Total Arterial Revascularization in Delhi
WHAT IS TOTAL ARTERIAL REVASCULARIZATION (TAR) ?
Total Arterial Revascularization (TAR) is a surgical approach used in coronary artery bypass grafting (CABG) where only arterial grafts are used to bypass blocked coronary arteries. The goal of TAR is to improve blood flow to the heart without using vein grafts, which are more prone to long-term complications like occlusion or atherosclerosis.
BENEFITS OF TOTAL ARTERIAL REVASCULARIZATION (TAR)
Key features of TAR:
Use of Arterial Grafts: Typically involves using the internal thoracic arteries (ITA) (often the left and right ITAs), the radial artery, or occasionally the gastroepiploic artery for grafting.
Improved Longevity: Arterial grafts are more durable than vein grafts, leading to better long-term outcomes because arteries are more resistant to the development of plaque or narrowing over time.
Lower Risk of Complications: Arterial grafts have a lower rate of failure compared to vein grafts, which means patients may have a reduced need for future re-intervention.
Advantages of TAR:
Better Long-term Patency: Arteries are more resistant to blockages, leading to superior long-term results.
Lower Risk of Recurrent Angina: Fewer chances of re-narrowing (restenosis) of the grafts.
Reduced Mortality: Studies suggest TAR may lower long-term mortality rates in comparison to conventional CABG using vein grafts.
PROCEDURE(S) OF TOTAL ARTERIAL REVASCULARIZATION (TAR)
The procedure of Total Arterial Revascularization (TAR) involves using only arterial grafts for coronary artery bypass surgery (CABG). The goal is to reroute blood flow around blocked or narrowed coronary arteries using arteries instead of veins, which generally have a better long-term patency rate. The specific procedural steps depend on the choice of arterial grafts and the number of bypasses required.
RECOVERY AFTER TOTAL ARTERIAL REVASCULARIZATION (TAR)
Recovery after Total Arterial Revascularization (TAR) involves the healing process following a surgical procedure in which only arteries, typically the internal mammary arteries, radial arteries, or other arterial grafts, are used to bypass coronary blockages. This method is often chosen for its potential long-term benefits, as arterial grafts tend to remain open longer than vein grafts. Here’s what recovery typically entails:
1. Post-Surgery Hospital Stay:
Initial Intensive Care: After surgery, patients usually spend the first 1–2 days in an intensive care unit (ICU) to monitor vital signs and cardiac function closely.
Regular Ward Transfer: Patients are transferred to a regular hospital ward once stabilized, usually staying for 5–7 days, depending on individual recovery rates and any complications.
2. Early Recovery (First Few Weeks):
Pain Management: Some chest pain, soreness, and discomfort at incision sites are common. Medications are prescribed to manage pain.
Wound Care: Proper care of the incision site is crucial to prevent infection. Follow-up with a healthcare provider is needed to monitor healing.
Restricted Activities: Physical activity is limited initially, with restrictions on lifting heavy objects and strenuous exercise for the first few weeks. Walking and light activities are encouraged as tolerated.
3. Cardiac Rehabilitation:
Supervised Exercise: Patients are often enrolled in a cardiac rehabilitation program, which typically starts a few weeks after surgery. This program includes supervised exercise tailored to improve heart health and endurance.
Lifestyle Education: Education on heart-healthy eating, stress management, and quitting smoking is provided to reduce the risk of future heart disease.
4. Long-Term Recovery (Months):
Gradual Resumption of Normal Activities: Over 6–12 weeks, most patients are able to gradually resume daily activities, including returning to work, driving, and more vigorous exercise, depending on individual progress.
Monitoring and Follow-ups: Regular follow-ups with a cardiologist are important to monitor heart function and graft health. Medications to manage cholesterol, blood pressure, and prevent clotting may be prescribed.
COST OF TOTAL ARTERIAL REVASCULARIZATION (TAR)
The cost of Total Arterial Revascularization (TAR) in India can vary significantly based on factors such as the hospital, surgeon expertise, location, patient condition, and the type of arterial grafts used. On average, the cost of TAR in India may range from INR 4,00,000 to INR 6,00,000, though prices could be higher in top-tier hospitals or for more complex cases.