By OUR STAFF REPORTER
DEHRADUN, 20 May: An 88 year old man Kashmeer Singh, a resident of Dehradun was suffering from chest pain, breathing difficulty and swelling of feet for a long time. He took medical consultation at Shri Mahant Indiresh Hospital, where Dr Ashok Kumar Jayant, Head of the Cardio Thoracic Vascular Surgery (CTVS) Department, after evaluation, advised him to undergo an urgent Coronary Angiography Test.
The Coronary Angiography revealed that all three main Coronary Arteries and their branches supplying blood to the heart muscle had developed more than 90% blockage. This was affecting the functioning of the heart and all organs of the body.
Coronary Angiography also showed that there was deposition of hard stone-like calcium in all coronary arteries and these blockages cannot be opened by the technique of Angioplasty which if attempted could lead to rupture of the arteries, massive bleeding and even death of the patient.
Dr Ashok Kumar Jayant advised urgent Coronary Artery Bypass Grafting (CABG) for the treatment of the blockages. The relatives were very hesitant for the bypass surgery as they were afraid that their patient will not be able to tolerate the stress of the big operation at his extreme age.
Dr Ashok Kumar Jayant explained to the relatives that early CABG was very necessary otherwise the patient could have complications and even death at any moment. He reassured the relatives that in his 36 years’ experience in CTVS he had successfully done several similar operations in such elderly patients. He explained that the patient will be operated by the modern technique of stitching the bypass grafts on the beating heart. The heart would continue to beat and pump blood normally in the body throughout the operation. As a result of this beating heart bypass grafting technique the several complications that result when artificial machine pumps and pipes are used are prevented completely. Eventually the relatives and the patient agreed for the CABG operation.
The patient underwent CABG operation which lasted for 5 hours and five bypass grafts were constructed on the various coronary arteries of the heart. Three of these five bypass grafts were constructed by using the arterial conduits or pipes from the body and two bypass grafts were constructed by using veins from the leg. This is also a record achievement in Uttarakhand.
The operation was successful and Kashmeer Singh was shifted to the CTVS ICU for further care and recovery. From the second day onward after surgery he was able to walk unsupported and after an uneventful recovery he was eventually discharged after seven days of the operation.
Senior consultant Anaesthesiologists Dr Parag and Dr Hariom, the assistant technicians and the nursing staff all contributed in the success of the surgery.
Coronary Artery Bypass Grafting in very aged patients is challenging and difficult because of the wide spread of calcifications of the arteries of the heart and the various organs of the body. The various body organs undergo an age related decline in their metabolic function which could lead to dysfunction of the organs after the operations and subsequent complications. Due to the availability of hi-tech operation theatre, ICU and equipment, highly experienced team of specialist doctors, technicians and nursing staff of Shri Mahant Indiresh Hospital even such complex operations are being conducted routinely and successfully.
