Keyhole operation brings hope for heart patients

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A 61-year-old man from Bristol has undergone pioneering surgery to treat diseased arteries using a "keyhole" technique which surgeons say will soon replace open heart surgery for some patients, and save the NHS thousands of pounds.

Dennis Dummett spent just three days in hospital after the surgery at Bristol Royal Infirmary just over a week ago, and is now at home and planning to resume his hobby of square dancing.

Open heart surgery involves opening up the chest to split and separate the breast bone, and connecting the patient to a heart-lung machine because the heart has to be stopped temporarily. Patients are usually in hospital for 10 days or so and need several weeks' recuperation.

In Mr Dummett's case, a combined team of cardiologists and surgeons carried out the surgery, which uses two minimally-invasive or "keyhole" surgical techniques. They made a small cut under his left nipple, allowing the surgeons access through two ribs. The internal mammary (breast) artery was then grafted on to the major left anterior descending artery of the heart. The success of the by-pass graft was tested almost immediately by squirting X-ray traceable dye through it.

In the second stage of the operation, a catheter was inserted into an artery in his groin, introducing a narrow balloon into the blocked right major coronary artery. The balloon was then inflated and deflated to push aside the blockage in a routine angioplasty procedure.

The operating technique was partially developed by an Italian, Professor Antonio Calafiore, who works at a hospital in Chieti, near Rome. However, the combination approach of keyhole surgery and angioplasty was the brainchild of Professor Gianni Angelini, director of the Bristol Heart Institute based at the hospital.

Professor Angelini said: "We are looking at the possibility of up to half of our future heart patients being treated in this way. There are tremendous implications for healthcare costs from this integrated approach to treating coronary disease."

Professor Angelini said there was less scarring, less bleeding and greatly reduced trauma with the technique. It reduced the risk of a stroke, faced by 4 per cent of patients.

Mr Dummett admits that he was apprehensive about the pioneering techniques. He was asked to volunteer only two weeks before his operation.

"I put my faith in the specialist BRI staff. I would advise anyone who has the chance of this technique to take it."

The British Heart Foundation welcomed the new operation, saying it would improve chances of a full recovery.

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