IJCP Book Of Medical Records

Medical And Health Records

First Total Arterial Revascularisation in India - Dr OP Yadava

First Total Arterial Revascularisation in India There is no permanent cure for coronary artery disease and whenever bypass surgery is performed, there is always a chance for recurrence of the disease. It has been seen that the chances of recurrence are much higher, when the bypass surgery is performed using veins from the leg (almost 50% recurrence at 10 ten years), where as the results with arterial grafting is much better (>90% patency with the Internal Mammary Artery at 20 years).  However, not only grafting with arterial conduits is technically demanding and time consuming, but also there is paucity of the arterial grafts.  The standard bypass operation world over is to use one arterial graft (LIMA – LAD) and use veins for rest of the arteries.  We for the first time in 1992 treated triple coronary artery coronary blockages by using all three arterial grafts, that is both internal mammary arteries and the third arterial graft called the Right Gastroepiploeic Artery which runs along the greater curvature of the stomach and is taken  out through a laparotomy. By thus providing, all three arterial grafts in  a situation of triple vessel coronary artery disease (TVD), without use of any venous conduits at all, we were hoping that patients will get very good long term results in terms of relief of symptoms, preservation of the left ventricular function and long term survival.  To the best of our knowledge, we were the first team in the country to have used this combination in a situation of TVD.

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