When the patient reached the hospital with severe chest pain and difficulty in breathing, little did he and his family know that he had a tumor and an impending heart attack to fight. An Indian based cardiothoracic surgeon decided to do an open heart surgery on this patient when and angiogram and chest MRI, X-ray showed major arterial block along with blockages in the smaller arteries coupled with a tumour sitting close to the heart.
Though the biopsy revealed that it was a noncancerous growth, its removal was necessary to prevent future complications.
Increased age of the patient and his prior medical condition called for caution during the open heart surgery as the levels of anaesthesia to be administered would have to be calibrated very carefully. The experienced surgeon went ahead with the surgery, putting the patient on heart lung machine, took venous grafts from the patient’s leg and connected them to the coronary arteries.
The main aim was to bypass (CABG) the blockages and reroute the blood to establish normal blood flow to the heart. Quick decision making in such cases is essential to prevent major injury to cardiac muscle. Once the blood flow was restored to the heart, the surrounding tumour was resected completely and sent for biopsy. The patient was discharged healthy and fit after a week.
Coronary artery bypass grafting (CABG) improves the patient’s quality of life and increases longevity by 10-15 years.Had it been a case of artery blockage only, percutaneous angioplasty- minimally invasive surgery, that involves inserting a thin tube called catheter with a balloon at one end would have been inserted through a major artery in the leg and guided to the site of blockage using X-ray imaging techniques. The procedure is usually done by an interventional cardiologist. After the catheter removes the plaques, the balloon is inflated to restore the arterial diameter. In some cases to maintain the arterial opening a stent made up of medically approved material is put in place to prevent collapse of the artery. Multiple grafts are possible to overcome large number of obstructions. The patient is put on medications and sent home after giving complete follow up instructions.
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