Current strategies in surgical myocardial revascularization: Indian perspective

Current strategies in surgical myocardial revascularization: Indian perspective

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Coronary Artery Bypass Grafting (CABG) is the treatment option for Left Main and multi vessel coronary artery disease.Newer techniques and grafting strategies have been introduced in the last two decades to combat the stent surge.Offpump coronary artery bypass (OPCAB or beating heart bypass surgery) is widely performed in corporate hospitals in our country with use of multiple arterial conduits (Total Arterial Revascularisation).This practice of OPCAB has been largely abandoned in the western countries as it is not supported by current available evidence.Newer techniques like robotic surgery, endoscopic bypass surgery (TECAB), anastomotic devices are expensive and have limited application in our country.

This article reviews lunette mascot the available current evidence on this subject, highlights the current practice in private hospitals and the reasons thereof in India and outlines the strategy being adopted in AFMS.A retrospective analysis was carried out of 172 patients who underwent CABG at INHS Asvini between 01 Jan 2008 and 31 May 2013.39% had Left Main Coronary artery disease, 85% patient had triple vessel disease, 56% were diabetics, 12% had undergone stenting in recent past.Beating heart strategy was used in 10%, average no of grafts per patient was 2.3 with LIMA and Radial artery being used as a conduit in 84% and s2720 4% respectively.

4.6% patients succumbed in post-operative period.