SURGERY IS NOT THE LAST RESORT, IT MIGHT BE THE BEST

Often the word Surgery fills most people with dread, even though it might be in their best interests. Many international studies and randomized trials have firmly established superior long term benefits of Coronary bypass surgery compared to coronary stents or any other medical treatment in patients with Triple vessel coronary artery disease especially in diabetics. In spite of excellent outcomes and low complications, the message to the general public has not been adequately conveyed. The apprehension and misinformation regarding surgery leads them to choose alternative methods of treatment.

Coronary artery bypass surgery (CABG) which completed its 50 years, and has saved millions of lives is facing new challenges in India.Nearly 2 lac of these operations are done every year in our country. The advancement of technology and the growing experience of cardiac surgeons have made the surgery safer and in an uncomplicated planned (elective) bypass surgery, the mortality rate is nearly 0%.

Beating heart surgery technique which is practiced by most Indian surgeons has significantly contributed to the excellent outcomes over the years. Indian surgeons have acquired vast experience of these procedures. Out of 7000 heart surgeries done by DrTrehan, more then 5000 are coronary artery bypass surgeries.

Near explosion of serious coronary disease in young population appears to be more of an Indian phenomenon. We now regularly see patients in their twenties with advanced CVD(cardiovascular disease). Surgery or other treatment can save lives but the long term health benefits can be achieved only by life style changes. Largely sedentary life style , irrational food habits and stress are among the major culprits. This is unfortunately going to be a major health issue in modern India and coronary artery bypass surgery with most dependable outcomes will play a central stage in the therapy of coronary artery disease.

Today the trend is to be minimally invasive for surgical procedures. But for coronary bypass surgery, in spite of concerted efforts over two decades, only limited success could be achieved in doing these operations with small incision or key holes. Robotic assisted and totally endoscopic coronary bypass (TECAB) is yet to be universally applicable. Newer technologies like mechanical anastomotic devices and percutaneous wire techniques hold a promising future.

Dr. Rajeev Trehan, MS (General Surgery),MCh.(CTVS)

Senior Consultant Cardiothoracic and Vascular Surgery

Neotia Getwel Healthcare Centre, Siliguri