“South Africa became known as a global leader in cardiac medicine when Professor Christiaan Barnard and his team performed the world’s first heart transplant in Cape Town in 1967. Few people are aware to what extent this tradition of innovation has continued in South Africa over the past 45 years through to the present day,” says Jacques du Plessis, Managing Director of Netcare’s Hospital Division.
“As South Africans we can hold their heads high this National Heart Awareness Month, September 2012. We have expertise and technology in South Africa which are second to none in the world,” adds Du Plessis. “Netcare, for example, is able to offer cutting edge cardiac services at the centres of excellence within our hospitals throughout the country. Our goal is to make these services available to many more South Africans.”
Netcare Christiaan Barnard Memorial Hospital in Cape Town is not only highly regarded for its heart transplant surgery but also its work with the artificial or ‘Berlin Heart’, which is implanted into patients with heart failure who are waiting for transplants.
Not so long ago, these patients’ only hope was that an appropriate donor heart would become available in time to save their lives – which sadly was not always the case due to the severe shortage of donor organs. Now, thanks to the technology employed by skilled and experienced cardiac specialists at the hospital, there is new hope for them as the artificial heart helps to keep them alive while waiting for a transplant.
Netcare first hospital to use Berlin Heart
Netcare Christiaan Barnard Memorial Hospital was the first facility in South Africa to use the Berlin Heart, implanting this lifesaving device into the chest of a 60-year-old man in 2001. The polyurethane Berlin Heart was developed in Germany. It is driven by an external pneumatic compressor, connected to the artificial heart by means of a tube.
Specialists at the cardiac centre of excellence at Netcare Christiaan Barnard Memorial Hospital have also recently started using another lifesaving device, the HeartWare Ventricular Assist System (HVAD), to restore a patient’s blood flow while they wait for a transplant. This device assists the left ventricle of the heart to pump properly and is only suitable for patients whose right ventricle is functioning properly.
If this is not the case, the Berlin Heart is used instead. HVAD can enable patients to wait safely for a new heart, without further deterioration in their health. The device helps patients regain their strength and tends to improve the outcome of the transplant when it can finally take place.
The hospital is also a global leader in the treatment of heart rhythm disturbances or arrhythmias. Between September and early 2012 more than 300 arrhythmia procedures using the state of the art Sensei Robotic Catheter system had been performed at the cardiac centre. This is the highest number of procedures of this kind that had ever been performed at any cardiac centre in the world.
Cutting edge technology being used
The Sensei Robotic Catheter system allows ‘short circuits’ in the heart to be ablated with a heated catheter tip. This returns the heart’s rhythm to normal and reduces the need for other treatments such as pacemakers and drugs. The hospital was the first centre in the Southern Hemisphere to use the Sensei Robotic Catheter system and it remains one of only two centres (the other is in Australia) to utilise the cutting edge technology.
A true innovator in the field of heart medicine, Netcare Christiaan Barnard Memorial Hospital was also the first in the world to use the technology to treat dangerous arrhythmias in the ventricular tachycardia of the heart.
According to Du Plessis, Netcare Sunninghill Hospital in Johannesburg is another local facility that has become a leader in the treatment of heart rhythm disturbances. The recently upgraded electrophysiology laboratory (EP Lab) at the hospital is one of the most sophisticated and best-equipped facilities of its kind, offering patients a comprehensive arrhythmia service.
The laboratory is the first in Africa and the second in the southern hemisphere to offer stereotaxis for remote magnetic navigation within the heart and incorporates technology such as a CARTO mapping system and a Siemens imaging system.
What Stereotaxis does during cardiac surgery
Stereotaxis is a computerised magnetically controlled navigation system that guides devices used in minimally invasive cardiac arrhythmia surgery. It creates a magnetic field that interacts with a tiny magnet in the tip of a catheter. It allows finer navigation within the heart which enables cardiologists to perform more complex procedures.
The replacement of diseased heart valves with artificial ones by means of open heart surgery is common practice at a number of facilities in South Africa. Another breakthrough remote cardiac procedure involving the use of catheters to implant a device known as the Transcatheter Heart Valve to replace a diseased heart valve, is offered by cardiac specialists at Netcare Milpark and Netcare Sunninghill hospitals in Johannesburg.
The procedure, known as the Transcatheter Aortic Valve Intervention (TAVI), is far less invasive than traditional open-heart surgery and makes it possible to repair the heart valves without having to use traumatic open heart surgery. Patients who are seriously ill are therefore much more likely to survive the procedure and tend to recover quicker. TAVI can extend patients’ lives by many years and considerably improve their quality of life.
Further life-changing procedures
While valve replacement is lifesaving and improves the quality of life of patients, between 3% and 6% of those with artificial heart valves will at some stage develop a leak between the artificial valve and the surrounding heart tissue.
This is known as a paravalvular leak and it is often not serious enough to require treatment. However, in cases where the blood leak is more substantial, this may place strain on the heart and cause symptoms of heart failure. Such leaks are life threatening and require repairing.
Up until now patients with paravalvular leaks have had to undergo open-heart surgery to repair the leaks. A much less invasive procedure and therefore lower risk option is the percutaneous repair of a leak. This new operation is undertaken through a small puncture in the groin, using a catheter and catheter wires to reach the leaking valve and 3D real time trans oesophageal imaging for precise visualisation.
The patient only requires a mild anaesthetic and usually recovers from the operation within a matter of a few days. This procedure is now offered at Netcare Union Hospital in Alberton.
“An association with pioneering medical specialists, ongoing investment in state of the art technology and equipment as well as quality nursing care in intensive care facilities, has resulted in Netcare achieving an enviable record in the arena of heart medicine through the years to the benefit of our patients. It is a legacy of which all South Africans can be proud,” concludes Du Plessis.
(Press release, September 2012)
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A history of transplants
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