The Telegraph
Since 1st March, 1999
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Heart surgery with minimum scar

For heart patients daunted by the prospects of the unsightly scar or the enormous ordeal of a coronary bypass surgery, there is cause for cheer. The pioneer of minimally-invasive and beating-heart surgery, Valavanur A. Subramanian of Lenox Hill Hospital, New York, will operate on patients at Apollo Gleneagles Hospitals at a two-day workshop on September 25 and 26.

“We will be honoured to have Dr. Subramanian down at our hospital. He has been doing minimally-invasive cardiac surgery without cutting the breast bone for quite some time,” says Ramesh Sheshadhri, director of cardio-vascular surgery, Apollo Gleneagles Hospitals. “The main aim of the workshop is to spread awareness on this procedure which reduces morbidity to a great extent,” he adds.

Subramanian, director of cardiac surgery, Lenox Hill Hospital, had co-developed the first disposable practical clinical membrane oxygenator in cardiac surgery, and also the implantable total and partial circulatory support system (the bladder booster pump).

In 1973, as director of the experimental Cardiac Surgery Research Laboratory at Boston University Medical Center, he introduced a new rotating disc membrane oxygenator for clinical use after initial experimental evaluation. The intra-aortic balloon pump, which buys critical hours for very sick heart patients, is another product of his labour.

However, Subramanian is still best known for his in-depth research and involvement in developing the technique of minimally-invasive heart surgery since 1994. Conventional open-heart surgeries are carried out through a long incision in the centre of the chest. To allow the surgeons to work upon the heart, it is stopped temporarily when the heart-lung machine oxygenates and pumps blood through the rest of the body.

“The goal of the minimally-invasive technique is to reduce the amount of trauma to the patient while maximising the health benefit,” explains Sheshadhri, who does the “maximum number” of beating-heart surgeries in the country. He will join hands with Subramanian and Nilesh Patel, also of Lenox Hill Hospital, to perform “cutting-edge surgeries” on needy patients at the workshop.

Minimally-invasive surgery has proved to be a “one-stop solution” for many problems associated with open-heart surgery, according to doctors. Since the surgeries are carried out through very small incisions (10-12 cm), the risk of infection is lowered along with post-operative pain and discomfort. “The scars are negligible, the surgery involves minimal or no blood transfusion and the patient can go home in four to five days,” says Sheshadhri.

Apart from the better cosmetic results it yields, a minimally-invasive surgery is sometimes the only choice of therapy for the elderly, who are at high risk for kidney failure and pulmonary infection. They could invite complications if their hearts were stopped in the traditional way and they were put on the heart-lung machine, feel cardiac surgeons.

The Apollo Group hospital, organising such a workshop “for the first time in eastern India”, has arranged for the procedures to be telecast live from the operation theatre to the hospital auditorium. “The workshop would benefit all clinical and interventional cardiologists and cardiac surgeons in the city,” says V. Satyanarayana Reddy, CEO of the hospital.

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