Elective surgery done on Tuesday after docs’ advice: Health Ministry

HEALTH Minister Khaw Boon Wan has had heart bypass surgery following advice from his doctors after a check-up last week.

He went through coronary artery bypass graft (CABG) surgery at the National Heart Centre Singapore (NHCS) on Tuesday.

CABG is an open-heart procedure where surgeons have to crack open the patient’s chest bone.

Mr Khaw is recovering very well, said a spokesman for the Ministry of Health (MOH).

Yesterday, barely a day after his surgery, he was already sitting up and talking, said the spokesman.

Angiogram
Mr Khaw had also undergone an angiogram on his heart on Monday.

An angiogram is an X-ray test that uses a special dye and camera to take pictures of the blood flow in an
artery or a vein.

The angiogram allows doctors to see exactly where the blockages are.

The MOH spokesman would not reveal how many blockages Mr Khaw had.

She would only say that Mr Khaw had been feeling fine before his check-up.

“It was a routine check-up and an elective surgery,” she said.An elective surgery meansthe procedure is not an emergency.

After his surgery, he spent the first day in the intensive care unit. He was moved to a general ward after
that.

The youthful-looking minister, who has been one of Singapore’s most vocal advocates of healthy living, has been taking medication for high cholesterol, said the MOH spokesman.

Mr Khaw, who turns 58 in December, has also told some reporters that his father had suffered from high
cholesterol.

Cholesterol is a direct contributor to cardiovascular disease.

Everyone has cholesterol in the blood.

But if the levels of low-density lipoprotein (LDL) are too high, the excess can accumulate on the walls of the arteries.

LDLis also called “bad cholesterol”.

It can clog up arteries, increasing the risk of heart attack and stroke.

Doctors told The New Paper that the choice of angioplasty or bypass surgery is based on patient-specific
characteristics, such as diabetes or heart failure, which may favour one strategy over another.

Angioplasty, or ballooning, a less invasive procedure to correct blocked arteries, should be considered when
one or two arteries have become narrowed. But this is provided the arteries are suitable for angioplasty.

But when there is significant narrowing of the left main coronary artery or of all three major coronary arteries, CABG should be considered.

Some of these blockages are so dangerous that if the angioplasty fails, the patient may suffer a fatal heart
attack.

This is especially if the blockage is in the left main coronary artery, said Dr Lim Chong Hee, a senior consultant and director of the Heart and Lung Transplantation Programme at NHCS.

He was not the surgeon who operated on Mr Khaw. MOH declined to reveal who operated on the minister.

Explained Dr Lim, who was speaking in general terms: “The left main coronary artery is very short, only
about1cmto 1.5cm long.

“If you stent it and it works, that’s fine.

“But if for some reason, the ballooning and stenting do not work and the artery gets blocked, the damage to the heart muscle that it supplies blood to will be huge.”

It is not known whether it was Mr Khaw’s left main coronary artery that was affected.


Low risk
The risk of death for someone undergoing CABG at the NHCS is very low, between 1 and 2 per cent, said Dr Lim.

“The risk is dependent on the risk group. If you are very old, you are a woman and obese, that risk of
dying is much higher, at 8 to 10 per cent,” he said.

For someone like Mr Khaw,who is male, relatively young and going through a non-urgent, elective surgery, the risk is between 1and 1.5 per cent.

Angioplasty risks are slightly lower, but the re-operation rates aremuchhigher.

“Many more patients who undergo angioplasty need to be operated on again compared to those who undergo CABG,” said Dr Lim.

The NHCS does 800 CABGs a year. One in 10 of them are emergency operations, while the rest are elective.

An average CABG operation takes about three hours.

In 95 per cent of the cases, the patient is put on a heart-lung machine during surgery. The machine temporarily takes over the function of the heart and lungs during surgery.

The rest of the cases are operated on without the machine.

The average hospital stay is between five and seven days. The patient usually has a scar of 10 to 15 cms running down the chest.

Just recently, Dr Lam Pin Min (Ang Mo Kio GRC) asked Mr Khaw for his “secrets” to looking younger than his age.

Mr Khaw, who exercises in a gym regularly, had said then that there’s no secret recipe, but that technology helps.

That includes regular health check-ups and, if need be, medical and surgical intervention.