Beating Heart Bypass for Triple Vessel Disease

Surgeon: Dr. Vishal Khullar  |  Specialty: Cardiothoracic & Vascular Surgery, Heart and Lung Transplant

Hospital: Nanavati Max Super Speciality Hospital, Vile Parle West, Mumbai

Procedure: Coronary Artery Bypass Grafting using Bilateral Internal Thoracic Arteries and Left Radial Artery Conduit

Video Testimonial: youtu.be/kyfas1psgro

PATIENT PROFILE

Condition

The patient first noticed difficulty breathing in early February, which he initially dismissed. On evaluation by a cardiologist, an echocardiogram and supporting tests were performed, followed by a coronary angiography. The angiogram revealed six blockages across the coronary arteries, three of them critical at around 90 percent narrowing. The clinical diagnosis was critical triple vessel coronary artery disease, meaning the three main vessels supplying blood to the heart muscle were all significantly obstructed. This is the kind of severe blockage that heart bypass surgery is designed to treat. In plain terms, the heart was being starved of blood, and the situation was severe and immediately life threatening if left untreated.

Emotional & Psychological Impact

The diagnosis came as a profound shock. The patient described how his entire world changed within the space of a month, going from a vague, easily ignored breathing problem to learning he needed major heart surgery. There was no long history of illness to prepare him; the disease was discovered suddenly and unexpectedly, which made the emotional weight of it especially heavy for him and his family. Facing open heart surgery as a working professional who had felt essentially well raised real fears about recovery, returning to work, and resuming normal life. It was against this backdrop of sudden, frightening uncertainty that he came under the care of Dr. Vishal Khullar.

The evaluation followed Dr. Khullar’s standard pathway across his cardiac surgery treatments, moving from symptoms to imaging to a definitive surgical plan.

What Was Assessed During the Consultation

• Symptom pattern: classic angina with chest pain radiating to the left arm
• Echocardiogram and supporting cardiac tests to assess heart function
• Coronary angiography to map the number, location and severity of blockages
• Suitability for angioplasty (stenting) versus surgical bypass
• Overall medical fitness for major cardiac surgery

Why This Procedure Was Chosen

• With six blockages and three critical lesions at around 90 percent across all three main vessels, angioplasty was not a viable option. The disease burden was too extensive for stenting.
• Coronary artery bypass grafting was selected to restore reliable blood flow to all affected territories of the heart in a single, definitive operation.
• A beating heart, or off pump, approach was chosen, allowing the bypass to be performed without stopping the heart on a heart lung machine.
• Internal mammary arteries from inside the chest wall were used as grafts. These arterial grafts have an excellent long term track record and are expected to stay open for the rest of the patient’s life.

In a cardiac bypass case the key pre operative documentation is the coronary angiogram, which maps the blockages and guides the surgical plan, alongside baseline imaging and ECG. Standardised photographs are less central than in aesthetic surgery, but baseline records should be retained.

Step by Step Overview

• Pre operative formalities and surgical planning completed under the guidance of Dr. Vishal Khullar
• Patient anaesthetised and prepared for off pump (beating heart) surgery
• Chest opened to access the heart
• Internal mammary arteries harvested from inside the chest wall for use as grafts
• Beating heart coronary artery bypass grafting performed. Grafts placed to bypass the blocked segments while the heart continued to beat
• Graft flow and stability confirmed
• Chest closed in layers

Procedure Facts

The post operative course was smooth and uneventful. The patient was mobilised early, walking in the ICU within two days of surgery, and was discharged on the fifth post operative day. By around the fifteenth day his sutures had been removed and he was walking comfortably and managing daily activities independently. For patients at this stage, the practical guidance on recovering from heart surgery covers what to expect and which warning signs to watch for. The surgical goal of restoring reliable blood supply to the heart with durable arterial grafts was fully achieved.

Post operative recovery. Patient mobile and recovering

Outcomes at a Glance

“The surgery happened, and within two days I started walking in the ICU. Today it is the fifteenth day and I am fit. All the stitches have been removed, and I am able to walk and do everything. I can even drive after a month, and I can attend office. I am sincerely grateful to Dr. Vishal Khullar and his team, and to the Nanavati ICU team and the entire team of Nanavati Hospital. Thank you very much.”

Profile: Male · working professional · Mumbai

Procedure: Beating heart coronary artery bypass grafting · Nanavati Hospital, Mumbai · February 2026

Surgeon: Dr. Vishal Khullar · Nanavati Hospital

Feedback recorded from the patient’s clinical follow up and attributed by profile only. Patient name withheld.

Recovery Timeline (as observed in this case)

General guidance for this procedure typically includes prescribed cardiac medications, a gradual increase in activity, sternal precautions while the breastbone heals, and scheduled cardiology follow up. Add the exact instructions issued by the clinical team.