The patient stares out at the camera, his fragile heart exposed during life-saving surgery. The astonishing picture of Swaroup Anand shows just how far open-heart surgery has come in the last decade. The 23-year-old went under the knife in Bangalore at Wockhardt Hospital while he was still very much awake. Doctors chose to numb his body with an epidural to the neck rather than send him to sleep with general anaesthesia. Lead surgeon Dr Vivek Jawali, said they had performed more than 600 operations this way since 1999. Speaking from his hospital in India, he told the MailOnline: 'There has been a huge effort in recent times to make heart surgery less invasive. This can be done in two ways. Firstly smaller cuts can be made and this is helped with modern technology and robotics. 'Secondly we are trying to interfere as little as possible with the body's natural functions.' The patients are given a mild sedative rather than being knocked out - this drops their heart rate but means they can respond to commands. 'The patients are drowsy so they can be aroused but are also able to drift into sleep,' Dr Jawali said. 'If we need them to cough or breathe more deeply to clear air from their heart they can respond. This makes the procedure a lot easier to perform.' As the patient is awake the doctors also have a better idea of how the body is reacting to the surgery from their respiratory system to their brain function. Dr Jawali added that patients did not report feeling afraid during the operation. 'We give them headphones so they can listen to their favourite music,' he said. 'After the operation we find they have selective amnesia. They can remember parts of the operation but in a patchy manner.' The surgeon said performing coronary bypasses on conscious patients also reduced mucas in those with poor lungs, kept their blood vessels dilated and better preserved their organs. Dr Jawali has recently released a DVD giving a step-by-step guide to the procedure for surgeons at other hospitals. 'There is now a global movement supporting this kind of procedure,' he said. The first UK heart bypass while the patient was awake was performed at Harefield Hospital in Middlesex in 2003. Source
