Times Of India
25 Nov 2012
Indian–American Doctor Plans To Conduct First Surgery In City In Early 2013

Soon, people suffering from heart troubles can avail of a new therapy. For the first time in India, to resuscitate weak hearts and make them stronger, an Indian–American surgeon will carry out triple therapy a combination of angiogenesis, stem cells and bypass surgery.

Dr Mukesh Hariawala is all set to introduce the "natural bypass" in Mumbai’s Jaslok Hospital in the first quarter of 2013. The surgery involves spontaneous development of new blood vessels in the heart by laser stimulation and subsequent injection of patient's own stem cells harvested from bone marrow.

"This surgery is like a natural bypass, wherein, we create alternative vessels from body’s own functions," Dr Hariawala told TOI. He said the surgery is mainly meant for very sick patients, whose blood vessels degenerate over the years–especially those who suffer from diffused disease, which is more common in diabetics.

"We remove the patient’s bone marrow, and then the stem cells are separated over the next six to eight weeks. For the triple heart therapy, a hybrid operating suite is required, which would have a combination of a cath lab and operation theatre," said the Harvard–trained doctor.

Once the patient is taken for the surgery, with the help of laser, doctors perform angiogenesis–the process in which new blood vessels are grown from the pre–existing ones. In this process, vascular endothelial growth factor (VEGF) is a signal protein produced by cells that restores the oxygen supply to tissues when blood circulation is inadequate.

"When VEGF is released within the body because of the laser, it forms alternative blood vessels. At the peripheral area where the angiogenesis is performed, we then inject the patient’s own stem cells. This patches up or completely restores the blood vessel and the patient will not need further cardiac intervention," said Dr Hariawala.

The clinical trial for the triple heart therapy has been successfully carried out on 22 patients worldwide. "Within first quarter of 2013, we will be able to provide this treatment," Dr R R Pulgaonkar, chief executive officer of Jaslok Hospital, said.

But Dr Hariawala warned that the triple therapy is not the answer to all heart problems. "Not all patients suffering from heart problems will be able to get this treatment. This is a complex procedure and is done on only those patients, who suffer from extremely degenerated blood vessels and on whom the bypass surgery alone will not work," he said.