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India's first minimally invasive Hybrid Revascularization procedure performed at Apollo Hospitals, Chennai

06 Mar 2018

The surgery was performed to treat a triple vessel coronary artery block and improve blood flow to the heart. The cutting-edge procedure gave a new lease of life to a 57-year-old male patient from Chennai.

Minimally Invasive Hybrid Revascularisation is a procedure that combines minimally invasive coronary artery bypass grafting surgery (CABG) and angiography stenting procedure to restore blood flow to the heart when there is a build-up of plaque in the blood vessels. Mr. Zahir Hussain, 57-year-old business man from Manali, Chennai was brought to Apollo Hospitals with a heart attack that blocked triple vessel Coronary artery. Patients with triple vessel blockage are mostly treated with a conventional Bypass surgery (by splitting the central chest bone) which is an intense procedure that needs a longer recovery time post-surgery.

Dr MM. Yusuf, Minimally Invasive Cardiac surgeon, Apollo Hospitals and his team decided to use a minimally invasive technique rather than the traditional approach on Mr. Zahir Hussain. This minimally invasive-Hybrid Revascularisation procedure allows the surgeon to work on a beating heart through a small chest incision (small thoracotomy) between the ribs with the help of High definition camera and monitor (Thoracoscope), without having to split the breastbone. This procedure helped quick recovery and major morbidity.

Dr. MM. Yusuf, and his team performed this new procedure with a unique two stage approach. Patient had a triple vessel coronary artery disease with moderately reduced heart function. Blockage of blood flow in the main vessel requires surgery while blocks in the other blood vessels supplying blood to the heart, could be treated either with surgery or angiography stent insertion. As the patient was a business man he wanted to have a speedy recovery to attend to his work swiftly. Hence the team performed an Endoscopic Minimally Invasive CABG to the main vessel followed by Angiography and stent insertion to the other vessels.

Describing the procedure Dr. Yusuf, Cardio Thoracic Surgeon, said "Endoscopic Minimally Invasive CABG a small thoracotomy - beating heart approach, the surgeon can perform the operation through a tiny incision under the left nipple (four or five centimeters wide) while the heart continues to beat. This technique lowers the risk of complications such as stroke, lung problems and kidney problems which are associated with the use of a heart-and-lung machine (in a conventional bypass procedure). The patients have reduced pain and less need for postoperative pain medication, smaller scars, a shorter stay in the hospital and a faster recovery.

He added, "As a stage two approach Zahir Hussain underwent Angiography and Drug Eluting Stent insertion to the remaining 2 blockages in the coronary artery under specialised Intravascular Ultrasound Guidance. This was performed by Dr Damodharan, Senior Consultant Cardiologist. The patient had excellent results in the check angiography after stent insertion and surgery."

Hybrid revascularisation has alleviated all complications and the patient was discharged home on the fourth day post the procedure without any blood transfusion. This procedure is suitable to treat most patients with triple vessel coronary artery disease. Patients tend to have less pain with negligible risk and are able to return to normal activity within two weeks.

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