A. SREENIVASA REDDY (ABU DHABI)
A 55-year-old UAE resident is recovering well after undergoing a technically demanding five-vessel heart bypass operation involving 11 surgical connections between arteries and grafts.
Santokh Singh Ajit Singh, an Indian resident of the UAE, sought treatment at Aster Hospital, Al Qusais, Dubai, after experiencing chest pain radiating to both shoulders for nearly six days. A coronary angiogram performed on May 25 revealed severe blockages in several arteries supplying blood to his heart.
Following an evaluation, doctors diagnosed him with advanced coronary artery disease accompanied by angina. Coronary artery disease occurs when fatty deposits accumulate inside the arteries, narrowing them and restricting the flow of blood to the heart. Singh was also found to have high cholesterol, a major risk factor for the condition.
He underwent five-vessel coronary artery bypass surgery on June 2. The operation took approximately eight hours because of the extent of the disease and the number and complexity of the arterial connections required.
Doctors performed the operation while the patient’s heart continued to beat. They used three arteries from his body—the left and right internal mammary arteries from the chest and the left radial artery from the forearm—to create new routes for blood to reach the heart muscle.
The technique, known as total arterial anaortic revascularisation, uses arteries rather than veins as bypass grafts and avoids handling the aorta, the body’s largest blood vessel. The hospital said avoiding manipulation of the aorta can help reduce the risk of stroke.
The operation was performed by consultant cardiothoracic surgeons Dr Sandeep Srivastava and Dr Shipra Srivastava. They created five bypasses involving 11 surgical connections between the arterial grafts and coronary arteries and among the grafts themselves.
During the operation, doctors found long sections of severe disease in two coronary vessels—the left anterior descending artery, or LAD, and one of its diagonal branches. They removed hardened plaque from inside both vessels through coronary endarterectomy and reconstructed them with arterial patches before supplying them through bypass grafts.
“This was one of the most technically demanding bypass surgeries we have performed due to the patient’s extensive coronary artery disease,” Dr Sandeep Srivastava told Aletihad. “We completed a five-vessel bypass on a beating heart with 11 different forms of arterial connections using the patient’s own arteries, while also removing plaque and reconstructing severely diseased vessels,” he added.
The heart’s blood supply is commonly described in terms of three major coronary artery systems, which give rise to smaller branches. Dr Sandeep Srivastava said all three major coronary artery systems and some of their branches had multiple blockages, requiring five bypass grafts. Two of the bypassed vessels—the LAD and one of its diagonal branches—also required plaque removal and patch reconstruction.
Dr Shipra Srivastava said performing the operation on a beating heart and avoiding manipulation of the aorta helped minimise the potential risk of stroke while restoring blood flow. “This case demonstrates that patients with even the most complex coronary artery disease can access advanced cardiac care and excellent outcomes here in Dubai,” she said.
The patient remained stable after the operation and had an uneventful recovery, according to the hospital.
“When I learned I needed such a complex heart surgery, I was naturally anxious. The doctors explained every step of the treatment, which gave me confidence and reassurance,” Singh said.
“I am recovering well and thankful to have received such advanced treatment here in Dubai,” he added.