A team of doctors at Star Hospitals in Hyderabad have developed a new operating technique for diabetic patients undergoing bypass surgery. The new technique is regarded as one of the first of its kind in the world.

Diabetic patients undergoing off pump coronary artery bypass surgery can have a considerable reduction in sternal wound infections by using this innovative operating technique.

Dr Lokeshwar Rao Sajja, a cardio thoracic surgeon, at Star hospital played a vital role in designing this innovative technique. The operating technique is basically designed from mammary artery harvesting which preserves the sternal blood supply even after both the mammary arteries are harvested for bypass surgery.

Conventionally, bypass surgery is done using one internal mammary (thoracic) artery and additional vein grafts taken from the legs or artery from the fore arm. Now there is a huge body of scientific evidence that confirms that patients receiving two internal mammary arteries during bypass surgery have significantly improved long term survival and this is true even in diabetics.

But presently, around the world, only four per cent of patients undergoing coronary bypass surgery are receiving two internal mammary arteries. It is because of the fear of increased sternal wound infections in diabetics when two mammary arteries are used. Sternum is the breast bone in the middle of chest wall to which the ribs are attached in the front.

The risk of infection in the sternal wound is because there is a risk of reduced blood supply to the tissues (ischemia) in the sternal area when both the internal mammary arteries are used for bypass by the older techniques.

In this new technique, the sternal ischemia is reduced and sternal wound infections are negligible. Dr Lokeswar Rao also designed MASP (Mammary meticulous construction of ‘Y’ grafts), using both left and right internal mammary arteries.