Kindly give your opinion about my father's heart operation for block.

Hi,

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I have gone through all the reports of your father (attachment removed to protect patient identity). He has got a triple vessel disease and all the three major coronary arteries are critically blocked. The main problem before giving a suggestion is that you have not enclosed the report of his 2D echo and left ventricle ejection fraction is to be known before giving a valid suggestion. So, kindly enclose a copy of 2D echo of your father. As of now, I would suggest you to go for MICAS. MICS CABG (coronary artery bypass graft) or MICAS stands for minimally invasive coronary artery surgery. It is a relatively new and advanced technique of heart surgery by performing coronary bypass for coronary artery disease. In this technique the heart is approached through the side of the left chest through a small 4 cm incision. This cut is placed just under the nipple. The chest is entered between the ribs without cutting any bones and by splitting the muscle. Similar to a regular heart surgery, the operation is performed using all arteries or a combination of arteries and veins removed from the leg. The vessel from the leg in these operations is also removed endoscopically without cutting the skin over the leg. Highly advanced instrumentation and advanced techniques allow for the operation to be performed very safely. MICS CABG has several advantages over the traditional technique. First and foremost is the fact that no bones are cut. This has several advantages in reducing pain, retaining function and having a positive effect on breathing. Unlike traditional heart surgery return to normal life including driving or other activities is not disrupted and can be started almost immediately. The blood loss is almost negligible eliminating blood transfusion in most and eliminating blood borne infection. All infections are reduced whether it be wound infections or post surgical lung infection. This makes the procedure ideal in diabetics and older patients who have poor resistance to infection. The incision is so cosmetic and measures just 2 to 3 inches that it is practically impossible to tell that a heart operation has been done. The procedure lasts only 4 hours, unlike the conventional heart surgery that takes 9 hours. All these benefits put together make for ultra short hospitalization and recovery. The best part is that all the blocks irrespective of their location in the heart can be bypassed in a safe and predictable manner. I think MICAS is a very safe option for him and much better than open heart surgery.