A cardiac surgeon from Kerala, who pioneered 'beating heart' surgery, has developed a re-usable stabilizer, used to immobilise an area of the heart, where surgery has to be done.
A cardiac surgeon from Kerala, who pioneered ‘beating heart’ surgery, has developed a re-usable stabilizer, used to immobilise an area of the heart, where surgery has to be done.
The stabilisation system is essential to keep the heart steady, while carrying out surgery.
Currently, these stabilisers are imported and are disposable.
“In beating heart bypass surgery or off-pump coronary artery bypass (OBCAB), the heart would still be beating during the procedure, and what we do is to use a device called stabilizer, with two finger like pods, which we rest on the side of the coronary artery which we plan to work on. This could be used as a suction stabilizer or as a mechanical stabilizer, wherein it presses on that part of the heart. These pods minimises the movement of the coronary artery region, so that we could work on it,” Dr. Murali Vettath, cardiac surgeon with Malabar Institute of Medical Sciences (MIMS) at Kozhikode in Kerala told the Indian Science Journal (ISJ).
Currently, surgeons across the country uses imported, disposable stabilisers, which jack up the cost of surgery. The stabiliser developed by Dr. Murali is metallic, which can be re-sterilised like any other surgical instrument. The only disposable part used in it is the pods that could be changed if needed.
Dr. Murali is among a few cardiac surgeons in the country, who performs coronary surgeries on beating heart without the use of a Heart-Lung Machine (HLM). He has already performed 6,500 open-heart surgeries – more than 3,800 beating heart, with a mortality of less than 0.5 per cent.
During conventional open heart surgery, the heart and lungs are bypassed and blood from the body is taken through plastic tubes to an oxygenator, which acts as the lung and then through HLM, pumped back to the body. This is still necessary if the surgery is required to be done inside the heart, like replacing valves, etc.
As coronary arteries are present on the surface of the heart, it is possible to stop just that part of the coronary artery that needed to work on, thereby avoiding the pathology of stopping the heart and connecting to Heart Lung Machine (HLM).
“As the coronary arteries are superficial, we have modified and devised ways and means of lifting the heart, turning it and positioning it in such a way that it still is beating, but we could get access to all the walls of the heart. But it is technically more demanding than the conventional CABG on CPB, where the heart is made bloodless and motionless by stopping the heart using some medicine after cross clamping the aorta,” said Dr. Murali. “It is much better in patients with co-morbidities like low pumping of heart, heart failure, renal failure, respiratory failure and in patients with bad aorta and after stroke.”
Since beating heart surgery does not require a HLM or ‘pump’ to support the body while the heart is stopped, it reduces both surgical complications and costs, according to Dr. Murali.