Dr SS Bansal
Dr SS Bansal

Is Bypass Surgery for heart patients avoidable? Senior interventional cardiologist Dr Bansal answers

ANI | Updated: Apr 22, 2021 22:02 IST

Faridabad (Haryana) [India], April 22 (ANI/PNN): Yes, the bypass surgery for heart patients is avoidable, said Dr SS Bansal, Senior Interventional Cardiologist at SSB Heart and Multispecialty Hospital, Faridabad.
He added that complex CTO Angioplasty and Stenting by Radial/Femoral Approach have made avoiding bypass surgery possible in many patients.
He shared a testimony of a patient Ramesh (Name Changed), a 62-years-old man suffering from severe angina on minimal exertion for months. After angiography, it was found that the patient's two out of three coronary arteries (arteries supplying blood to the heart muscle) and RCA &LCX were completely blocked completely- chronically with signs of the extreme complexity as both the lesions were angulated, long, hard and calcified with bridging collaterals. His third artery LAD had a patent stent.
His heart's pumping power was very weak (EF 30 per cent) but heart muscle for occluded arteries was viable. When such blocks are present, patients are often subjected to bypass surgery. Angioplasty in such cases is extremely difficult and requires lots of experience from the operator. Even highly experienced cardiologists find it difficult to handle such complex blocks without bypass surgery.
In this case, both femoral arteries were also completely blocked making this route unavailable for intervention. Attempting such a complex disease from the radial route (wrist artery) was a big challenge.

Dr Bansal and his team tried to open these complex blocks with special hard CTO wires with the help of a special micro catheter through the radial artery of the wrist called radial artery and fortunately, both the blocks got opened completely and non-surgically.
Successful opening of double complex CTO lesions through the Radial artery at the wrist is very difficult and done for the first time in the region. The patient recovered very well and was discharged after 3 days in very good condition from the hospital. This has given new hope to such patients with complex diseases.
Successful stenting to left circumflex, OM1, and right coronary double stenting was done using a radial route which made the procedure more challenging. Dr Bansal felt thankful for the great advancement in technology along with his 26 years of rich experience in the field which made him confident enough to take up the challenge and solve the patient's problem.
This success creates hope for many patients who are either at very high risk for bypass surgery due to their comorbidities or who don't accept bypass surgery as an option. Chronic total, Occlusion was treated by bypass surgery in the past which was the only way to treat these difficult blocks but due to these novel techniques and evolved hardware in experienced hands through the radial artery (wrist) is a boon for such patients with blocked leg arteries.
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