, says latest study
A new technique was developed to perform bypass surgery, while keeping the heart in beating condition while traditionally, bypass surgery is done by stopping the heart and using heart lung machine.
A landmark study conducted by seven Indian cardiac surgeons led by Dr Lokeswara Rao Sajja from Hyderabad has concluded that conducting bypass surgery while keeping the heart beating is as safe as doing it with the support of heart-lung machine in heart patients, particularly in India.
The study, titled “Promote Patency Trial,” was published in Indian Journal of Thoracic and Cardiovascular Surgery two days ago, Dr Sajja revealed on Friday.
A paper on this trial was first presented by Dr Sajja on behalf of the group of seven surgeons, at the 98th annual meeting of American Association for Thoracic Surgery held at San Diego in May last year. “It was widely appreciated by international community of cardiac surgeons,” he said.
He said traditionally, bypass surgery is done by stopping the heart and using heart lung machine. Recently, a new technique was developed to perform bypass surgery, while keeping the heart in beating condition.
“The first procedure is called on-pump coronary artery bypass grafting (CABG) surgery, while the latest method is called off-pump or beating heart surgery. Particularly in India, where there is a high prevalence of diabetes and kidney ailments among the heart patients, off-pump CABG is safer and has lesser complications, compared to on-pump surgery,” Dr Sajja said.
According to him, on an average, about 1,50,000 bypass surgeries are done annually in India, of which 60 per cent are now being done on beating heart and the remaining 40 per cent are done with the aid of heart-lung machine.
The study which began in March 2016 ended in October 2017, surveyed 320 patients who had undergone bypass surgery either by on-pump and off-pump CABG. “They were investigated with angiography at an interval of three months to evaluate the quality of grafting. Post-operative angiography confirmed that the patients who underwent off-pump surgeries were as healthy as those who had undergone on-pump CABG,” Sajja said.
Apart from Dr Sajja, who is presently working at Star Hospitals in Hyderabad, the others who took part in the study are Dr Kunal Sarkar (Medica Hospital, Kolkata), Dr Gopichand Mannam (Star Hospital, Hyderabad), Dr Krishna Kumar (KIMS, Hyderabad), Dr P Chandrashekar (GKNM Hospital, Coimbatore), Dr Sanjeeth Peter (DDMM Heart Institute, Nadiad, Gujarat) and Dr Anvay Mulay (Fortis Hospital, Mumbai).
Dr Sajja, who had conducted more than 12,000 bypass surgeries over 20 years, also said he had designed an innovative technique, wherein two internal mammary (thoracic) arteries are used for grafting during the bypass surgeries.
“Conventionally, bypass surgery is done using one internal mammary artery and additional vein grafts taken from the legs or artery from the fore arm. But we have proved that using two internal mammary arteries during bypass surgery has significantly improved long term survival, especially in diabetic patients, as it reduces external wound infections,” he said.
