Dr Vivek Jawali, chief cardiovascular surgeon along with his team at Wockhardt Heart Hospital at Bangalore have set a global benchmark by performing the first coronary bypass surgery along with an aortic valve replacement without using general anaesthesia or ventilator support while the patient was on a heart lung machine.The technique of high thoracic epidural analgesia is a highly precision based methodology which involves injection of micro doses of local anaesthetic in the epidural space around the spinal cord which anaesthetises only the chest region while the rest of the system is fully awake.