PM's operation successful, 'he is fine'

Prime Minister Manmohan Singh on Saturday successfully underwent a coronary bypass surgery at the All India Institute of Medical Science in New Delhi as doctors removed 10 blockages in his heart.

"The prime minister is conscious, stable and is responding," Dr K Srinath Reddy, the chief of the prime minister's medical panel and a former head of cardiology at AIIMS.

Dr Sampath Kumar, the head of the cardio-thoracic department at AIIMS supervised and monitored the procedure, which began at 8:45 am after a couple of hours of preparatory procedures and concluded at 7:30 pm. The prime minister was returned to the intensive care unit at 8:55 pm.

Dr Ramakanth Panda, the chief of the Asian Heart Institute in Mumbai, headed the surgical team comprising doctors that performed the beating heart surgery. The prime minister had undergone his first heart surgery in 1990 and then had an angioplasty in 2004. This week, he complained of chest plain and the angiography revealed 10 blockages, which prompted the doctors to opt for a surgery.

On the surgery

Giving an overview of the procedure, Dr Reddy said: "After the angiography on January 21, we decided a surgery would be a better option in the long run and decided to go in for a by-pass. Since certain drugs administered during the angiography had to be withdrawn, the surgery was scheduled for January 24."

Explaining the procedure, Dr Panda said three of the five grafts used in the surgery were taken from the chest.

"And since he had already undergone one surgery, we took one graft each from his left arm and left leg," he said.

Four of the grafts were arteries and one was a vein, which was taken from the leg, the doctors said.

Asked if any complications arose during the surgery, Dr Panda said the prime minister was stable throughout the duration of the beating heart surgery.

Asked about the long duration of the surgery, the doctors said since it was a second surgery, it took very long.

"During the first surgery, we usually reach the heart in five minutes and the by-pass is done quickly. Since this is his second surgery and also due to the multiple blockages there were a total of five by-passes to be done," Dr Panda said.

Questioned again on the duration of the surgery, which some initial reports said would take five to six hours, Dr Panda, who has some 1,000 by-pass surgeries to his credit, said: "Show me one instant when a second surgery is completed in 5-6 hours as you claim. It usually takes this much time. And why is there so much emphasis on time?"

He said the doctors did not care as much about the duration of the surgery as the successful completion of the surgery. "You want to do a perfect job. Time is not an issue at all for us. That is also one reason that I do not have a clock in the operation theatre," Dr Panda said.

On the prime minister and his life after surgery

Asked how the prime minister was after the surgery, the doctors said he was conscious and doing well. "He is conscious. It will take a couple of hours for him to respond completely. We are monitoring him," Dr Reddy said.

On the things that they would be keeping an eye on, the doctors said bleeding and minor infections are on top of their list.

"In such procedures, there could be extra bleeding in the first two or three days and there are chances of the patient getting infected. There has been no bleeding till now. We will constantly observe him," Dr Panda said.

The prime minister can get back to doing some of his work in two weeks, the doctors said. "He can start doing some of his minor work in two weeks and most of his work in four weeks. H would have recovered completely by the sixth week and resume normal work," Dr Panda added.

Asked if there had been any negligence in monitoring the prime minister's health and whether the detection of the blockages was delayed, the doctors said there was no negligence and it was diabetes which was the reason for the blockages.

"He is a long term diabetes patient and that greatly increases the risk of coronary heart diseases," Dr Reddy said, explaining how a person like the prime minister, who is a teetotaller and maintains a very active and healthy lifestyle, came to have so many blockages.

On whether the prime minister can carry out normal duties when he recovers, the doctors said not only will he get back to normal duties, he would be better than what he used to be in the recent past.

"In fact, he would have been restricted before the surgery due to the blockages. We have taken care of that. Now, when he recovers, we can assure you that he would be much more active than what he was earlier," Dr Panda said.

Asked if this included long campaign tours in the run up to the elections, Dr Sampath Kumar said: "Of course. In fact, one of the reasons we opted for the surgery was because the prime minister wanted be ready and fully active well before the elections begin so that he can get on with the campaigning without any worries."

Dr Panda also ruled out the possibility of any other complications arising in the near future. "This surgery will see him off for the rest of his life. By our reading he won't need any more surgeries," he said.

Recalling their interaction with the prime minister before he was wheeled into the operation theatre to be administered anaesthetics, the doctors said he was very tranquil, calm and composed. "The prime minister was fully confident about the expertise and skills of the doctors on the team. He just said I am ready," Dr Panda said.