The Hindu Business Line : `Awake' open heart surgery performed

While the cardiac surgeon Dr T. Jayarama Pai, who performed the operation, contends that the `awake surgery' helps to reduce complications associated with major open-heart surgeries to a great extent, the patient, a 21 year-old lady hailing from one of the interior pockets of Tamil Nadu - Virudhnagar, called it a `miracle'.

Hospital authorities claim this to be the first `awake heart surgery' performed in the Indian sub-continent for correction of congenital heart disease.

Explaining the procedure, Dr Pai said that the patient was given a special epidural shot near the spinal cord to blunt the sensation all over the chest and abdomen. But for the numbness in the chest and abdominal region, the patient was able to talk fluently, and move her hands and legs as well. She was then put on the operation table. Using an electric saw, a 10 cm long incision was made on the breastbone to rip it and expose the heart.

The patient was then put on a heart-lung machine. After stopping the heart, the birth defect - a large hole was identified and closed. The patient, he said was watching her heart beat in the cardiac monitor when the correction was being made to patch the hole in her heart.

According to Dr Pai, the latest procedure helped to avoid certain complications that patients were more prone to, when operated upon in an unconscious state.

"In the awake heart surgery, the neurological and brain problems could be identified at the earliest since the patient is conscious of the happenings on the operation table, instead of waiting for the patient to recover from the anesthesia," he explained. He further stated that the post-operative pain, which necessitated repeated pricks of sedatives and narcotics could be zeroed down.

Notwithstanding such pressures due to pain and response of the patient in the post-operative period, the patient could also be discharged within a short span of three days, the cardiac surgeon said. On cost, he said: "`it would remain the same, whether performed in the usual way or with the patient's cooperation, when he or she is fully awake."

Though the procedure does not look too complicated, it would take a great deal of guts to take this test `wide awake.' But Dr Pai says that the patient would not get to see the surgery being performed, although he/she would be fully aware of the happenings in the theatre.

According to him, it could be performed on adults and those having no spinal problem.