CHENNAI: When you’re over 75, doctors will think a dozen times before suggesting surgery — unless it’s to do with the knee or some anterior part of the body. The chance that a doctor says ‘yes’ get slimmer and slimmer as the age of the person goes north. Heart surgery on anyone that old (or older) usually carries a host of mortal risks as soon as the patient is in the operation theatre. At 91, ex-cop Rizwan* (name changed) is an exception to that rule. Admitted to Billroth Hospitals with a choking sensation and chest pain for a week, an ECG showed changes suggestive of coronary heart disease. He also had episodes of ventricular tachycardia which needed immediate cardiology care. Further scans showed critically low blood flow in his coronary arteries — pointing to an impending heart attack and the situation needed immediate attention. So they did a coronary angiogram. The angio showed 99 per cent blocks in three important blood vessels in his heart and a high degree of calcification in his diseased vessels made him unsuitable for an angioplasty (balloon treatment). The gold standard here would have been to do a coronary artery bypass surgery. However, a bypass surgery in a 90-year-old patient is a very rare occurrence and is associated with high risks. With trepidation and extreme caution they decided to go forward, given that he was in remarkable condition for a man his age. After a caution surgery where they bypassed the blocked portions and created almost normal blood flow again, he pulled through and was actually discharged in time to spend the Ramzan weekend with his family.