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Z. H.
Sikder Cardiac Care & Research Centre Draws International Attention.
New techniques of
doing by pass surgery on patients with badly diseased coronary arteries
have been developed at Z. H. Sikder Cardiac Care & Research Centre,
Dhanmondi, Dhaka. Dr. Murali P. Vettath,
the Chief Cardiac Surgeon and Clinical Director of the Centre, is going
to Germany to present 2 papers on these Latest developments in Coronary
Artery Bypass Surgery. Of the two papers, one
is “A New Technique of Coronary Bypass Grafting” used in this
center for the patients with badly diseased coronary arteries, being
performed on beating heart. Another paper is “Technique
of Total Arterial Coronary Grafting on Beating Heart”, which is
also being performed here using Octopus III (The latest equipment used
for stabilizing the beating heart). Dr. Murali has been
invited by the organizing committee of the IV Annual Meeting of
International Society of Minimally Invasive Cardiac Surgery, to present
these two papers in Munich, Germany. He is the only Cardiac
Surgeon from Bangladesh, who has been invited to present papers during
the conference. “This new technique
has been very useful in our young age group patients (averaging 47
years) who have been suffering from diffuse disease of coronary
arteries. Most of the patients operated upon are the ones referred to us
from different centers, after being branded as inoperable / high risk
for surgery. This technique gives new hope to these unfortunate
patients. We hope to standardize this procedure among the surgical
community around the world, so that it could be performed with excellent
results like ours.” said Dr. Murali, who developed this new technique. Early result from this
technique is excellent and the long-term results are awaited. The follow
up period has been nearly 20 months, and so far no undue problems have
been observed in our patient group. The most important aspect here is
that, bypass surgery has become possible in these patients, who would
have been either denied the surgery or would have undergone bypass
surgery with bad results in the immediate post-operative period itself.
Most of the patients who require bypass surgery in Bangladesh are of
younger age group as compared to the Western countries, where the
average age of the bypass surgery patient is above 60 years. The
long-term results could be improved if the patients follow a life style
of no smoking, healthy food (avoiding red meat and decrease the oil
consumption), regular exercise, control of blood pressure and
cholesterol. Over eating as
compared to the energy requirement of the body and high consumption of
oil and red meat could be the cause for early development of coronary
artery disease and heart attack in our patients. “Bypass surgery gives
solution for the existing coronary artery disease. Further progression
of the disease has to be controlled by life style modification” - said
Dr. Murali. Many patients after
bypass surgery restart smoking and go out of dietary control and do not
take the necessary medicines, as they feel better after surgery. This is
dangerous and can lead on to further problems. Another important
factor that can help a young patient is the use of arterial grafts.
Arteries carry oxygenated blood and veins carry impure blood in the
body. Both arteries and veins have been used as bypass grafts. Arterial
grafts give better long-term results as compared to vein grafts, but it
needs more technical expertise. From the very beginning, we have been
performing arterial revascularization using LIMA (Left Internal Mammary
Artery), an artery on the inside of chest wall on left side. Whenever
suitable, we do total arterial revascularization using other arteries
like RIMA (Right Internal Mammary Artery) and Radial arteries in young
patients. This is done by Beating Heart technique using Octopus -III
stabilizing system of Medtronic Corporation, USA. A paper will be
presented at Munich, Germany on this technique also. About 470 open-heart
surgeries have been performed at Sikder Cardiac centre with less than 1%
mortality rate. More than 100 bypass surgeries have been performed on
Beating Heart, which we first performed in June 1999. There was no
mortality on beating heart surgery patients so far. Presently, 80-90% of
our bypass surgeries are being done on beating heart at the centre. The
main focus on bypass surgery is to minimize the other multi organ
dysfunctions that have come across by performing Bypass surgeries on the
Heart Lung Machine. This Beating Heart Technique has enabled us to
perform surgeries on patients with Neurological problems, Blood
disorders, and lung problems. This would help most of these distressed
patients to have another lease of life. |
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