Health Talk

Minimally Invasive Coronary Bypass Surgery (CABG) in India

 CABG or Coronary Bypass surgery in India is conventionally performed by splitting or cutting through the breastbone or sternum. MICS CABG or MICAS stands for Minimally Invasive Coronary Artery Bypass Surgery and is a newer form of heart bypass surgery in India. It is a relatively new and advanced technique of performing coronary bypass for the treatment of coronary heart diseases.MICAS or MICS CABG surgery is considered to be a safe and complete operation and has revolutionised the way coronary surgery is performed. Apollo Hospitals has successfully completed 400 and more CABG surgeries in India.

In this technique, the heart is approached through the side of the left chest via 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. With highly advanced instrumentation, advanced techniques and skilled Clinicians, Apollo Hospitals performs the surgery very safely, making it one of the best hospitals for CABG surgeries in India.
Among different types of CABG surgeries in India, Minimally Invasive Cardiac Surgery has several advantages over the traditional technique:
1. 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.
2. Blood loss is almost negligible eliminating blood transfusion in most and eliminating blood-borne infection.
3. 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.
4. The incision is so cosmetic, measuring just 2 - 3 inches, that it's practically impossible to tell that a heart operation has been done.
5. The procedure lasts only 4 days unlike the conventional heart surgery that takes 9 days.
All these benefits put together make for very 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.
Q.What is MICS CABG?
Ans:This is a technique of coronary artery bypass or CABG wherein the entire operation is performed from the side of the chest (on the left) through an incision that is about 2 inches.
Q. How does it differ from conventional CABG?
Ans:Conventional CABG or Coronary artery bypass requires the breast bone or sternum to be cut into half. Recovery from conventional bypass surgery requires a longer duration upto 8 weeks as the bone needs toheal. In MICS CABG, the operation is performed through the side of the chest wall. No bones are cut and healing is rapid. Healing is usually complete in ten days.
Q. Will MICS CABG help me leave the hospital early and get back to work?
Ans:Definitely yes! This is exactly the reason to do this operation. Hospital stay is as short as 2 days and most patients get back to work or normal activities in 10 days.
Q. I am a diabetic. Is MICS CABG appropriate for me?
Ans:Absolutely. You may be the ideal candidate for MICS as infection rates are almost eliminated. The quality of your vessels will dictate whether you are suitable for this technique and your surgeon is the best judge.
Q. I am a smoker/asthmatic. Is MICS CABG still an option for me?
Ans:Yes. It could be the ideal option for you. It's best for your surgeon to take that decision along with your respiratory therapist.
Q. Is MICS CABG performed in all centers?
Ans:No, not all heart surgeons are trained in MICS. Including ours, there are only a handful of centers all over the world that are capable of performing MICS safely.
(Dr. Dilip Kumar Mishra is a Cardio Thoracic Surgeon with Apollo Hospitals, Chennai.)
Q. My 10 year old daughter wants a TV in her room. She is creating a lot of chaos at home because of this. My husband is considering to fulfill her demand. However, I don't want to install a television set in her room. Kindly advice. 
(Name withheld)
Ans: Most homes have the same problem. Children spend hours sitting in front of the television in most homes. This is one leading cause of the epidemic of obesity. Further, it leads to the child engaging in untimely snacking and may even lead to weight problems. At this age, social interaction and regular physical activity is of utmost importance. I would suggest that you please refrain from installing a TV in your child's bedroom.
Q. Is discipline important in raising children? My wife thinks we need to hit my son at times when he is naughty. But I feel that we need not hit him. We can explain things to him. Please guide us. 
(Name withheld)
Ans: Discipline is definitely important in bringing up a child. But that does not mean we have to hit the child. Beating a child to help maintain positive behavior will cause long lasting emotional damage for the child. Discipline can be used to teach the child that some kinds of behaviour are acceptable and others are not. It is very important to set a few boundaries for our children so that they maintain positive behavior at home. This will also help them to learn how to behave in the school or other social settings. 
Q. Please advise how I can get relief from mental stress. I am very disturbed because of high stress. 
(Name withheld)
Ans: All of us go through some form of stress or the other. However, if it affects our daily life functioning, then we need to look into the sources of stress and also take measures to help deal with it. To begin with, do try and find out what is making you so stressed. Further, here are a few pointers that you could try out to help stay calm. 
1. Meditate. A few minutes of practice per day can help ease anxiety 
2. Deep breathing – Take a 5 minute break and focus on your breathing 
3. Engage in some form of physical exercise regularly
4. Be aware of your environment
5. Listening to music also helps to stay calm
Ms.Gariasi Dutta, MSW (TISS) is Psychological Counsellor with Down Town Hospital, Guwahati. She can be contacted at 98640-55560 or