Bypass Surgery

Q: Does bypass surgery correct the problems with heart arteries? What are the chances of needing future bypass surgery?

A: Coronary Artery Bypass Surgery, although an extremely useful technique, is not a permanent solution to coronary artery disease. In fact, it is a palliative procedure that is able to prolong life. The underlying problem of coronary artery disease is atheroclerosis, an insidious process that starts in childhood and continues through life in a progressive, often inexorable fashion culminating in heart attack, stroke or peripheral artery disease if not aggressively treated.

Q. What is the treatment of atherosclerosis?

A. We used to think that the fundamental process is abnormal lipid deposition in heart arteries. Research has shown it is more complex than this: the heart arteries are inflamed and result in blood cells reacting to the initial inflammation resulting in further injury to the artery. The heart artery, to protect itself, tries to rebuild itself, resulting in abnormal growth within the artery wall. The damage to the wall causes abnormal lipid accumulation which we call atherosclerosis. Bypass surgery simply bypasses the most severely blocked areas in the artery but the process of atherosclerosis is not addressed with surgery. So what can we do to arrest if not ameliorate this process? Intensive dietary restriction (little to no fat/cholesterol intake), daily and regular exercise program, stopping smoking, and anti-lipid medications have shown to stop, if not reverse the atherosclerotic process. These measures remain the mainstay of my treatment advice to my patients. “An ounce of prevention is worth a pound of cure.”

Despite these measures, however, many patients continue to develop arterial disease. Some of these patients, unfortunately, end up requiring another bypass operation. This is the frustration of cardiologists and their patients. This means we have not isolated all the factors involved in this exceedingly complex disease: atherosclerotic heart disease. Consequently, the doctors work only begins after a heart bypass operation. A patient should follow up closely with his internist or family physician and cardiologist as required. Regular cholesterol and lipid panel checks and dietary counseling are only a part of the intensive follow-up process required after bypass surgery. If close follow-up is not done and if the patient does not follow the doctor’s recommendation closely, the unfortunate and almost certain outcome is another bypass operation, heart attack or death. It is my fervent hope as doctors that our patients don’t fall prey to these unfortunate consequences of this deadly, yet silent disease called atherosclerosis.

About Dr. Nanavati

Dr. Vimal Nanavati is an Interventional Invasive Cardiologist residing in San Diego, California.  He was recruited to Northern California from Ohio in 1997 to initiate a quality Cardiology Program for the people living on the Northern Coast of California.  Dr. Nanavati inaugurated the Arcata Heart Care Program and was the director of their first Cardiac Catheterization Lab at Mad River Hospital from June of 1998 to March 1999.  

In 1999, Dr Nanavati relocated to Redding in order to provide his patients with more comprehensive cardiology services.  Since 2005, Dr. Nanavati has been in San Diego providing Cardiology Services.

Dr. Nanavati performs cardiac catheterizations, angioplasty, coronary Stent deployment, intracoronary ultrasound, and Doppler Pressure measurements in the coronary artery.  He also provides the complete array of non-invasive diagnostic tests such as echocardiography, stress testing, pacemaker follow-up, and EKG testing.  Since March 2002, Dr. Nanavati has added EECP (Enhanced External Counterpulsation), the only noninvasive therapy for angina not amenable to intervention or bypass surgery.

Dr. Nanavati received his medical training in Chicago, Illinois, where he grew up.  After finishing his fellowship training at the University of Illinois in 1993, he traveled to Ohio where he was in practice until 1997.  Dr. Nanavati is Board Certified in Cardiovascular Diseases and Internal Medicine.  He is a member of American College of Cardiology, Society of Angiography, and Interventions, American College of Physicians, California Medical Association, and San Diego County Medical Society.

Dr. Nanavati's Philosophy of Patient Care in his own words: 

"Treat every patient as if they were your own family member."

"If I cannot provide the most advanced therapy, I will find someone eminently qualified who will."

"The smile on a patient's face is my greatest reward." 

"If you don't need the procedure, I'm not going to order it." 

"The best patient is the informed patient."

Dr. Nanavati feels it a singular honor and privilege to serve the heart care needs of all patients and family members who use this site. This website is dedicated to them.

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Critical Care Cardiology

Dr. Vimal Nanavati is an Interventional Invasive Cardiologist residing in San Diego, California.  He was recruited to Northern California from Ohio in 1997 to initiate a quality Cardiology Program for the people living on the Northern Coast of California.  Dr. Nanavati inaugurated the Arcata Heart Care Program and was the director of their first Cardiac Catheterization Lab at Mad River Hospital from June of 1998 to March 1999.  

In 1999, Dr Nanavati relocated to Redding in order to provide his patients with more comprehensive cardiology services.  Since 2005, Dr. Nanavati has been in San Diego providing Cardiology Services.

Dr. Nanavati performs cardiac catheterizations, angioplasty, coronary Stent deployment, intracoronary ultrasound, and Doppler Pressure measurements in the coronary artery.  He also provides the complete array of non-invasive diagnostic tests such as echocardiography, stress testing, pacemaker follow-up, and EKG testing.  Since March 2002, Dr. Nanavati has added EECP (Enhanced External Counterpulsation), the only noninvasive therapy for angina not amenable to intervention or bypass surgery.

Dr. Nanavati received his medical training in Chicago, Illinois, where he grew up.  After finishing his fellowship training at the University of Illinois in 1993, he traveled to Ohio where he was in practice until 1997.  Dr. Nanavati is Board Certified in Cardiovascular Diseases and Internal Medicine.  He is a member of American College of Cardiology, Society of Angiography, and Interventions, American College of Physicians, California Medical Association, and San Diego County Medical Society.

Dr. Nanavati's Philosophy of Patient Care in his own words: 

"Treat every patient as if they were your own family member."

"If I cannot provide the most advanced therapy, I will find someone eminently qualified who will."

"The smile on a patient's face is my greatest reward." 

"If you don't need the procedure, I'm not going to order it." 

"The best patient is the informed patient."

Dr. Nanavati feels it a singular honor and privilege to serve the heart care needs of all patients and family members who use this site. This website is dedicated to them.


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Heart Attack Symptoms and Information

If you are experiencing these symptoms, dial 911 immediately!

  • Chest discomfort

  • Shortness of breath

  • Arm pain

  • Dizziness

  • Jaw pain

Every year, tens of thousands of Americans survive heart attack, go back to work and enjoy a normal life. You have every reason to be confident of a full recovery. Your heart is healing and with each passing day you’ll get stronger and more active.

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If you do not currently have medical insurance, no problem. If you have a diagnosis of heart disease or you think you may have heart disease, feel free to set up an introductory meeting. We have several heart care packages that allow you to receive continued Heart care with our Board Certified Cardiologist. After an initial evaluation, we can determine which package works best for your specific needs. Call us now. Don't wait for a heart attack!

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