After PM comes out of ICU, surgeon recalls moments at OT

New Delhi, Jan 28 (PTI) As Indian Prime Minister
Manmohan Singh came out of the Intensive Care Unit (ICU)
Wednesday, a surgeon looked behind with pride and satisfaction
how the 11-hour coronary bypass surgery went as per plan and
not a step was missed.

The dissection of the heart especially since the Prime
Minister was undergoing a second bypass was listed by one of
the surgeons as among the most complicated part of the
operation at the All India Institute of Medical Sciences
(AIIMS) here last Saturday.

"It is always the dissection of the heart. Because it
was the second time bypass right from the opening of the
sternum (bone which protects the heart from injuries) ...to
opening the heart from chest tissues," said Dr Pradyot Kumar
Rath, one of the cardiac surgeons from Asian Heart Institute,
Mumbai, who was involved in the surgery when asked which was
the most complicated part.

Dr Rath said since the surgery was a redo one it
carried higher risk besides beating heart surgery was also a
challenge. Redo are done when the grafts placed in the
previous bypass surgery get obstructed and fresh grafts are
placed to smoothen the blood flow.

"We had to maintain the blood sugar level by
administering the insulin. Besides we have to ensure that
heart does not get injure during the opening up of chest and
then the grafting," he told PTI while explaining the
precautions taken by surgeons during the operation of the
Prime Minister, who is a diabetic.

During the operation, surgeons ensured that there was
no bleeding which always remains a risk during a repeat bypass
surgery. They had planned four grafts initially but found that
one more blood vessel was needing a graft, so finally five
grafts were placed on Singh.

Rath, who passed out of Beherampur Medical College,
has been with Dr Ramakant Panda, head of surgery team, for
the last 14 years and specialises in beating heart coronary
artery bypass surgery. So far, he has performed more than
1,000 bypass surgeries.

The surgery of a serving Prime Minister came as a
recognition of his talent, he said.

"I felt very honoured when I was informed about the
surgery," he said.

Asked if there was any pressure on the doctors, Rath
said "...there was certain amount of pressure definitely but
you know if you have to be on top, you have to perform well
under pressure like (cricketers) Sachin, Yuvraj."

"Its like playing test match in a different
atmosphere. Some tension is always there but all patients are
different. If one comes under the pressure one cannot perform
well...you have to treat him as any other patient and do the
thing," he said.

Singh was brought to AIIMS after the complaints of
chest pain. The angiography performed last Wednesday revealed
multiple blockages and collapse of stents which were placed in
2004 to dilate the vessels and ensure smooth blood supply to
heart muscles. PTI ABS
PMR
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