The most commonly performed adult heart surgery all over the world  is coronary artery bypass surgery popularly known as bypass surgery. First bypass surgery was done in India in 1975. In1990s about 10000 surgeries were performed  annually. Now about 60000 surgeries are performed in India, annually. Bypass surgery means, to overcome blocks in blood vessels of heart and create new pathways in heart blood vessels so that heart gets new channels of blood supply whichprevents future heart attack.

Normally there are three arteries in heart which supply blood to the heart muscles. Over a period of time these arteries get blocked due to different reasons.That leads to chest pain initially which is called as angina and later on leads to heart attack.

Blocks in heart arteries are a very common problem

Blocks in heart arteries are a very common problem in present generation and it is going to increase with rapidly changing lifestyle in India. These blocks are commonly caused by smoking, diabetes, high BP, excess cholesterol in blood, sedentary lifestyle, stress, family history of heart blocks,  poor diet habits and kidney problems.

Blocks in heart can be tackled by two ways either by Stenting or Bypass surgery. These two procedures everybody should understand because stenting seems like an easier and quicker choice as compared to bypass surgery.

Angioplasty and stenting means, the blocks in heart artery to some extent opened up by a small balloon and an artificial tube is inserted across the block. This is ideal in case of a sudden heart attack or single block in arteries. It is not suitable for people with main artery blocks and for patients three and more blocks.

Stenting may solve problem temporarily

Stenting may solve problem temporarily but in long term it leads to problems. Multiple stenting is unnatural, a foreign body is inserted in heart. These stents get blocked over a period of time especially more so in diabetics. The pattern of re-blockis unpredictable, it can happen any time.

A person spends lot of  time taking care of his heart in future life with stents. Multiple hospital admissions, re angiograms, re procedures and ultimately heart function reduces over a period of time. Many times, people are afraid of operations so they opt for stenting.

Bypass surgery is superior to stenting

Bypass surgery is most natural way of treating this problem.  In this operation patients own blood; vessels are used to bypass the blocks. This operation is one-time treatment which clears all blocks in one go in the most natural way.Surgery generally takes 3 to 5 hours.

In this procedure patients own artery from chest and veins from legs are used for bypass the blocks. All the blocks are cleared in this operation at one time . Patient is kept on ventilator post operatively and a few days in ICU. Normally total hospital package is given for 8 days by most of the  hospitals.

Bypass surgery is superior to stenting as it gives a long-term benefit. It gives longer life, better quality life, much lesser hospital visits in future life and much lesser consumption of medication over lifetime of patient. Reducing cost of treatment for whole lifetime  is important benefit for Indian population with bypass surgery than stents.

People are worried for life risk when they think about heart surgery. It is a most commonly performed operation all over the world. This surgery is very safe operation. Success rate is about 99%.

Advances in bypass surgery

There are advances in bypass surgery. We try and do surgery on beating heart without using heart lung machine whenever possible. In India most of  Bypass surgeries are carried out on beating heart. Few patients we operate  by smaller cuts or key hole surgery, this gives smaller cuts to patients, less pain and quick recovery of patients.

However, which technique to use for surgery, depends on patient’s problem. Surgeon performs operations keeping  safety of patient in mind. Patients resume normal life and return to work by about one month. Self-driving re recommended after 6 weeks.

Patients may lead absolutely normal life up to 20 yrs and above  after  bypass surgery.

Comparison between Bypass surgery versus Stenting

Dr. Satish M. Kini
MBBS, MS, MCh, FACCS (USA)
Cardiothoracic & Vascular Surgeon
#131, First Cross, R K garden,
New B E L road, Bangalore 560054
Mob : 9901753729
Email: smkini2000@yahoo.com

Author Dr.Satish.M.Kini  is Fellow Texas Heart institute, Houston, Texas, USA, Fellow Transplantation, Houston, Texas, USA and Fellow Royal Price Alfred hospital, Sydney, Australia. Dr.Satish.M.Kini is one of the leading Cardio-thoracic & Vascular Surgeons in Bangalore. He performs the Bypass surgery on a beating heart without using any artificial machines and   must have performed over 10,000 major surgical procedures in this field.

The post Why Bypass surgery has become common in India? – A comparison between Bypass surgery versus Stenting appeared first on Health Vision.

New Delhi, 07 September 2020: The Associated Chambers of Commerce and Industry of India (ASSOCHAM), one of the apex trade associations of India concluded the fifth edition of the ‘Illness to Wellness’ series themed ‘Heart Wellness During COVID-19’. The event saw an illustrious panel of cardiologists from across the country hold active dialogues on the best preventive measures to be taken for heart patients during COVID-19. The discussion saw the panellists put forth a plethora of measures like increasing safety precautions, eating right, exercising regularly and knowing when to reach out to doctors as symptoms develop for citizens to take up during the pandemic.

