About us

Dr. Kshitij Dubey, M.B.B.S., M.S., M.Ch., is an established cardiac surgeon working as a senior consultant at Apollo Hospital, Indore. He is one of the few surgeons, who performs the surgery with an extremely small cut. The small cut surgery is technically known as Minimally Invasive Direct Coronary Artery Bypass (MIDCAB).

Dr. Kshitij Dubey took special training at Leipzig in Germany for this surgery. The small cut is a boon for the patients as it causes less pain and less blood loss while ensures faster recovery. However, since the technique requires high end skills and training it is still not adopted at most places in India.

Dr. Dubey has successfully performed more than 100 surgeries with the smaller cut establishing its merits and advantages over conventional bypass surgeries. Because of this Indore has come on global map as one of the few centres for the same in India. He has been honoured by many institutes in recognition of his contribution and efforts.

Dr Dubey is an advocate of prevention rather than remedy and is involved in various activities for better life style and awareness programme about heart diseases. He delivers lectures on healthy diet patterns, appropriate exercising and gives demonstration of Basic Life Saving, that is, steps to be taken by laymen during a heart attack (cardiac arrest).

Dr Dubey gives highest priority to any opportunity to interact with  people and advices them to adopt a life style with a lesser risk of heart disease. He is open to any comments or queries from patients as well as common people.

Angioplasty or Bypass Surgery

Bypass or Angioplasty? This is often the biggest dilemma for heart patients and their family members. Generally, bypass is considered bigger, riskier and costlier than angioplasty. This concept exists because common persons are not aware of the changes that have taken place in bypass surgery procedure. During 1980s and early 1990s bypass used to be a cumbersome, painful and lengthy procedure. However, with advent of smaller cut surgery (MIDCAB) things are very different now. To see and evaluate things in correct perspective lets first understand what is MIDCAB and how it is different from the conventional bypass surgery.

MIDCAB

Minimally Invasive Direct Coronary Artery Bypass is a breakthrough in heart surgery and there are very few doctors who perform this kind of operation. During a MIDCAB procedure only a 2 to 3” hole is cut under the nipple. Unlike conventional surgery there is no cut through the rib bones (sternum) which is extremely painful during recovery. Since the cut is small, most of the problems experienced during the conventional bypass and recovery after it automatically get sorted out.

Moreover, during MIDCAB the removal of veins and arteries from leg is done with advanced  endoscopic procedure that doesn’t require cutting through the skin of leg. This again helps in  faster recovery.

The table below shows a comparison between conventional bypass surgery and new technology based small cut surgery.

Critaria Conventional Surgery MIDCAB or Small Cut Surgery
Size of Cut 8-10 inches 2-3 inches
Type of Cut On chest cutting through rib bones (sternum) Just below nipple without cutting any bone
Blood Loss High blood loss causing weakness. Negligible blood loss
Recovery Time Takes couple of months at least to resume day to day work Routine like driving can start within couple of weeks after the surgery.
Pain Its painful as bone gets cut and wound is bigger No bone cut and wound is very small so almost pain free.
Post surgery Infections Strong possibility as wound is bigger and takes long to heal Near zero possibility due to smaller wound.
Mark on body With a long cut the mark is very evident Small cut mark is almost not noticed

Thus it is crystal clear that the small cut surgery (MIDCAB) is a much more effective and preferable option than conventional bypass surgery. Now given hereunder is another table showing comparison between Angioplasty and MIDCAB or small cut bypass.

Critaria Angioplasty MIDCAB – Small Cut Bypass
Life of Solution Short Term Solution

Invariably things worsen after few years  and patient has to first undergo all tests and finally the bypass.

Long Term Solution

A bypass is good for at least 15 years and with a better life style one may make it a  permanent solution.

Treatment It postpones the ultimate problem for a certain period. It is a total treatment and the existing blockages are completely bypassed.
Recovery time 2-3 days 3-4 days
Possibility of re occurrence Very common Very rare
Economy Good quality stents are extremely costly and cost much more than bypass if the obstructions are more than one. Bypass has almost the same cost immaterial of no of blockages and provide total solution to the problem.

 

Thus it is clear that not only that MIDCAB is better than conventional bypass in most cases it is better than angioplasty as well. Of course there are medical situations where we have to opt for angioplasty or even conventional bypass over MIDCAB but those are remote cases and can not be generalised.