We told him that the new method would be much less expensive

Prof Jawad Sajid Khan

Shopkeeper Mohammad Munir, 46, was conscious and talking throughout the operation in Lahore.

And he was even back at work in his shop only three days after his surgery last week.

Jawad Sajid Khan, who led the five-member team of Surgeons at the Punjab Institute of Cardiology, said: "We told him that the new method would be much less expensive.

"Thank God he agreed and we were able to create history."

He said Mr Munir was charged some 15,000 rupees ($250) and returned home the next day, instead of the usual hospital stay of about two weeks after heart surgery.

Patients at risk

In an interview with the BBC, Professor Khan credited the success of the operation to his anaesthetist, Dr Mubashir Zia, who he said had made the operation possible by rendering the spine numb using an epidural, rather than by general anaesthesia.

This technique, Dr Zia said, had been adopted elsewhere to operate on lower parts of human body.

Professor Khan is confident that the new technique will be particularly useful for patients who are at risk under a general anaesthesia.

By cutting down some of the post-operative care, he said, the procedure is also likely to prove more economical.

But he said that because it was the first time an epidural had been used in heart surgery "we kept ready as a standby the conventional method of heart surgery through a heart and lung machine".

Surgeons in the United States announced in July this year that they had successfully completed a heart bypass operation on a patient who was left awake throughout.

The US operation was the first time such a procedure had been repeated outside the Turkish hospital which pioneered it.