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Precision Cardiac Care: 130-kg Patient Undergoes Successful Minimally Invasive Heart Bypass Surgery at DPU Super Specialty Hospital

The Cardiovascular and Thoracic Surgery (CVTS) team at DPU Super Specialty Hospital, Pimpri, Pune, has successfully performed a complex, minimally invasive coronary artery bypass grafting (CABG) procedure on a 46-year-old patient weighing approximately 130 kg. The case presented heightened clinical complexity due to the patient's recurrent multi-vessel blockages, uncontrolled diabetes, and severe obstructive sleep apnea (OSA).

By avoiding the trauma of traditional open-heart surgery, the surgical team accessed the coronary arteries through a tiny 3–5 cm incision, demonstrating how precision surgical techniques and multidisciplinary coordination can deliver safer outcomes for high-risk patients.

Overcoming High-Risk Surgical Barriers

The patient had undergone coronary angioplasty three years earlier for multiple blockages. When critical blockages recurred within just two to three years, surgical revascularisation through CABG became an urgent necessity. However, his profile presented major surgical hurdles:

• Severe Obesity (130 kg): Significantly elevates the risk of wound infections, impaired sternal healing, and prolonged immobility.
• Obstructive Sleep Apnea (OSA) & Diabetes: Poses heightened risks of respiratory compromise, airway collapse during anaesthesia, delayed extubation, and microvascular complications.

Given these severe risk factors, Dr. Ashish Baviskar, Cardiovascular, Thoracic & Vascular (CVTS) and Advanced Cardiac Surgeon, alongside his surgical team, opted for a Minimally Invasive Direct Coronary Artery Bypass (MICS-CABG).

Bypass Surgery Without Dividing the Breastbone

Traditional bypass surgery relies on a median sternotomy, which requires cutting completely through the patient's breastbone (sternum). For patients with severe obesity and diabetes, sternal incisions carry a significantly higher incidence of non-healing, deep-wound infections, and chronic pain.

Instead, the surgical team navigated through an intercostal approach working through a 3–5 cm keyhole incision between the ribs.

"Minimally invasive cardiac surgery allows us to perform complex procedures through a much smaller access point while avoiding a sternotomy. In this patient, severe obesity, diabetes, and obstructive sleep apnea added considerable perioperative complexity, making meticulous planning essential."

— Dr. Ashish Baviskar, Advanced Cardiac Surgeon

Anaesthetic Precision in Obstructive Sleep Apnea

Safely guiding a 130-kg patient with OSA through thoracic surgery demands strict anaesthetic protocols. Dr. Venuraj Warke, the lead treating anaesthesiologist, engineered a tailored strategy addressing:

• Airway Control & Oxygenation: Continuous monitoring of gas exchange and lung mechanics to prevent intraoperative hypoxia and lung collapse.
• Targeted Drug Dosing & Positioning: Custom weight-based pharmacology to avoid extended drug clearance times.
• Rapid Extubation: Through strict perioperative respiratory management, the patient was successfully extubated just two hours after surgery, drastically cutting the risks tied to prolonged mechanical ventilation.

Collaborative, Multidisciplinary Post-Operative Care

Minimally invasive cardiac surgery relies on seamless coordination across multiple hospital departments. Alongside the lead surgeons and anaesthesiologists, the patient’s recovery was driven by a dedicated support unit:

• Surgical & Perfusion Support: Miss Bharati, Mr. Gowhar, and Mr. Dishant
• Intensive Care Unit (ICU) Nursing Staff: Around-the-clock hemodynamic stability and early ambulation protocols
• Cardiac Physiotherapy Team: Targeted chest physiotherapy and mobility regimens designed to restore pulmonary function early

Institutional Commitment to Cardiac Innovation

DPU leadership highlighted how advanced, minimally invasive interventions align with the hospital's patient-first philosophy:

• Dr. P.D. Patil, Chancellor, Dr. D.Y. Patil Vidyapeeth:

  "This complex case demonstrates the importance of combining advanced cardiac surgical expertise, multidisciplinary decision-making, and patient-centred care to ensure complex needs are met close to home."

• Dr. Bhagyashree P. Patil, Pro-Chancellor, Dr. D.Y. Patil Vidyapeeth:

  "The successful use of a minimally invasive approach in a patient facing severe clinical challenges reflects our focus on adopting techniques that reduce surgical burden while maintaining maximum patient safety."

• Dr. Yashraj Patil, Trustee & Treasurer, Dr. D.Y. Patil Vidyapeeth Society:

  "Advanced healthcare is defined by translating infrastructure and multidisciplinary care into meaningful recovery outcomes. We remain committed to expanding access to advanced cardiac sciences across the region."

About DPU Super Specialty Hospital Cardiac Sciences

The Centre for Cardiac Sciences at DPU Super Specialty Hospital brings together Cardiology and Cardiovascular & Thoracic Surgery (CVTS) under one roof. Spread over 9,77,757 sq. ft. with a 2,011-bed tertiary care infrastructure, the hospital provides round-the-clock emergency cardiac care, dedicated catheterisation laboratories, advanced imaging, and minimally invasive cardiac solutions.