UCTPAH offers first bronchial thermoplasty in Africa

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A newly established lung and heart centre offering a range of specialised medical interventions and treatments has been established at UCT Private Academic Hospital (UCTPAH). Consultant pulmonologist and specialist physician, Professor Keertan Dheda, who is also a key member of the critical care team at UCTPAH’s closed intensive care unit, explained that the new centre seeks to advance lung and heart health in Southern Africa through the provision of advanced treatment for a wide range of pulmonary and cardiac conditions.

“We identified the need for a centre that would offer life-enhancing medical interventions for patients affected by heart and/or lung conditions, which can be extremely debilitating,” said Dheda, recognised by the National Research Foundation (NRF) as an A-rated scientist and the current president of the South African Thoracic Society.

The multi-disciplinary team at the UCTPAH Heart and Lung Centre collaborates to offer solutions to even the most challenging of cases, including complex interventional pulmonology procedures and cardiorespiratory surgery.

Leading specialists in the multi-disciplinary team include Dheda, cardiologists Professor Ashley Chin, Dr Blanche Cupido and Dr Jens Hitzeroth, pulmonologists Dr Greg Calligaro and Dr Greg Symons, cardiothoracic surgeons Professor Johan Brink, Professor Anthony Linegar, Dr Loven Moodley and Professor Jacques Sherman. ENT (ear, nose and throat) surgeons, audiologists, pathologists, microbiologists and the critical care team also contribute to the medical expertise of the multi-disciplinary team.

Chin, who specialises in electrophysiology, adds that the centre’s comprehensive cardiac and pulmonology service offering includes cardiac imaging, cardiac interventional procedures, and complex electrophysiological procedures and device implantation. “A wide range of cardiac electrophysiological procedures is performed at the centre, including complex ablations for arrhythmias, such as atrial fibrillation and ventricular tachycardia, as well as implantation of medical devices including pacemakers, implantable cardioverter defibrillators and biventricular pacemakers,” he says.

“The centre is also equipped to offer advanced treatment for heart failure and benefits from the expertise of one of only two specialists in the country who have done a fellowship in the management of adult congenital heart disease.”

“In addition, the heart centre is one of few units in South Africa that, through the close collaboration of cardiologists and cardiac surgeons, is able to perform specific interventional cardiac procedures such as complex percutaneous coronary intervention, transaortic valve implantation, other structural cardiac device-based therapies and minimally invasive mitral valve repair.”

Another important service available at the centre is endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). “This represents a less invasive technique for initial investigation of mediastinal lymphadenopathy, or enlarged lymph nodes deep within the thoracic cavity, thus obviating the need for surgery. Patients are discharged the same day,” Dheda says.

A specialised service for the management of cystic fibrosis in adult patients is also offered at the centre.

The UCTPAH Lung and Heart Centre is the only facility in Africa to offer a minimally invasive bronchoscopic procedure known as bronchial thermoplasty, which can significantly improve quality of life for adults with severe asthma that cannot be effectively controlled with medication. Dheda said that there are approximately 3m South Africans living with asthma, and that in some five percent of these patients, conventional therapies are not effective in managing their condition.

“It is noteworthy that this small minority of asthmatics, whose condition is so severe that they may be potential candidates for bronchial thermoplasty, account for some 80% of asthma-related healthcare costs as they tend to require repeated hospitalisation, often having to be cared for in a high care or intensive care unit as their asthma attacks can be life threatening,” Dheda said.

“Bronchial thermoplasty involves using a catheter to deliver heat energy to reduce excess smooth muscle burden in the airways that can constrict the airways during asthma attacks (exacerbations). This procedure assists in providing long-term asthma control, in conjunction with conventional asthma medicine.

“Bronchial thermoplasty is performed in three outpatient treatment sessions, each lasting between 40 minutes to an hour, three weeks to a month apart. “There is no need for general anaesthetic as the procedures are performed with the aid of local anaesthetic and conscious sedation, and the patient can usually go home within a few hours of undergoing the treatment,” he adds.

Studies on the longer-term safety and effectiveness of bronchial thermoplasty have found that most patients are admitted to hospital far less frequently for asthma attacks following the treatment and also report a marked improvement in their quality of life.

The new general manager of UCT Private Academic Hospital, Daniel Matthew, welcomed the establishment of the new Lung and Heart Centre. “The combination of highly specialised medical expertise in both cardiac and pulmonary medicine offered at the new UCTPAH Lung and Heart Centre is already proving to be a tremendous asset to South African healthcare and holds great hope for the people who stand to benefit from its services,” Matthew said.

UCTPAH is an innovative collaboration between Netcare, the University of Cape Town Medical School and Groote Schuur Hospital.

“As UCTPAH is an academic medical facility, this development is all the more gratifying because the life-saving and life-enhancing expertise of these eminent specialists is being shared with the new generation of healthcare professionals, who will in time also make significant contributions to the health of our nation,” he concludes.


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