Dr Asraful Hoque Sium, a cardiac surgeon of National Institute of Cardiovascular Diseases, stands beside the patient after the first-ever special cardiac surgery in the country without cutting chest bones and leg of the patient.
A Bangladesh surgeon has conducted a heart surgery without cutting chest bones and leg of a patient in a minimally invasive procedure said to be an alternative to open heart surgery.
The special procedure of cardiac surgery, which is called MICS-CABG, Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) with Endoscopic Vein Harvesting (EVH) was carried out on a patient at the National Institute of Cardiovascular Diseases (NICVD), the only public specialised cardiac hospital in the country, hospital sources said.
The 50-year-old patient, Md Al Amin, is now well and he would be released from the hospital soon, said Dr Asraful Hoque Sium, an assistant professor of the Department of Cardiac Surgery at NICVD, who conducted the heart surgery at the institute on Wednesday.
Hailing from Nayachar village of Dhamrai in Saver, Al Amin, son of late Mamtaj Uddin, was admitted to the hospital on 15 September with cardiac problems, hospital sources said.
“I’ve successfully conducted the bypass surgery on Al Amin without cutting his chest bone and leg through MICS-CABG, in Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) with Endoscopic Vein Harvesting (EVH) system,” said Dr Sium, also unit chief and resident surgeon of NICVD.
“This is the most latest technique of treating patients suffering from heart disease. The surgery, the first of its kind in Bangladesh, was performed by using specialised surgical instruments,” he told the daily sun.
Dr Sium, also one of the youngest cardiac surgeons in South Asia, said, “The EVH system operation is like a laparoscopic surgery for harvesting vein for CABG (Artery Block in Heart) operation without cutting leg. In the bypass surgery, MICS-CABG “MIDCAB (Minimally Invasive Direct Coronary Artery bypass grafting) is carried out without sternotomy.”
About the benefits of MICS-MIDCAB with EVH, he said the operation is done with less blood loss. “It reduces post-operative discomfort and pain, quickens healing time and lowers risk of infection. It eliminates the possibility of deep wound infection of sternam non-union. It also reduces leg infection,” he mentioned.
“The cost of this type of cardiac surgery is very low than the traditional ones,” he said.
Talking to daily sun, Professor Rampado Sarkar, head of the department of cardiac surgery of NICVD said, “This type of cardiac surgery has been done by Dr Sium which is the first of its kind in Bangladesh. Of course, this is a great success of a Bangladeshi cardiac surgeon. This will create hope for the people of the country and we hope that Bangladeshi patients will no more go abroad for treatment of heart disease.”
While describing Endoscopic Vessel Harvesting, some experts said many patients will be surprised to learn that a bypass operation includes two surgical procedures.
“Primarily, the bypass surgery involves using a healthy blood vein to bypass a damaged or blocked artery in the heart. The second procedure is the actual removal of a healthy blood vessel, typically the saphenous vein in the patient’s leg, which will be used to construct the bypass.”
On the other hand, the traditional vessel harvesting procedures require a long incision or a series of incisions down the length of the patient’s leg, from the groin to the ankle. The greater saphenous vein is harvested intact through this large incision. The harvested vessel is then used as a graft that surgeons sew in place to bypass the blocked coronary artery.
Recent advances in technology have made it possible to perform this second procedure in a new, less invasive way, called Endoscopic Vessel Harvesting, or EVH. Instead of making a large incision in the leg of a patient, surgeons can now make small incisions in the patient’s leg. This new procedure results in less muscle and tissue damage. When harvesting the vein graft, this procedure may eliminate many of the complications associated with the former technique. This may offer significant benefits to patients, experts added.
They said an endoscope, a special instrument used to view the inside of a hollow area, is connected to a video camera and inserted through a small incision in the leg. The endoscope is used to view the saphenous vein inside the leg and allows the surgeon to remove the vein with minimal stress to the leg.
Recently, Dr Sium received TOYP (Ten Outstanding Young Person) 2019 award.
He was awarded the TOYP 2019 award in the category of “Outstanding Contribution to Medical Innovation and Advancement”, hospital sources said. JCI Bangladesh conferred the award on Dr Sium at a function at a hotel in the capital on September 18.
On August 25, he had successfully conducted a special cardiac surgery on a 12-year-old girl, Nupur, without cutting her chest bone which is called Minimally Invasive Cardiac Surgery (MICS) system, also an updated technique in treating heart diseases. The surgery was also the first of its kind at a public hospital in the country.
On September 2, Dr Sium conducted another bypass surgery in the MICS system on a patient named Matin, 40, who was admitted to NICVD on August 25.