Cardiac surgery reinvented

MICS procedure by renowned surgeon at Sheikh Zayed Hospital has advanced the benefits for heart patients

Most people in our society are familiar with the critical nature and complexity of open heart surgery. It can be grueling for the heart patient who often endures extreme pain and experiences a months-long recovery period.

However, 17-year-old Hamid Raza, whose surgical procedure was done in Sheikh Zayed Hospital through a new heart surgical procedure technique was discharged from the health facility within five days of the surgery.

This latest heath technique is the Minimal Invasive Cardiac Surgery (MICS) procedure.

Raza’s operation was performed on 25th of May and he was allowed to go home on the 30th of May, the patient’s older brother told Bol News. Raza is healthy and fit after the surgery; he eats well and is able to do his daily activities pretty normally. There is no sign of stress in his body.

Maintaining this Raza’s brother said, this procedure is far much better than the bypass and open heart surgery methods. “The patient recovers quickly although it is obvious that after a surgery the patient does suffer from weakness but my brother is recovering piquantly.”

photos: Mohsin Raza/Bol News

The patient’s brother claimed the staff was very cooperative. “Meanwhile the whole surgical procedure was carried out through Sehat Card and we didn’t have to pay any money. Moreover the procedure is good because very little blood was lost and Hamid just got a small scratch on his body through which operations were performed.”

Arslan Shoukat, husband of 36-year-old Samara Nasir, a heart patient, told Bol News that his family was ‘very satisfied’ with the efforts of the doctors who performed this operation. “The recovery time is short and my wife is gradually recovering. After the surgical procedure was concluded we just stayed for only four days in the hospital. In addition to this, I would like to suggest other heart patients to choose this method of surgery because the risk factor is very low as this particular procedure does not require opening the chest for the operation. The procedure is new, that’s why it is a bit more expensive than other heart surgery procedures.”

Explaining his wife’s health condition, Shoukat stated that his wife’s left side of the body was already paralysed before the surgery, which is why he suggested to her to take a one-month bed rest, while in other surgical methods it takes three months for patients to recover properly. “I haven’t noticed any side effects in my wife’s health or body and the condition of my wife is pretty normal just like any other patient. Now we are going to visit the doctor again to get the stitches removed as we were told by the doctor that after 15 days, the stitches will be removed.”

Minimal Invasive Cardiac Surgery (MICS) is also called MICS CABG (Minimal Invasive Cardiac Surgery Coronary Artery Bypass Grafting) technique is a heart surgical procedure which is carried out by cutting a small hole in the body rather than conventional open-heart surgery.

This is a very safe technique to treat heart related problems. MICS is being practiced in many foreign countries as an alternative to other traditional surgery methods for the treatment of heart diseases. Pakistan is a country in which heart-related problems and patients are increasing day by day because of the lifestyle and diet problems of the people.

Many of the heart patients have to go through a ‘tough and hard’ process of open heart surgery. This new introduced technique could prove to be a great respite for heart patients in Pakistan. Presently, this procedure is not known to most people as they haven’t even heard of it yet.

Dr Aqeel Ahmad, Head of Cardiovascular and Thoracic Surgery at Sheikh Zayed Hospital, is performing various types of heart surgeries through this technique.

He completed his graduation from Punjab Medical College in 2000 and started his training in Sheikh Zayed Hospital in 2005. While in 2010, he did his post-graduation in cardiac surgery. Since then he has been operating in all cardiac procedures.

This week, Bol News spoke exclusively to Dr Ahmad to find out more about the newly-adopted surgical method.

Explaining the initiation of MICS, Dr Ahmad stated, “I have been working on this procedure of Minimal Invasive Cardiac Surgery since 2015. Then I got the chance to work with one of the leading MICS surgeons, Dr Fiaz Hashmi, in 2019 and 2020. In 2018 and 2019 I got the chance to visit Turkey and UAE respectively. But practically I watched and learned from Dr Hashmi who works in the US in one of the leading cardiac centres of the world. This process was initiated by the medical community of the US.”

photos: Mohsin Raza/Bol News

Adding to this Dr Ahmad also said some centres in Pakistan have adopted this technique initially like NICVD. Similarly a year ago, this procedure was adopted by Mayo Hospital but unfortunately the concerned professor retired early. Dr Mazahur Rehman is going to operate a few cases in the private Omar hospital. Initially in 2019, this process was commenced by the Social Security Hospital located at Multan Road.

Illustrating the difference between the conventional heart surgery and MICS procedure Dr Ahmad further said, “There is a big difference because in routine cardiac surgery, we have to open the chest to carry out all the surgical procedures. In simple words, a chest bone is cut to perform heart surgery. During this routine method, many problems arise such as excessive bleeding beside high risk of getting infected and the patient having to go through a three-month long recovery period.”

While in MICS procedure, we have to cut a two to three centimetres (cm) small hole from where most of the cardiac surgical procedures are carried out especially valve surgery and all the other important procedures, he elaborated. “Similarly, bypass grafting is possible by cutting a small hole from the left while all the valves are operated by cutting a small hole from the right side.”

In addition to this Dr Ahmad added that all the heart-related surgical procedures can be carried out through MICS because this process does not require the cutting of the bone. “There is no excessive bleeding and no pain. In fact, the patient is able to go home after three to four days of the surgery. There is no difference in timing between conventional and MICS surgical procedures; both types of surgery are performed with the time span of three to four hours.

Speaking about the success rate of MICS, Dr Ahmad said, “So far, we have performed six surgeries and in all the cases, the patients were sent home after three to four days of the surgery. All the patients are satisfied and enjoying their life. This procedure is so ‘smooth’ that one of my patients, just after one day of his surgery, couldn’t believe that he had got his surgical procedure done. It is very easy and tolerable and the patient feels comfortable after the procedure.”

Dr Ahmad maintained that there was no lost blood and only a small invisible mark from where the operation was performed. The patient is allowed to go home on the third day of the operation and after one week the patient can do any type of work.

Speaking about the cost of the treatment, Dr Ahmad told Bol News there is a big cost difference because the disposables for MICS procedure are a bit expensive. Commenting on the inclusion of new medical advancements such as MICS into the syllabus of medical colleges Dr Ahmad said, “All the public medical colleges are associated with some tertiary care hospital in one way or other. Similarly private sector medical colleges are attached with some of the good private hospitals as well. It is time to invite the international surgeons and available Pakistani surgeons to make a curriculum which includes new medical techniques and advancements.”