Indian Premier Manmohan Singh undergoes heart bypass; Pranab Mukherjee takes charge

January 25, 2009 Prime Minister Manmohan Singh received a successful coronary artery bypass surgery and was recuperating well in the state-run All India Institute of Medical Sciences (AIIMS) Sunday.

Dr. Manmohan Singh is the 17th and current Prime Minister of the Republic of India. He also serves as the Union Minister for Finance, succeeding P. Chidambaram.

"The 76-year-old Prime Minister is doing fine now. He is conscious, stable, comfortable and is making rapid progress. He also met his family and congratulated all doctors. [His] ventilator has been taken off and he is breathing on his own. This is an important step," said Dr. Ramakant Panda, one of the surgeons, after the 11-hour procedure on Saturday.

According to critical care specialist Dr. Vijay D'Silva, who has been entrusted with his post-operative care, Singh has been given a liquid diet since morning including a cup of tea, and was speaking to doctors after the procedure. "The way you [doctors] are taking care of me, you should also take care of other people", Dr. D'Silva, who received his basic medical training in Nagpur and headed the ICU at Mumbai's Jaslok and Lilavati Hospitals before he helped set up the ICU at the ultra-modern Asian Heart Institute, quoted Singh as saying.

"We started the operation at 7:45 am. The second operation always takes longer and makes it difficult to reach the heart. We did a total of five by-passes to clear multiple blockages in his arteries. Surgery was the long term answer since there were many blockages. We will take the PM out of the breathing machine in the next 2-3 hours and the PM should stay for three days in the ICU and then 4-5 days more in the hospital," Drs. Panda and D'Silva explained.

Singh's personal physician and AIIMS cardiac surgeon, Dr. K. S. Reddy, has predicted the PM will be allowed to attend to some official work in two weeks, to most of the duties in four weeks and will be able to resume office in six weeks. "PM was sent to the Operation Theatre at 6:40 am, surgery was done at 8:45 am and was concluded at 7:30 pm. PM was sent back to the ICU at 8:55 pm," said Dr. Reddy.

"The team has brought about 20 boxes of special equipment with it. Earlier, Dr. K. S. Reddy had discussions with Dr. Panda in connection with the line of treatment to be followed," the team of 11 doctors said.

The team of surgeons made a 6 to 7 inch incision along the scar that marked the PM's 1990 bypass operation, and he was given five grafts. "The new grafts, all 3 mm long, will last the PM the rest of his life," said Dr. Pradyot Kumar Rath from the Asian Heart Institute. "If the PM could have been so active with all the blockages, he can be even more active now," Dr Panda said.

Singh underwent a coronary angiography at the AIIMS hospital on Tuesday and Wednesday and was discharged on Thursday. The tests results revealed multiple arterial blockages and Singh returned to hospital on Friday for pre-surgery tests.

External Minister Pranab Kumar Mukherjee, age 73, has been given the charge of Finance Ministry after he held meetings with Congress President Sonia Gandhi and then Prime Minister Singh. Mukherjee said he would meet the Prime Minister because he was going for treatment and when he was abroad, Singh was in hospital. "These are quite natural things. You should not be unnecessarily worried over and coming here in large numbers," he said.

Mukherjee has also taken charge over some prime ministerial responsibilities, while Singh recovers, officials and media reports said. But no acting prime minister has been named while Singh is recuperating. Mukherjee will also preside over Cabinet meetings and will further handle coal, environment and forests, including information and broadcasting and finance portfolios.

Pranab Kumar Mukherjee, a native of West Bengal, India, is the Minister for External Affairs of India in the Manmohan Singh-led Government of India. A prominent leader of the Indian National Congress in the 14th Lok Sabha, he is known to be a competent party apparatchik, "a prominent Gandhi family loyalist who did not win a popular election until 2004".

Singh, a diabetic, underwent a bypass surgery in Britain in 1990 and had an angioplasty in 2004 in Delhi in which stents were introduced in his arteries. He had earlier been operated for a benign enlarged prostate in 2007, and for nerve compression in both wrists in 2006 and cataract removal procedure last year, officials said.

The Congress Party, which leads the coalition Government, has said that he will remain Prime Minister if Congress and its allies win again. But Congress is reportedly planning to replace him, possibly within two years, with Rahul Gandhi, the 38-year-old son of Sonia Gandhi, the Italian-born Congress leader. "Days are not far off for Rahul Gandhi to become Indian Prime Minister," Mr Mukherjee said earlier this month.

Rahul is an Indian politician and member of the Parliament of India, representing the Amethi constituency. He is a member of the Nehru-Gandhi family, the most prominent political family in India. He is the son of current Italian-born Congress President Sonia Gandhi, and former Prime Minister Rajiv Gandhi, who was assassinated in 1991. Gandhi was 14 years old when his grandmother, Prime Minister Indira Gandhi, was assassinated by her security guards. His great-grandfather, Jawaharlal Nehru, was the first Prime Minister of India, and his great-great-grandfather Motilal Nehru was a distinguished leader of the Indian independence movement.