In a landmark contribution to medical science and cardiovascular surgery, the Apollo Hospitals Chennai have completed 25,000 coronary bypass operations including 10,000 on beating hearts using advanced cardiac surgical techniques. This was revealed by Dr Prathap C Reddy, chairman of the hospital group in a function organised to mark the medical and surgical breakthrough.

According to him, Apollo has become the most sought after destination for heart care in India because of its commitment to heart surgery in the country and outstanding patient outcomes during the last 25 years.

While speaking to Pharmabiz, Dr M R Girinath, chief cardiovascular surgeon of the hospital said that Coronary Artery Bypass Graft (CABG) surgery can be done using a heart-lung machine and stopping the heart and is called 'On-Pump CABG'. The CABG can also be done without using a heart- lung machine and also without stopping the heart. It is known as 'Beating heart CABG' or Off-Pump CABG.

"There are certain advantages for this beating heart surgery when compared to the conventional coronary bypass procedures. The method of beating heart surgery eliminates the complexity of using a heart-lung machine. It helps for a marked reduction in post-operative complications such as bleeding, need for prolonged ventilation, memory loss, strokes and renal failure. Further it reduces the need for blood transfusion and helps for shorter ICU and hospital stay. The hospital mortality rate after On-pump CABG (Coronary Artery Bypass Graft) in the hospital was 2.1 per cent, but the Off-Pump CABG (beating heart) has significantly reduced the hospital mortality to around 0.6 percent", he told Pharmabiz.

On the disadvantage side, he said the method needs an experienced anaesthetist and surgeon. It is best avoided for some of the patients with diffuse coronary disease or those with small coronary arteries or those with severely damaged hearts.

Earlier while addressing the media, the chief cardiovascular surgeon said "at Apollo Hospitals, we continue to innovate and pioneer newer techniques. We train surgeons, cardiologists, anaesthetists and paramedical staff for the future. During the present decade, the excellent results, both in short and medium term, have convinced us that beating heart surgery is an excellent operation for the kind of patients that are seen in India".

From 1984 to August 2009, the hospital has performed a total of 34,948 Open Heart Operations. Out of these 74 per cent are CABGs, with On-Pump CABG comes to 15725 and Off-Pump CABG to 10164. In short, the hospital has performed 25889 CABG surgeries within a quarter century.

During the interaction, the surgeon said, unlike in the west, CABG numbers are likely to grow in India because of the increasing prevalence of Coronary Artery Disease (CAD), population growth and ageing of population. Likewise, CABG is less expensive than PCI (Percutaneous Coronary Intervention) in India. He said lack of population based preventive programs also cause high growth of CABG. The doctor clarified that greater use of the beating heart technique made it easier to do more operations. "In India we use the technique for 60 per cent of all CABG, as compared to less than 20 per cent in Europe and USA. We are now planning to do much more in the next quarter century by coordinating and unifying the efforts of our widespread and growing number of hospitals," he said.

While addressing the media, Dr Prathap Reddy said India has the sad distinction of being the heart disease capital of the world. The media should partner with healthcare in creating awareness to arrest this epidemic.