Complex procedure performed on a 65-year-old male with long-term diabetes and severe kidney and heart damage
The patient suffered a heart attack without presenting typical symptoms

20 June 2023; Ras Al Khaimah, UAE: RAK Hospital in Ras Al Khaimah achieved a significant medical breakthrough by successfully performing a coronary artery bypass surgery (CABG) on a high-risk patient without the use of a cardiopulmonary bypass machine. The innovative approach, conducted while the patient's heart was still beating, proved to be a game-changer for individuals with complex medical conditions, such as severe heart and kidney damage.
The patient, a 65-year-old male, who had been living with Type 2 Diabetes Mellitus for many years, arrived at RAK Hospital's emergency department experiencing alarming symptoms, including reduced urine output and breathlessness. Diagnostic tests revealed that he had suffered a heart attack, further complicated by the adverse effects of long-term diabetes on his kidneys.

Given the extent of his heart disease, traditional methods like stenting were not feasible, and the patient required coronary artery bypass surgery. However, his compromised heart function and renal impairment posed additional challenges for the surgical team.
Conventionally, CABG surgery involves stopping the heart and using a cardiopulmonary bypass machine to maintain blood circulation. However, this method requires a significant amount of fluid to prime the machine, leading to potential complications and inflammation.

In a remarkable departure from conventional practice, the cardiac surgeons at RAK Hospital opted for a beating-heart surgery approach. This technique, which requires specialized equipment and extensive expertise, allows surgeons to operate on the heart while it is still functioning. By avoiding the use of a bypass machine, the risks associated with fluid overload and inflammation were significantly reduced, particularly for patients with pre-existing kidney conditions.
The surgical team at RAK Hospital successfully performed the CABG surgery, stabilizing portions of the beating heart and navigating the complexities of the procedure. The patient experienced a smooth recovery and was discharged within a week, with instructions to prioritize self-care and better management of his health.
This groundbreaking achievement highlights the commitment of RAK Hospital to pushing the boundaries of medical innovation and providing exceptional care to high-risk patients. The success of the beating-heart surgery approach offers hope to individuals with complex cardiac and renal conditions, enabling them to regain their quality of life and pursue their aspirations.

Dr. Adil Rizvi, Chief Cardiac Surgeon and Joint Medical Director at RAK Hospital emphasized the importance of recognizing atypical symptoms of a heart attack, particularly in diabetic patients. He highlighted that symptoms such as excessive sweating, vomiting, arm or jaw pain, and a feeling of unease could indicate a heart attack, even without the presence of chest pain. Diabetic individuals should be vigilant and not ignore any of these warning signs.
Dr. Rizvi further explained the complexity of the case, where the patient had both heart and kidney damage due to diabetes. The patient's condition was initially deemed unfit for angiography, requiring multiple cycles of dialysis to improve his overall health before the procedure could be performed. Given the circumstances, the surgical team made the decision to conduct the surgery while the heart was still beating, a challenging task that demands specialized equipment and extensive experience to stabilize specific areas of the heart during the operation.

Expressing satisfaction with the successful outcome, Dr. Rizvi highlighted the patient's swift recovery and resumption of his regular activities. The expertise and dedication of the medical team enabled the patient to regain his health and normal routine.
Dr. Rizvi's comments underscore the significance of timely medical intervention, awareness of atypical heart attack symptoms, and the importance of individualized treatment plans for patients with complex medical conditions. The successful beating heart surgery showcases the hospital's commitment to delivering advanced cardiac care and improving patient outcomes.

Dr. Raza Siddiqui, Executive Director, RAK Hospital expressed his pride in the surgical team's expertise and dedication, stating, 'RAK Hospital continues to prioritize medical excellence and remains at the forefront of pioneering healthcare solutions, catering to the diverse needs of patients and driving positive transformations in the field of cardiac surgery.”
“The successful outcome of this surgery reaffirms our commitment to delivering advanced and patient-centric care. By adopting innovative techniques and leveraging our experience, we can provide viable treatment options for individuals who may not have been suitable candidates for traditional procedures”, added Dr Siddiqui.