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By uday

(Worlds first case of total arterial CABG in a pregnant woman)
In a ground breaking medical achievement, Dr. M.D. Dixit, Chief Cardiac Surgeon, led a skilled team of surgeons in successfully performing a Coronary Artery Bypass Grafting (CABG) surgery on a 7-month pregnant woman at the Arihant hospital Belagavi.

This remarkable surgery undertaken on January 1, 2024, marks a historic milestone as the first-ever recorded case of total arterial triple vessel coronary bypass surgery on a patient in the advanced stages of pregnancy.

The patient, Mrs. Anita (name changed), a 37-year-old woman, in her seventh month of pregnancy, presented with calcified Triple Vessel Disease along with left main disease. She also had Hypercholesterolemia with cholesterol levels more than 700 mg/dl. In such patients, the Aorta is profoundly thickened with multiple cholesterol deposits which makes conventional CABG nearly impossible.

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Coronary Angioplasty was not feasible owing to risks associated with radiation.
Given the delicate nature of the situation, the surgical team thoroughly discussed and considered all possible alternatives and decided to perform a total arterial revascularization using LIMA-RIMA ‘Y’ technique for three grafts. The surgical team consisting of Dr. M.D. Dixit, Dr. Amrut Nerlikar, Dr. Abhishek Joshi, Dr. Nikhil Dixit, Dr. Prashant MB, Dr. Avinash Londhe and Dr. Soubhagya Bhat, meticulously planned and executed the life-saving procedure.

The primary concern was the well-being of both the mother and the unborn child and they were carefully monitored in the Intensive Care Unit. Subsequently, Mrs. Anita was transferred to the ward and has now been discharged on 08/01/2024.

This unprecedented case exemplifies the dedication, expertise and collaborative efforts of the surgical team involved in the successful outcome and underscores the advancements in medical science and commitment of healthcare professionals to push the boundaries of what is possible for the well-being of their patients.

Dr M D Dixit: Performing heart surgery on a woman who is seven months pregnant poses several unique challenges due to the complexity of balancing the health and well-being of both the mother and the unborn child. One of the primary concerns is the potential risk to the developing fetus. Selecting the appropriate anesthesia is crucial. The choice of antibiotics, painkillers, medications and investigations are limited. Careful thought has to be given to the Surgical Approach and Timing of the surgery.

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