Why Jayadeva performs more angioplasties than bypass surgeries

Jayadeva Institute of Cardiovascular Sciences does the largest number of angioplasties in India. While they did 14,000 angioplasties in 2019, they did 1,400 bypass surgeries in the same period.

Dr CN Manjunath, Director, Jayadeva Institute of Cardiovascular Sciences, said, "Even if patient has three-vessel blockage or multiple blockages, the culprit vessel that is causing the heart attack will first be stented in an emergency. This is the reason why number of angoplasties have gone up."

If one gives only clot-dissolving medicine, the death rate is 10% to 12%. If one does angioplasty and stenting then the mortality rate is reduced to almost three percent. So today the procedure of choice for heart attack patients irrespective of number of vessels blockage is angioplasty and stenting, Manjunath added.

"Technology has also changed. Lot of complex heart procedures that were done through surgeries earlier can be done using angioplasty because of the refinement in hardware we use and various tools that have been developed," he said.

Earlier for example, calcified arteries were not being stented, patients were directly sent to surgery. Now, a debulking device can be used to insert a stent. "The growth of angioplasty, I agree is faster than bypass," he said.

But price control or not, unlike the private sector, angioplasty procedure cost has remained the same. For BPL patients, it is free upto two stents and sometimes three. In general ward, the cost of the procedure is Rs 50,000 plus cost of the stent which is Rs 30,000. In special ward, it is Rs 60,000 plus cost of stent, and in delux ward it is Rs 70,000 plus cost of stent.

In comparison, a bypass surgery at Jayadeva costs Rs. 95,000 in a general ward and Rs 1.75 lakh in a delux ward.

In Manipal Hospital, 100 angioplasties are done per month. One-fourth or one-fifth of this is the number of bypass surgeries down. An angioplasty costed Rs 2.5 lakh before the price cap and has remained the same as the hospital hiked the procedure cost to compensate for the slashing of the stent price margin.