Written By: Pavitra Sampath | Updated : March 25, 2014 6:58 PM IST
Mithalal Dhoka was suffering from diabetes and hypertension for more than two decades. In early February he developed chest pain and breathing difficulty for which he was initially admitted to Krishna Institute of Medical sciences, Hyderabad where a coronary angiogram was done on 10th Feb this year. The angiogram showed severe multiple blockages ( 17 blockages ) in all 3 major arteries of heart. All the arteries were very small (1 mm in diameter ). In view of very small arteries (less than 1 mm ), too many blockages and too much cholesterol deposit in the arteries, the patient was considered inoperable. Dhoka visited Asian Heart Institute in an unstable condition and was taken to operation theatre in a critical condition (low BP and high lung pressure). Read more about what to expect during an angioplasty.
But, all was not lost for this 58-year-old man. In a revolutionary surgery conducted by Prime Minister Manmohan Singh's heart surgeon Dr Ramakant Panda, Mithalal Dhoka got a new lease on life after undergoing 12 separate bypass grafts were created for blood to flow smoothly from and into the heart. Dr Panda, who had earlier operated on a patient with record breaking 10 grafts, has broken his own record by successfully operating this high risk case.The 11 hour long procedure that was conducted at Mumbai's Asian Heart Institute on Feb 12, could be the first such surgery in the world where so many grafts were created to bypass clogged arteries.
During the surgery Dr Panda first inserted an intra-aortic balloon pump (IABP) inside Mr Dhoka's heart to support his BP and circulation while Dr Panda carried out the 12 graft procedure where Mr Dhoka underwent a bypass surgery with bypass grafts to 12 arteries. Since the conventional technique of usinga mixture of arterial graft and vein graft
'An CT angiogram done after 20 days of surgery showed all grafts were working well. The patient underwent a stress test which was normal, which showed that while the patient was running an equivalent of 7 kilometer an hour his heart was getting full blood supply. The patient is doing well and is getting ready to get discharged,' said Dr Panda.
The case is unique and first time in the world since, under normal circumstances, most patients would have 3-4 blocks, but this patient had 17 blocks making him almost inoperable. Mr Dhoka had to have 12 bypass grafts, as compared to the normal 3-4 grafts. Another rarity was that the size of his heart's arteries were very small, and this parameter is paramount while determining if the patient can indeed undergo a bypass surgery. It also determines the risk of surgery and long term results. In Mr Dhoka's case this was again a parameter that made his surgery extremely high risk. What makes this surgery stand out is that the entire surgery was done on a beating heart.
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