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BITA GRAFTING: WHY IT WORKS FOR DIABETICS?

Dr. A. Sandeep Janardhan, Wednesday, October 23, 2019

WHAT IS CORONARY BYPASS SURGERY?

Coronary bypass surgery is a surgical procedure that diverts the flow of blood around a section of a blocked or partially blocked artery in your heart. By creating a new pathway to the heart, coronary bypass surgery improves blood flow to your heart muscle.


HOW TO TREAT DIABETIC PATIENTS WITH CARDIOVASCULAR CONDITIONS?

For people with diabetes who have extensive coronary artery disease, bypass surgery to give blood a new pathway to the heart is better than angioplasty, which involves using a tiny device to open up narrowed blood vessels.

Studies show that one technique works particularly well that uses two arteries from the chest instead of the saphenous vein from the leg. This technique is called bilateral internal thoracic artery (BITA) grafting. BITA grafting and complete restoration in blood flow improve surgical outcomes for our heart patients who also have diabetes.


IS THERE A RISK?

One reason why surgeons have tended not to use the BITA is because of concerns about wound infection involving the breast bone. Diabetics, in general, are at higher risk for infection. So, there has been some anxiety about using two arteries for the procedure.

However, the risk for wound infection is rare except in very overweight patients who were diabetic with widespread hardening of the arteries and in patients with poorly controlled diabetes.

For those patients, the risks of infection need to be weighed against the longer survival expected with BITA grafting. In addition, the use of meticulous harvesting techniques can reduce the risk of infection and allow our surgeons to offer BITA to more patients who may benefit from it.


WHY USING CHEST ARTERIES IS BETTER?

Surgeons observed that the traditional leg vein grafts developed problems, as the grafts started to narrow or close about a decade after surgery.

The use of an artery from the chest, the internal thoracic artery, greatly improved long-term results. Patients do better for longer and need fewer repeat surgeries.

There are two internal thoracic arteries, one on the left side, and one on the right side of the chest area. Ordinarily, only the left artery is rerouted in CABG surgery. In certain cases, both left and right arteries are used to restore blood flow to the heart.


WHY KIMS?

Heart surgeons in the nationally ranked KIMS, one of the best cardiac hospitals in Hyderabad, have vast experience performing heart bypass for coronary artery disease. To date, our surgeons, including Dr. B. Bhaskara Rao - renowned heart surgery doctor in Hyderabad - have performed more than 20,000 heart bypass surgeries, which restores blood flow to blocked arteries using blood vessels taken from your arm, leg or chest. We use a range of techniques -- from minimally invasive options to complex cardiothoracic surgery approaches -- which lets us offer heart bypass surgery to more people with coronary artery disease, including patients at high risk and with complex conditions. Our excellent survival rates and low complication rates give you the best opportunity for a successful outcome, making us one of the best heart bypass surgery hospitals in Hyderabad.

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