Dr. Rajneesh Malhotra.(Chief of Cardiac Surgery Max Super Specialty Hospital Saket New Delhi) with the answers to the queries about cardiac surgery in Diabetics in the light of SYNTAX TRIAL conducted on 1800 patient at 85 centers all over the word over a span of 5 years.

1.
Diabet H rt P ents
tic Hea Patie s
– By ass i afe
– ypa is s er
DR
R. Rajnee
esh Malho
otra,
Ch
hief of Cardiac Sur
rgery
Max Super Specialty
y Hospital
Sa
aket, New
w Delhi

2. Di
iabeti
ic Hea
art Pat
tients
s: Bypass is safer
r
alhotra.(Ch of Car
hief
rdiac Surgery Max S
Super Specialty Hospital
Dr. Rajneesh Ma
New Delhi with the answers to the q
i)
s
queries ab
bout cardiac surger in
ry
Saket N
Diabetic
cs in the lig
ght of SYNTAX TRIAL
L conducted on 1800
0 patient at
t 85 center
rs all
over the
e word ove
er a span o
of 5 years.
Procedure should be the choic of treat
e
ce
tment for diabetic s
suffering f
from
What P
Heart A
Attack?
It had alwa been a m
ays
major issue with diabet to
tics
choose between angioplasty and b
bypass surge at
ery
Attack. Though the ca
ardiac
the time of heart A
nd cardiolog
gist were fee
eling that wa
ay but
surgeons an
the world’s largest study, SYNTAX TRIAL confirmed
s
Bypass one up to angioplasty.

3.
Stent is
s a foreign th
hing to the b
body. In non diabetic the stent
e
closure is just 5% w
whereas in di
iabetics beca
ause of natu
urally
atory respon
nse the stent
t closure rise
es up to 20
increased inflamma
in six month of stent pla
acement. It h
has been see
en that in
% withi
case of bypass as th
he tissues ar
re used from
m one owns b
body this
atory does n
not play any role. Hence there is no
increased inflamma
nce in the ou
utcome of By
ypass for Dia
abetic or No
on Diabetic.
differen
What is
s the norm
mal life of the two pro
ocedures?
?
Stent
ts have incre
eased chanc
ces of rest en
nosis especia
ally in
diabe
etes and wit
thin in first six months of procedure in
tune of 10‐15% s
stents close down. Bypass surgery w
with
rial grafts tak
kes 30‐40 ye
ears to close down again
n.
arter

4. Because
e of the fe
ear of heart surgery p
people ado
opt for Angioplasty o
or Stenting. Is
g
it so?
Yes because of the fe
ear of heart surgery man
ny patients c
choose
sty over byp
pass surgery,
, knowing fully well that the
angioplas
long term
m results may not be goo
od and they may require
e
repeated
d coronary in
nterventions
s in knowing full well tha
at the
long term
m results may not be goo
od and they may require
e
repeated
d coronary in
nterventions
s in future. In
n only few
condition
ns both proc
cedures com
mplete in Diabetes.
Patie
ents with lef
ft main coronary stenosi
is and
diffu
use coronary
y artery disea
ase bypass s
surgery is still
the t
treatment of
f choise and
d long term r
results of
CABG
G are much better than Stenting. He
eart surgery
has c
come throug
gh radical ch
harges. 2‐3 in
nches of
incis
sions are eno
ough as com
mpared to 10
0‐12 inches
incis
sions previou
usly. This has
s made reco
overy faster
& sm
moother. One can join ba
ack the offic
ce in 3‐4
weeks time as co
ompared to 1‐2 weeks time in case
ngioplasty.
of an

5.
Dr R
Rajneesh M
Malhotra is a Best
Card
diac Surge
eon, Heart
t Specialis
st
Doctor and Ca
ardiac Doctor India.
He s
specialized
d in Cardia
ac Surgery
y
(CTV
VS).
Please f
feel free to
o CONTACT
T US for an
ny Questions/Concer
rns you mig
ght have.
Address:
A
Max Super S
M
Specaility H
Hospital (Ea block), S
ast
Saket
New Delhi
N
Ph: +91-999
P
99722781, +91-9650429068
W: http://ww
W
ww.drrajnee
eshmalhotra
a.com
E: drrajnees
E
shmalhotra@
@gmail.com
m