Today's Edition
A. SREENIVASA REDDY (ABU DHABI)
A 43-year-old heart patient with two of his arteries completely blocked was saved after a rare and complex surgical operation lasting nearly seven hours at a Dubai hospital.
The surgery involved carefully removing hardened debris from two major arteries — the Left Anterior Descending (LAD) and the Right Coronary Artery (RCA) — which were completely blocked along their entire lengths, and bypassing them while the heart was still beating, a statement said.
Doctors at Aster Hospital, Al Qusais undertook the highly specialised procedure after diagnostic tests revealed that all three major coronary arteries were diffusely diseased, with the LAD and RCA each blocked 100% from end to end. The condition had severely compromised blood flow to the heart, leaving no healthy segment suitable for a conventional bypass. The patient had been experiencing persistent chest pain and breathlessness even during minimal physical activity, with long-standing uncontrolled diabetes further complicating the clinical picture.
Given the extent and density of the blockages, the surgical team opted for complete coronary endarterectomy — a demanding technique in which hardened plaque is meticulously removed from inside the artery. Unlike standard bypass surgery, where grafts are attached beyond a blockage, this approach requires the artery to be opened along its length and the obstructive material extracted in one continuous piece. In this case, the procedure had to be performed in both the LAD and RCA, a combination rarely attempted.
The operation was led by Dr Sandeep Shrivastava and Dr Shipra Shrivastava, consultant cardiothoracic surgeons at the hospital.
Crucially, the entire surgery was carried out on a beating heart, without the use of a heart–lung machine. Operating on a beating heart adds significant technical complexity but can reduce complications and speed up recovery, particularly in high-risk patients, the statement said.
During the procedure, surgeons first opened the LAD artery and carefully removed plaque along its full length. The RCA, which was similarly obstructed, underwent the same process. In sections where the artery wall required reinforcement after plaque removal, the team carried out additional repairs using patch techniques to ensure smooth and unobstructed blood flow. Once the arteries were cleared, circulation was restored using the patient’s own arteries and a vein.
“This was a very complex case because both the LAD and RCA were completely blocked from end to end, leaving no segment suitable for a routine bypass,” Dr Sandeep Shrivastava told Aletihad. “By removing the plaque completely and repairing the arteries where needed, we were able to restore full blood flow and offer the patient a realistic chance of long-term recovery, even in a situation that might be considered untreatable elsewhere.”
Explaining the rarity of the procedure, Dr Shrivastava said: “Most surgeons do not touch such diffusely diseased coronary arteries, labelling them unsuitable for bypass surgery.”
In such situations, the patient is left to the mercy of the natural course of the disease. “But we specialise in handling such difficult cases. We took this challenge head on and treated him by performing coronary endarterectomy and bypass grafting to ensure complete relief for the patient,” the veteran cardiac surgeon said.
When Aletihad asked how the patient could have survived long enough to reach hospital with 100% blockage, Dr Shrivastava explained: “People do survive to reach hospital when they are lucky. This happens because small vessels supply some blood to the muscle in the territory served by blocked arteries. This supply is not enough for normal functioning, but at times it is enough to keep the patient alive until they reach hospital.”
To illustrate the point, he cited an example from everyday life. “It is like when the major highway to a city is blocked, small roads from the outskirts still bring some traffic into the city.”
The patient was identified as Jijil Chira, an Indian national living in Dubai. He is married and works as a logistics manager.
He recovered steadily after surgery and was discharged on the fourth postoperative day. He is now living symptom-free and has resumed normal daily activities.
According to the statement, patients with such extensive and aggressive coronary disease are often denied intervention because of the technical difficulty involved, making successful outcomes particularly significant.
Expressing his gratitude, Chira said: “I was refused treatment elsewhere because my blockages were too complex. But the cardiac team at Aster Hospital gave me hope and a second chance at life. I feel like I have been given a new lease on life and am deeply thankful for their care and expertise.”
While coronary artery bypass grafting is common, complete endarterectomy of multiple arteries on a beating heart remains uncommon and demands a high level of surgical expertise and coordination. In this case, the operation demonstrated how advanced techniques can be applied to restore blood flow even when blockages extend along the entire length of critical heart vessels.
Cardiovascular diseases remain the leading cause of death globally. According to the World Health Organization, an estimated 19.8 million people die each year from heart-related illnesses, with coronary artery disease and stroke accounting for the majority of these deaths — underlining the life-saving importance of advanced surgical interventions.
