Times of India
13 September 2010
By Sumitra Deb Roy
Mumbai, India

Kenyan businessman Lorenzo Bertolli, 71, took a six-hour flight back home to Nairobi less than two weeks after undergoing a critical heart surgery in a city hospital. The insurance magnate from Africa left India fully convinced that surgical expertise in this country is catching up with European countries.

And why not? Bertolli’s persistent complaint of breathlessness at the slightest hint of exertion and chest pain, which was diagnosed to be an acute case of aortic valve stenosis, was operated using a new and less painful procedure that allowed his recovery in record time. The stenosis or narrowing of the valve meant that the flow of blood to the arteries was severely impeded.

Living with a pacemaker for almost a decade now, Bertolli was told by his cardiologist back home, that correcting it could mean undergoing a complicated procedure. "I was aware about my heart problem since a long time but I waited till I could manage without a surgery,’’ he said. "But, when my cardiologist said it was time, I decided to come to India having heard about doctors here solving critical heart problems,’’ he said.

Bertolli landed at the Asian Heart Hospital (AHI) in Bandra, where team of doctors headed by cardiac surgeon Dr Ramakant Panda, informed him that he would be operated using a new technique. The technique called minimally invasive aortic valve replacement was used to treat Bertolli’s condition.

The USP of the technique as senior cardiovascular surgeon Dr Pradyot Rath, explained was that unlike conventional ways in which a patient’s entire chest bone had to be cut open, a mere 3-inch incision was made. "Using that smaller cut, we reached the aorta and remove the problematic valve and replaced it with a prosthetic valve,’’ he said.

The primary advantage of the technique being that the bone takes just about two weeks to heal as against two months in the conventional procedure where the entire chest bone is cut open. "Bone healing is definitely faster and it automatically accelerates the patient’s recovery,’’ he said, adding that it was advantageous even cosmetically.

Cardio-electro physiologist Dr Santosh Dora, who was also a part of the team, said it also involved less tissue damage. "Apart from less tissue damage, even blood loss is minimal and the patient has to be on a ventilator for a potentially shorter time,’’ he added. He, however, cautions that the technique is best suited for patients requiring only an aortic valve replacement. "If there are other cardiac problems associated, it may not be the best technique,’’ he added.

Other city cardiac surgeons feel that it could be a promising cardiac procedure but another potential surgery to treat similar conditions is in the offing. Head of cardiac surgery department at JJ Hospital, Dr N O Bansal said that within six months, valve replacement could be done laparoscopically. "As soon as all regulations are in place, surgeons would be making key-holes and removing problematic valves, making much smaller incisions,’’ he said.