Doctors at Kamineni Hospitals successfully perform complex awake coronary artery bypass grafting (CABG) surgery
Hyderabad: Surgeons at Kamineni Hospitals, Hyderabad, successfully performed an Awake Coronary Artery Bypass Grafting (CABG) surgery on Venkataramana, a 64-year-old RTC bus driver, hailing from Cherlagudem village, Sangareddy District. He is an active chain smoker because of which his heart valves developed a blockage. He also suffers from chronic obstructive pulmonary disease (COPD) because of which doctors could not operate on him under general anaesthesia (GA). So, awake coronary artery bypass grafting (CABG) was performed on Venkataramana.
General anesthesia (GA) has been the preferred anaesthetic technique for CABG surgeries. Since the first CABG surgery was performed in October 1998 on an awake patient with high thoracic epidural analgesia(TEA) block, occasional cases with varying degrees of success have been reported in medical literature. CABG surgeries using high thoracic epidural offer several benefits, including avoidance of GA, positive pressure ventilation, and ventilator-associated pneumonia.
“Awake coronary artery bypass grafting (CABG) means the patient is awake throughout the surgery, and on a ventilator. Awake CABG surgery using TEA leaves only the option of surgery for those patients who are not suitable candidates for GA, such as chronic smokers and those suffering from COPD,” said Dr.Suresh Kumar Esampalli, Chief Cardiac Anesthesiologist , Kamineni Hospitals – LB Nagar, Hyderabad.
He further added that TEA reduces the endogenous stress response, heart rate, and arrhythmias during manipulation of the heart, thus reducing the risk of myocardial ischemia and postoperative atrial fibrillation. Effective pain management allows adequate spontaneous ventilation and thus reduces postoperative pulmonary complications. It also allows immediate mobilization, early start of oral feeds, and recovery, thus decreasing intensive care unit (ICU) stay, he concluded.
Dr Suresh Kumar, Chief Anaesthesist, , Dr. Vishal V Khante, Senior Cardio Thoracic Surgeon, along with Dr Rajesh Deshmukh, Cardio Thoracic Surgeon, Dr. Sagar Chandra Buyar, Sr. Cardiologist, OT, and Nursing teamparticipated in the surgery.