When Manmohan Singh underwent multiple cardiac surgeries, including a complex redo procedure; know more about it

Redo cardiac surgeries, performed on individuals who have previously undergone heart procedures, require specialised techniques and expertise due to complications after initial surgery. 

But what are these complications, and how are these identified?

Dr Prateek Chaudhary, senior consultant, Interventional Cardiology at Asian Institute of Medical Sciences, tells indianexpress.com, “Redo cardiac surgeries are required when the disease activity progresses rapidly, often due to uncontrolled risk factors such as diabetes and hypertension or drug non-compliance. These factors can lead to the worsening of existing conditions, necessitating another surgery. Additionally, graft failures, particularly at the site where grafts join native arteries, can cause symptoms requiring intervention. Other conditions, such as valve dysfunction following a prior bypass surgery, may also necessitate reopening the chest for repair.”

Symptoms that signal the need for a redo surgery include shortness of breath, chest pain during exertion, palpitations, or sweating, he adds. Regular follow-ups with the treating doctor are critical to detecting these abnormalities early and determining if a surgical intervention is required.

How do advancements in surgical techniques and technologies make redo cardiac procedures safer and more effective?

Dr Chaudhary notes, “Redo surgeries are inherently more challenging due to the presence of adhesions formed during the healing process from the previous surgery. These adhesions make the procedure riskier and increase the chances of complications, such as bleeding.” 

Advanced tools and techniques, such as IABPs and improved stenting options, reduce the invasiveness of procedures when possible. (Source: Freepik)

However, advancements in medical science have significantly improved outcomes:

• Zip Fix Systems: These systems help close the sternum securely in patients undergoing redo bypass surgeries, which is particularly challenging in these cases.
• Intra-aortic Balloon Pumps (IABPs): These are frequently used in redo surgeries to support the heart and improve outcomes.
• Minimally Invasive Alternatives: Advancements in angioplasty and stenting techniques offer less invasive options for some patients, avoiding the need for another open-heart surgery and enabling quicker recovery.

These innovations, the doctor states, combined with meticulous surgical techniques, have made redo procedures safer and more effective.

Risks associated with redo cardiac surgeries 

According to Dr Chaudhary, redo surgeries carry higher risks compared to first-time procedures, primarily due to:

• Adhesions: The presence of adhesions complicates the surgical process and increases the likelihood of bleeding.
• Chest Bone Healing: Reopening the sternum reduces the chances of effective healing.
• Weaker Health Status: Patients requiring redo surgeries are often weaker and may have multiple comorbidities, which prolong recovery times.

To manage these risks, he says, surgeons take several precautions:

• Preoperative and intraoperative care is meticulously planned to minimize complications.
• Advanced tools and techniques, such as IABPs and improved stenting options, reduce the invasiveness of procedures when possible.

Post-operative care measures

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.