For diabetics undergoing coronary bypass surgery, here is some good news from Star Hospital Hyderabad. For the first time, An Innovative technique has been designed by Dr. Lokeswar Rao Sajja,Cardio Thoracic Surgeon , Star Hospitals ,for mammary artery harvesting which preserves the sternal blood supply even after both the mammary arteries are harvested for bypass surgery.
Conventionally, bypass surgery is done using one internal mammary (thoracic) artery and additional vein grafts taken from the legs or artery from the fore arm. Now there is a huge body of scientific evidence that confirms that patients receiving two internal mammary arteries during bypass surgery have significantly improved long term
survival and this is true even in diabetics.
But presently, around the world, only 4% of patients undergoing coronary bypass urgery are receiving two internal mammary arteries. It is because of the fear of increased sternal wound infections in diabetics when two mammary arteries are used. Sternum is the breast bone in the middle of chest wall to which the ribs are attached in the
The risk of infection in the sternal wound is because there is a risk of reduced blood supply to the tissues (ischemia) in the sternal area when both the internal mammary arteries are used for bypass by the older techniques.
In this technique, the sternal ischemia is reduced and sternal wound infections are negligible. Dr. Lokeswar Rao also designed MASP (Mammary Artery Surgical Platform) device to facilitate faster and meticulous construction of ‘Y’ grafts using both left and right internal mammary arteries.
This technique is very useful for Indian population who are the victims of coronary artery disease at the younger age (10 – 15 years earlier than the western population) and who also have a higher incidence of diabetes. Bypass surgery using two mammary arteries
confers a long term survival advantage and also symptom free survival and a second bypass surgery is rarely needed.
The internal mammary arteries are resistant to develop blocks and fortunately we have two internal mammary arteries located close to the heart which can be used during bypass surgery. Today without any apprehension of wound infection; the two mammary artery grafts can be used during bypass surgery for a suitable wider population.