Thiruvananthapuram, November 13, 2025: A 55-year-old male patient from Wayanad, who had undergone a kidney transplant four years ago and was on lifelong immunosuppressive medication, presented to the Cardiology OP at KIMSHEALTH complaining of severe chest pain even while undertaking mild physical activity.

On evaluation by way of an angiogram, he was found to have multiple tight blockages in the coronary arteries, warranting an emergency bypass surgery. Conventional bypass surgery, which involves cutting through the sternum, poses a high risk for the patient, as immunosuppressive medications can slow bone healing and increase infection risk. The medical team, led by Dr. Atul Abraham, Consultant, Department of Cardiothoracic and Vascular Surgery, KIMSHEALTH, therefore opted for the Minimally Invasive Coronary Artery Bypass Graft (MICS CABG) procedure.

Minimally invasive heart surgery involves making small incisions between the ribs, letting the surgeon reach the heart without cutting through the sternum, as is done in traditional open-heart surgery. These incisions measure about 2 to 3 inches, which is significantly smaller than the traditional open-heart surgery’s 6 to 8-inch cuts, said Dr. Atul Abraham.

This procedure offers multiple advantages over conventional bypass surgery, including faster recovery, shorter ICU and hospital stay, minimal blood loss, lower risk of wound infection or delayed bone healing, and better cosmetic results. Patients also experience less anxiety and a more positive body image after surgery, often returning to normal or even heavy physical activity within two to three weeks. Performing a minimally invasive coronary artery bypass graft on a post-renal transplant patient is rare. However, given the complex medical profile of this patient, these advantages were more favourable for an MICS-Bypass, added Dr. Atul Abraham.

The surgery lasted four hours, and the patient was discharged after five days of hospital stay. Dr. Padmaja N.P., Senior Consultant, Department of Cardiology; Dr. Satish Balan, Consultant, Department of Nephrology; Dr. Vipin B. Nair, Consultant, Department of Cardiothoracic Surgery; Dr. Subash S., Consultant, and Dr. Hari Dev J.J., Associate Consultant, Department of Cardiothoracic Anaesthesia, were also part of the treatment.