New Delhi, Jan 24: Though Prime Minister Manmohan
Singh is undergoing a complex bypass surgery, leading
cardiologists on Friday said it is a "routine" operation performed
at AIIMS and there is nothing to worry.
"No, I do not think there is any reason to worry.
Everything should be alright because this operation is a
routine one which is done at AIIMS since 1975," AIIMS former
Director Dr P V Venugopal, who carried out the country`s first
heart transplant, said.
His view is also backed by Dr Upendra Kaul, a leading
cardiologist.
"I don`t think there is room for any concern or problem,"
Dr Kaul, Executive Director, Cardiology at Fortis and Escorts
hospitals said.
"Any person who has undergone bypass surgery eight to
ten years ago runs a chance of having the problem again and
one of the solutions is repeat bypass surgery if there are
multiple blockages. It is done regularly and it needs a little
more care," he said.
Asked by when would the Prime Minister be able to resume
his work, Dr Venugopal said, "In fact, we don`t like patients
to be on bed rest. After 48 hours (of the operation), we ask
them to slowly start with their daily lives.
"Once, he (Prime Minister) leaves the hospital in about
seven days, he would be able to resume his normal routine in
about 4-6 weeks."
About 30,000 individuals undergo coronary artery bypass
graft (CABG) operation every year in the country.
"According to estimates, about 30,000 such CABGs are
performed every year. The surgery is one of the safest
techniques used to clear blockages in the heart vessels," Dr S
K Agrawal, senior cardio vascular thoracic surgeon at Sanjay
Gandhi Postgraduate Institute of Medical Sciences, Lucknow
told a news agency.
He said that even when a patient is old, the surgery has
95 per cent chances of being successful. "Even the second
surgery, often known as re-do surgery has fairly high chances
of success even at an advanced age," Agrawal said.
The surgery is performed when arteries get blocked and
procedures like angioplasty or medicines fail to clear the
blockage.
Surgeons using blood vessels from other parts of the body
create an alternate route by sidelining the blocked part to
carry blood.
The heart comprises muscle fibres which are aligned in
circular manner to form a conical chamber. The muscles
contract in unison, blood is forced out of the chamber into
different vessels which carry it to different organs.
Once the oxygen-rich blood comes out of the heart, it
again goes to the main vessel called aorta which carries it to
different parts of the body.
Since the first CABG, as an experiment, was attempted on
animals over 100 years ago, it has evolved as a most trusted
method for cardiac surgeons to improve blood circulation.
There are two main coronary arteries, which further
branch into smaller vessels which dive into heart muscle,
supplying blood needed for the working of heart.
"In the coronary artery disease, the channel inside these
small but vital arteries becomes blocked with plaque material,
which is cholesterol and other body fats. The blockage, if
large enough, obstructs the blood flow and deprives heart
muscle cells of vital nourishment from the blood stream," said
Agrawal.
Under stress when the demand of blood is high and supply
less, patients notice chest pain or pressure with further
exercise, known as angina.
Prime Minister Singh is a case of `unstable angina`,
doctors said.
Doctors from Asian Heart Institute and AIIMS will try to
develop an alternate route for the supply of blood by
sidelining the blocked part using graft of arteries and
vessels derived from other parts of the body.
The first surgeon to attempt a direct hook-up to the
coronary artery was Dr Alexis Carrel who in early 1900s used
suturing techniques for grafting.
Although animal models used by him could not survive, his
principle of directly grafting into the coronary artery
branches is still used by surgeons across the world. In 1912,
he was honoured the Nobel Prize for Medicine.
Bureau Report
