Mumbai: Engineer Navin Chheda, 82, is all smiles when he hears doctors say that his “irregular heartbeats” are age-related issues and are not related to the bypass surgery he underwent 31 years ago at Breach Candy Hospital.
“In 1993, I was diagnosed with multiple blockages and needed four bypasses to fix them,” said Chheda, who shuttles between Indore and San Jose. The bypasses, he is told at regular medical examinations, are still working well.
Chheda’s bypasses, or grafts, are special, according to senior cardiac surgeon Dr Ramakanta Panda, who operated on him in Nov 31 years ago. “This is because grafts usually don’t last three decades,” Dr Panda said on Tuesday when Chheda dropped by to meet him at Asian Heart Hospital, Bandra Kurla Complex, for his arrhythmia or irregular heartbeats. According to the British Heart Foundation, a successful bypass surgery lasts about 15 years before needing another intervention. (Chheda got a stent fixed about a decade ago, but it was for a new blockage.)
There is a scientific reason for Chheda’s healthy grafts: he was among the first wave of Indian patients to get grafts made from arteries. In the initial days of cardiac bypass surgery, surgeons used grafts made of veins, typically drawn from legs. “Veins are thicker than other blood vessels and can be sutured easily,” said Dr Panda. But the venous grafts developed complications within seven to ten years, and the patients needed a new bypass surgery.
For Chheda, the decision to undergo bypass surgery in Mumbai was based on the fact that he grew up in Mulund. “I worked in Detroit for 20 years before deciding to set up a business in Hyderabad,” he said. He met several doctors before deciding on Dr Panda, Breach Candy Hospital, and the then-new arterial grafts.
Arteries are narrower than veins; arteries of Indians are known to be narrower than those of people of other ethnicities. But grafts made from arteries last more than double the period of venous grafts. Dr Panda, who trained under American surgeon Dr Floyd Loop, who pioneered arterial grafts, said Chheda seemed like an ideal candidate for arterial grafts as he was younger than most cardiac patients.
Nowadays, arterial grafts, though difficult to execute, are the first choice of doctors. “The results are superior with arterial grafts and are best suited for patients who are young and/or diabetic,” said Professor Dr Balaji Aironi from BMC-run KEM Hospital & G S Medical College, Parel. An arterial graft that is functional after 30 years is an achievement, he said.
Dr Panda said that arterial grafts are “technically more challenging” than venous grafts, and there is a sharp learning curve for doctors. “In the US, due to insurance issues, arterial grafts are not done regularly, but there are no such issues here,” he added.