CABG popular termed as Bypass operation are being operated regularly here in KYAMCH. Our specialties with CABG are all arterial bypass, beating heart, multiple bypass (4 or more than 4) and coronary atherectomy with CABG. All arterial means all conduits with CABG are arterial. Conduits commonly used in CABG are LIMA + Veins. In our practice LIMA/RIMA are arteries lying inside the chest wall are used. So extra scar in legs/ hands can be avoided. If extra arterial conduits needed, we use to take radial artery (Forearm artery) or right gastroepiploic artery from upper abdomen in addition to LIMA & RIMA. Usefulness of arterial conduits are long lasting in comparison to the leg veins. Venous grafts are not long-lasting. They start to be blocked from Day 1 of operation, 60% of venous grafts are to be blocked or diseased in different percentage by 5 years. All most all the venous grafts are blocked or significantly diseased by 10 years. Open heart versus beating heart, we are in scientific selection. For more than 3 bypass grafts, we use to choose open heart in an arrested condition some centers for financial benefit randomly performs CABG on beating heart with minimum number of grafts. In that situation the patient does not get desired benefits. We think, this shorts of patients have to come back to the surgeon very soon with symptoms & signs which they had before operation, keeping this idea in mind we are operating both beating CABG & CABG on arrested heart depending on the requirement of heart without concealing the facts. Along with full range of open heart surgery and closed heart surgery in KYAMCH Thoracic Surgery and Vascular Surgery are also performed regularly.
Our Orthopedic Surgery Department with the help of Vascular Surgery, offering full range of trauma management which is unique and only example in Bangladesh. For limb survival following trauma or road traffic accident maintenance of vascularity is a must. Immobilization of fracture with vascular management is challenging because of time. After 6 hours of injury it is not practical to re-establish vascular continuity. In one center (in Bangladesh there is no such center other than KYAMCH) if there is provision of vascular surgery along with orthopedic surgery, trauma cases can be managed very successfully. |