Cardiovascular disease (CVD) remains a leading cause of death globally, accounting for around 20 million fatalities annually. In India, the rates of coronary artery disease (CAD) are particularly alarming, with a notable prevalence of early onset, rapid progression, and high mortality rates. As a cardiovascular surgeon at Devaki Hospital, Dr. X. Reenus Demel has witnessed firsthand the critical need for effective treatment options for his patients.
The burden of CVD in India is staggering. In 2016, CVDs accounted for 28.1% of total deaths and 14.1% of total disability-adjusted life years (DALYs). Among states, Kerala, Punjab, and Tamil Nadu report the highest rates of CVD. According to Dr. Reenus, addressing both conventional risk factors—such as hypertension, diabetes, dyslipidemia, smoking, and obesity—and emerging factors, including ambient air pollution and psychosocial stress, is crucial for long-term patient health.
In terms of surgical treatment, coronary artery bypass grafting (CABG) is a common procedure in India, particularly beneficial for patients with complex CAD, such as those with diabetes and low heart function. Dr. Reenus Demel emphasizes the use of arterial grafts, such as the internal thoracic artery and radial artery, which significantly enhance graft patency rates and long-term survival.
One remarkable case recently handled by Dr. Reenus involved a patient who underwent both a mitral valve replacement and bypass surgery. The patient had been turned away by multiple hospitals, as the surgery was deemed too high-risk. However, Dr. Reenus, known for his expertise in managing complex cases, accepted the challenge. After a week of careful observation, he and his team successfully performed the surgery. The patient’s son shared his heartfelt gratitude, stating that other doctors had refused to operate due to his father’s critical condition, but Dr. Reenus demonstrated both skill and compassion by proceeding with the surgery.
He described the surgery as "very challenging," noting that his father’s pre-existing varicose veins added to the complexity. Thanks to Dr. Reenus and his team, the surgery was a success, and the patient made a remarkable recovery. This case highlights how advanced cardiac interventions can lead to life-saving outcomes, even in the most critical and complex cases.
Emerging alternatives to traditional CABG, such as minimally invasive direct coronary artery bypass (MIDCAB) and robotic-assisted CABG, underscore the advancements in cardiac care. These innovative techniques involve smaller incisions, reducing surgical trauma, minimizing recovery time, and promoting faster healing for patients.
In conclusion, the ongoing evolution of cardiac treatment options allows doctors like Dr. Reenus to offer renewed hope and deliver significantly improved outcomes for patients facing complex and severe cardiovascular conditions.