HCG Hospital successfully performed a minimally Invasive Direct Coronary Artery Bypass surgery on a 43-year-old male patient for coronary heart disease. This is for the first time that such an innovative technique has been used to operate on a patient in Bhavnagar. Naresh, a 43-year-old male presented himself at HCG Hospitals with a complaint of chest pain from few days. The patient had undergone Coronary Angiography in another private hospital a couple of days back which revealed critical single-vessel disease in the left anterior descending artery (LAD).

The doctors at the private hospital had tried performing percutaneous transluminal coronary angioplasty (PTCA) which is a minimally invasive procedure to open-up blocked coronary arteries, allowing blood to circulate unobstructed to the heart muscle. But due to LAD dissection during the procedure, the patient was referred to HCG Hospitals.

The patient underwent the preoperative investigative procedures at HCG where the test results turned out to be normal. His ejection fraction was down to 45%. Ejection fraction (EF) measures the amount of blood pumped out of the heart’s lower chambers, or ventricles. It is the percentage of blood that leaves the left ventricle when the heart contracts. An (EF) between 55% to 75% is considered to be normal. If it is 50% or lower, then it’s a sign that the heart, usually the left ventricle might not pump out enough blood.

Dr. Brij Mohan Singh and the team of doctors investigated the patient’s test reports and planned for a CABG (MIDCAB). Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) is a surgical treatment for coronary heart disease that is a less invasive method of coronary artery bypass surgery (CABG).

Naresh’s condition was critical with a LAD dissection the previous day. His heart was blocked and needed a surgical procedure immediately to restore normal blood flow to an obstructed coronary artery. After evaluating his condition, the team of specialists decided to go ahead and perform this unique surgery for the first time in Bhavnagar. The foremost advantage of this surgery is the fact that no bones are cut. Patient selection is also important to perform CABG (MIDCAB). Stable patients with preserved ventricular function (unless CPB assistance is used) and with no severe chest deformities or pulmonary comorbidities should be considered. It is not recommended for very obese patients. Unlike traditional heart surgery, back to normal life including driving or other activities is not disrupted and can be started almost immediately.

The patient underwent the CABG (MIDCAB) procedure through a 2-inch left lateral thoracotomy instead of the conventional sternotomy. The procedure was successful, and the patient

recovered very quickly that he was extubated 2 hours after surgery and was shifted the next day to the ward. Since his recovery rate was good, he was advised an early discharge.

Speaking on the unique procedure Dr. Brij Mohan Singh, Director, Department of Cardiac Surgery, HCG Group of Hospitals Gujrat said “Minimally Invasive Direct Coronary Artery Bypass is the newest technique for cardiac surgery and most of the common surgeries can be done through this approach. Very few cardiac centers in India have started doing MIDCAB at present. Advantages with respect to conventional cardiac surgery through sternotomy include less pain, minimal blood loss, quick recovery period, early resumption of normal work (2 weeks compared to 2 1/2 months for conventional surgery through sternotomy), and cosmetically acceptable scar. By initiating the MIDCAB program at HCG Hospital Bhavnagar we are certainly looking forward to serve more patients in the region which will benefit them with a quick and safe operative method”.

Dr. Bharat Gadhavi, Regional Director of Gujarat, Healthcare Global Enterprise Ltd. said, “We are extremely proud to have successfully treated a patient through minimally invasive Direct Coronary Artery Bypass surgery for the first time in Bhavnagar. We are glad that people of Bhavnagar can now benefit from this innovative and advanced procedure through the skills & expertise of our specialists at HCG. I would like to applaud the entire team involved in the treatment of the patient for considering a new improved way of performing the surgery and their pioneering spirit”.

Mr. Naresh, the CABG (MIDCAB) patient said “I would like to thank the entire team of specialists at HCG Hospital Bhavnagar, without them I wouldn’t have survived. I and my entire family were worried post my left anterior descending artery dissection in a private hospital. We had no hopes of the future. But the doctors here at HCG hospital took up my critical case and performed the unique surgery, because of which I have recovered today and leading a normal life again.