Supported by the hygiene brand SAVLON, the programme which promotes healthy living with focus on wellness and preventive health through healthy habits, diet, exercise, and holistic health saw the speakers discuss at great length why patients should not be scared to reach out to doctors or hospitals in fear of contraction, rather they should be on the lookout for symptoms other than fever to be for early detection of COVID-19.

Patients need to be aware of their normal heart rate:

Putting forth this suggestion, (Padma Shri) Dr. Mohsin Wali, Cardiologist and Former Physician to The President of India, said, “The most harmful feature of this virus is that it is uncertain. The virus either increases the heartbeat or decreases it, even if there is no fever. Patients need to be aware of their normal heart rate and any changes to it, they should inform their doctor.  The first symptom of this disease is no symptom. In some people I noticed they would get tired easily. At such a stage if we are alert then we can be prepared for further possible damages. In working young people, we sometimes notice changes in their chest, even if they received a COVID negative report the previous day. It is important that patients reach out to doctors immediately for any symptoms.”

Dr.Wali also stressed on the importance of reaching out for mental health support and the increased need for psychological counselling now and in future as he expects a surge in its demand owning to the distress caused by COVID-19. He further stressed on the importance of keeping lungs active and increasing their capacities by undertaking activities like blowing conch shells, balloons and whistles. It is not necessary that you develop symptoms like fever, cough or severe pneumonia and then call for help. These might be there, but when you start to feel slowness, exhaustion or reduced oxygen level then you should reach out to a doctor.”

Inflammations  can lead to heart attacks:

Highlighting the multiple ways in which the heart gets affected by COVID-19,  (Padma Bhushan) Dr. Ashok Seth, Chairman, Fortis Escorts Heart Institute and Chairman, Cardiology Council, Fortis Group of Hospitals, said, “There are multiple ways in which this virus attacks the heart. Clinical effecting of the heart can happen directly even in people with mild symptoms. The virus tends to form clots in the body. It is one of the ways in which virus attacks the body. It also forms inflammations which can lead to heart attacks. Formation of clots in young people in lungs can lead to severe breathlessness, low blood pressure and low oxygenations. The clotting tendency can even lead to stroke in young people. These are direct effects of the cardiovascular system. Inflammation can also affect the heart muscles leading to reduced pumping efficiency of the heart. The virus can also cause heart rate disturbances. There are multiple ways the heart gets affected by the virus. The more serious the patient gets, the more the heart gets affected.”

He further added that after a patient recovers from COVID-19 and gets discharged from hospital, they might suffer from After COVID Syndrome that will see majority of them suffer from symptoms like breathlessness, tiredness, exhaustion, joint paints, coughs or inefficiency in performing daily activities for weeks or months. For complete recovery, they might need support of cardiologists, internal medicine specialists, respiratory physicians, pulmonologists, physiotherapists and psychologist to be restored to life completely. He also emphasized that precaution on part of citizens needs to be heightened if not increased further despite the economy openingas India is currently on the upward slope of its COVID track and its peak is yet to be reached.

 Incorporate best diet in meals:

Laying out the best diet to incorporate in meals during COVID-19 for healthy living, (Padma Shri) Dr. K. K. Aggarwal, Cardiologist, Physician and Former President of the Indian Medical Association, said, “Balanced food should involve all seven colours and six tastes of food in moderation and variety along with a non-inflammatory diet. Food we have during fasting season is non-inflammatory and inflammatory ingredients are like sugar, rice, refined flour or oil. Anything refined is inflammatory and should be avoided. Take up a non-inflammatory diet and add all supplements that are lost by the virus.” He further added that for individuals who are prone to inflammations, COVID-19 if contracted, can be harmful as the virus has a tendency to accelerate inflammations in the body leading to increased health complications.

Supporting the discussion, Mr. Anil Rajput, Chairperson, ASSOCHAM CSR Council, said, “The Illness to Wellness series has been sharing expert opinions on how to take care of your mental and physical health during the pandemic. The Coronavirus has set forth a wide range of damages and challenges for the world that doctors and researches are still struggling to get a grasp on. Therefore, the old and golden adage of prevention is better than cure is something we should all follow. As iterated by the veteran doctors today, masks need to be strictly worn in public spaces with adequate distancing measures to keep ourselves safe. We hope that the expert measures shared by the eminent panellists enlightened the attendees and the insightful information shared equipped them to fight the virus proactively.”

Dr. Rajesh Kesari, Founder and Director, Total Care Control, acted as the moderator of the event and raised pertinent questions before the panellists to guide the discussion into a strong knowledge-sharing webinar. His smart manoeuvring of the discussions helped reap health foresights from the veteran cardiologists. Dr.Kesari summed up the discussion at the end by focusing on the importance of masks in our precautionary measures for both heart patients and healthy citizens.

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