Heartening news: have triple bypass, walk out next day

The method is simple enough to be carried out elsewhere, says Patel, and the New Delhi-based Escorts Heart Institute and Research Centre is planning to bring the technology to India soon.

From January to July this year, 45 patients were operated on at the Manhattan hospital using this procedure. Thirty-nine patients saw the tubes on their body being removed in front of their their eyes on the operating table. Seventy per cent were discharged within 14 hours of surgery, 10 per cent in 24 hours. Only two patients needed re-admission within the customary 30-day follow-up: one for pleural effusion; the other for wound infection. There has been no report of any mortality.

While the findings and results are soon to be published in a leading medical journal, the procedure has already created a buzz in the medical fraternity.

In his first interview to the media, Patel explained to The Indian Express his ‘‘painless bypass’’ procedure. In layman’s terms the doctor, with the help of a robotic device, cuts a two-and-a-half-inch incision in the front of the heart, instead of the usual large incisions at the side or the base.

He then rotates the heart to where the incision is, instead of cutting through bone or rib to reach the organ. ‘‘This is the first time in the world it has been done—rotating the heart to where the incision is,’’ says Patel.

He adds the surgery could allow those undergoing Coronary Bypass Grafting (CABG) to be placed in the ‘Outpatient’ category and discharged the same day, and to go about normal life within 24 hours.

The method can be emulated worldwide, says Patel, and refers to the interest shown by Escorts. ‘‘We are in touch with Dr Patel and are closely working on holding a workshop in India. We have done single bypass on patients but rotating the heart to the point of the incision is a step ahead,’’ says Dr Naresh Trehan, Chief Executive at Escorts.

More like a leap. While normal bypass surgery usually takes around 10 days of careful monitoring and surgery, followed by six-eight weeks of hospitalisation, robotic-assisted minimally invasive surgery that started in the late ’90s still calls for three days of pre-surgery and at least three weeks of hospitalisation.

Cardiologist Dr Kiran Patel, former president of the Association of American Physicians of Indian Origin, calls the rotation method a boon to mankind. ‘‘It is cutting-edge technology,’’ he says, speaking from his home in Florida. ‘‘People are bolder in approach with new technology, but it takes visionary surgeons like Nilesh Patel to think out of the box and come up with such a brilliant method.’’

The effect on the patients is felt in different ways. Patel — who came to the US six years ago after studying medicine in Gujarat and teaching it in Mumbai — speaks of a security guard who underwent triple bypass surgery.

‘‘Twelve hours later he was discharged. I saw the patient after a week and he asked me if driving with his condition was okay. I told him, ‘It’s fine now.’ He then told me that since no one had told him otherwise, he had driven home from the hospital the day of the surgery.’’

The security guard also told Patel that he had a hard time convincing friends and neighbours he had had a bypass.

The other advantage is financial: the new technique can cut medical costs down to a fifth of prevailing expenses and make heart surgery affordable to more people. One day at the ICU in a US hospital, including traditional robotic surgery, could cost a patient around $4000 to $5000, with patients normally confined to a three-week stay.

Patel’s one-day surgery costs $20,000 in all, including medication. In India, the cost of a regular bypass surgery at a private hospital is around Rs 2-3 lakh.