How is opcab done

How​ ​is​ ​OPCAB​ ​done?

It​ ​is​ ​clear​ ​that​ ​OPCAB​ ​would​ ​be​ ​technically​ ​more​ ​difficult​ ​to​ ​perform​ ​than​ ​conventional bypass​ ​for​ ​the​ ​plain​ ​fact​ ​that​ ​the​ ​fine​ ​surgical​ ​work​ ​needs​ ​to​ ​be​ ​done​ ​while​ ​the​ ​surface​ ​is still​ ​moving.​ ​There​ ​are​ ​certain​ ​devices​ ​which​ ​make​ ​the​ ​process​ ​a​ ​bit​ ​easier​ ​for​ ​the surgeon.​ ​Most​ ​important​ ​of​ ​them​ ​is​ ​called​ ​a​ ​tissue​ ​stabilizer​ ​(See​ ​the​ ​figure​ ​given below).​ ​This,​ ​when​ ​applied​ ​over​ ​the​ ​heart​ ​stabilizes​ ​a​ ​small​ ​portion​ ​of​ ​the​ ​heart​ ​wall​ ​and reduces​ ​the​ ​movement​ ​in​ ​that​ ​region.​ ​This​ ​makes​ ​surgical​ ​procedure​ ​a​ ​lot​ ​easier​ ​to perform.​ ​There​ ​are​ ​other​ ​devices​ ​which​ ​add​ ​to​ ​the​ ​safety​ ​like​ ​shunts​ ​which​ ​prevent blood​ ​loss​ ​and​ ​blowers​ ​which​ ​help​ ​to​ ​clear​ ​operating​ ​field.

©​ ​2017​ ​Heart​ ​and​ ​Aorta​​ ​All​ ​Rights​ ​Reserved

Is​ ​OPCAB​ ​a​ ​‘key​ ​hole’​ ​operation?

Generally​ ​this​ ​form​ ​of​ ​operation​ ​is​ ​done​ ​through​ ​a​ ​standard​ ​opening​ ​in​ ​front​ ​of​ ​the​ ​chest that​ ​bypass​ ​operation​ ​is​ ​infamous​ ​for.​ ​The​ ​reason​ ​why​ ​this​ ​approach​ ​is​ ​widely​ ​popular​ ​is because​ ​of​ ​its​ ​safety​ ​and​ ​adaptability.​ ​In​ ​various​ ​unexpected​ ​difficult​ ​situations​ ​it​ ​gives the​ ​surgeon​ ​many​ ​options​ ​to​ ​achieve​ ​the​ ​desired​ ​result.​ ​So​ ​to​ ​put​ ​it​ ​the​ ​right perspective,​ ​OPCAB​ ​is​ ​not​​ ​a​ ​‘key​ ​hole’​ ​operation.

©​ ​2017​ ​Heart​ ​and​ ​Aorta​​ ​All​ ​Rights​ ​Reserved

Is​ ​OPCAB​ ​a​ ​more​ ​expensive​ ​option?

There​ ​is​ ​no​ ​difference​ ​in​ ​the​ ​cost​ ​between​ ​the​ ​standard​ ​bypass​ ​and​ ​OPCAB.​ ​In​ ​many patients,​ ​as​ ​the​ ​ICU​ ​and​ ​hospital​ ​stay​ ​become​ ​much​ ​shorter​ ​and​ ​usage​ ​of​ ​costly antibiotics​ ​reduces,​ ​the​ ​total​ ​cost​ ​may​ ​even​ ​be​ ​less.

©​ ​2017​ ​Heart​ ​and​ ​Aorta​​ ​All​ ​Rights​ ​Reserved

How​ ​safe​ ​is​ ​OPCAB?

Bypass​ ​operation​ ​has​ ​become​ ​a​ ​very​ ​safe​ ​operation.​ ​The​ ​success​ ​rate​ ​for​ ​bypass operations​ ​in​ ​the​ ​best​ ​centers​ ​over​ ​the​ ​world​ ​is​ ​96-99%.​ ​Last​ ​year​ ​the​ ​OPCAB​ ​success rate​ ​at​ ​Medical​ ​Trust​ ​Hospital​ ​was​ ​a​ ​proud​ ​100%.

©​ ​2017​ ​Heart​ ​and​ ​Aorta​​ ​All​ ​Rights​ ​Reserved

If​ ​OPCAB​ ​is​ ​not​ ​‘Key​ ​Hole’​ ​operation, what​ ​is​ ​‘Key​ ​hole​ ​Bypass​ ​operation’?

The​ ​‘key​ ​hole​ ​bypass​ ​operation’​ ​is​ ​known​ ​as​ ​Minimally​ ​Invasive​ ​Coronary​ ​Artery​ ​Bypass or​ ​MICAS.​ ​In​ ​this​ ​operation​ ​the​ ​large​ ​wound​ ​in​ ​front​ ​of​ ​the​ ​chest​ ​is​ ​totally​ ​avoided.

Through​ ​small​ ​incisions​ ​at​ ​the​ ​side​ ​of​ ​the​ ​chest​ ​main​ ​blocks​ ​can​ ​be​ ​treated.​ ​The recovery​ ​is​ ​much​ ​faster​ ​and​ ​patient​ ​can​ ​be​ ​back​ ​to​ ​work​ ​in​ ​4​ ​weeks.

MICAS​ ​can​ ​also​ ​be​ ​combined​ ​with​ ​Stenting​ ​in​ ​what​ ​is​ ​called​ ​a​ ​HYBrid​ ​operation​ ​to​ ​treat complicated​ ​disease​ ​patterns.​ ​The​ ​first​ ​HYBrid​ ​operation​ ​in​ ​Kerala​ ​was​ ​done​ ​at​ ​Medical Trust​ ​Hospital​ ​last​ ​year.

Beating​ ​heart​ ​operations​ ​form​ ​30-40%​ ​of​ ​all​ ​bypass​ ​operations​ ​worldwide.​ ​Some​ ​of​ ​the institutions​ ​in​ ​India​ ​(including​ ​Medical​ ​Trust​ ​Hospital,​ ​Kochi)​ ​perform​ ​more​ ​than​ ​90%​ ​as beating​ ​heart​ ​procedures.​ ​As​ ​bypass​ ​operations​ ​enter​ ​fifth​ ​decade​ ​of​ ​their​ ​existence, the​ ​number​ ​of​ ​patients​ ​requiring​ ​repeat​ ​operations​ ​is​ ​on​ ​the​ ​rise.​ ​This​ ​is​ ​one​ ​place where​ ​beating​ ​heart​ ​operation​ ​has​ ​a​ ​special​ ​role.​ ​It​ ​helps​ ​to​ ​reduce​ ​the​ ​blood​ ​loss, hospital​ ​stay​ ​and​ ​ICU​ ​stay​ ​in​ ​repeat​ ​bypass​ ​situations.

©​ ​2017​ ​Heart​ ​and​ ​Aorta​​ ​All​ ​Rights​ ​Reserved