Doctors at Apollo Hospitals, Hyderabad, performed a sutureless coronary artery bypass surgery (CABS) on a 56-year- old man from Madhya Pradesh, paving the way mechanized or robotic surgery in the country. Using a device called a vein delivery system, the doctors eliminated the need for sutures on the pulmonary artery, thereby reducing complications and risks generally associated with normal surgery.
This unique procedure not only saves time but also does away with the need for clamps on the aorta to restrict the flow of blood. This sometimes results in small tears and breaking the hardened plaque coating the wall into tiny pieces or emboli. The emboli floats through the blood stream and may reach the brain, lungs, liver or kidneys causing serious problems, including paralysis.
According to Dr Vijay Dikshit, chief cardiothoracic surgeon at Apollo Hospitals and head of the team that performed the surgery, under the new technique, called Symmetry Bypass System Aortic Connector, a delivery system resembling a long-handled screwdriver is prepared with a vein draft and a star-shaped aortic connector. The tip of the connector is placed in the hole created by a aortic cutter, and by pressing a button the vein is sealed to the aortic mechanically with the help of the aortic connector. The seal does not allow blood to exit the place where two vessels are now joined. The connection is as secure as the traditional sutures. The team took just 20 seconds to conduct the bypass on pulmonary artery as against the normal 10 minutes.
The new procedure can be done on a beating heart, too. This allows the body to directly get oxygen-rich blood throughout the open heart surgery. Normally, while performing bypass, to restrict the flow of blood in the aorta on which bypass is being performed, it is clamped and the patient is put on pump.
Dr Dikshit said this was a first generation technique and with improvement it would lead to robotic surgery.
The device, developed by the US-based medical equipment major St Jude Medical Inc, has been approved by the US FDA. The device made of a alloy material called Nitinol costs $ 300 per unit, making the bypass surgery costlier by another Rs 15,000. The entire surgery costs about Rs 1.25 lakh, which includes the cost of the aortic connector.