Why Bypass surgery has become common in India? Blocks in heart arteries are a very common problem in present generation and it is going to increase with rapidly changing lifestyle in India. Blocks in heart can be tackled by two ways either by Stenting or Bypass surgery.
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
| BYPASS SURGERY | STENTING |
| * Physiological operation | * Synthetic Material used |
| * Longer Lasting | *Tendency to get blocked |
| * Ideal for diabetic patients | * Unsuitable for diabetic patients |
| * Ideal for Indians with small blood vessels | * Unsuitable |
| * Economical | * Expensive |
| * Repeat procedure not required | *May require repeat procedure |
| * Medicines requirements comes down | * Medicines keep adding |
| * Does not require strong blood thinner | * Require lifelong strong blood thinners |
| * Minimal follow up with doctor | * Regular follow up required |
| * Ideal for patients with rural background as no follow up required |
* Needs to rush to speciality hospitals in city |
| * Most economical over next two decades | * Recurrent expense in next decade |
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.
