A patient with stage four heart failure, and who was no longer responding to treatment, has been given a new lease on life after surgery from a team of cardiac specialists in Durban.
Riaan de Winnaar (43), who was diagnosed with heart failure in 2015, successfully underwent the Left Ventricular Assist Device (LVAD) procedure at Lenmed eThekwini Hospital and Heart Centre recently.
LVAD is a mechanical device designed to support the weakened heart by assisting the left ventricle in pumping oxygen-rich blood throughout the body.
The hospital said the procedure offers a lifeline for people ineligible for a heart transplant or awaiting a suitable donor heart, reports News24.
De Winnaar said he suffered a myocardial infarction in 2021, resulting in stage three congestive heart failure, but which was treatable with medication.
However, thereafter, his life consisted of three to four weeks at home, followed by another three to four weeks in hospital for intravenous diuretic treatment to manage fluid retention and related issues like liver and kidney function from lack of oxygenated blood supply.
“This was like losing my entire life overnight, and I couldn’t work or spend more than a couple of minutes on my feet before getting ill. In May this year, my fluid retention started getting out of hand, and I gained as much as 3kg daily,” he said.
De Winnaar said he went to his usual hospital, and doctors noted that his electrocardiogram (ECG) results had changed.
“They were having trouble controlling my fluid retention, even with the intravenous (IV) drug administration, and decided to fit the resynchronisation feature pacemaker in mid-June.”
He said the result was not what they expected. When the resynchronisation feature was set to active on the pacemaker, he suffered from uncontrollable seizures and an abnormal pattern of breathing.
“After another two weeks of the doctors trying to fix the situation and me still retaining fluids, I requested a transfer to Lenmed eThekwini Hospital and Heart Centre. My treating cardiologist refused this transfer. However, I signed myself out of the hospital and had someone drive me to Lenmed.”
He was admitted to the High Care Cardiac Unit at Lenmed, and the next day, seen by three different cardiologists and two teams of pacemaker technicians.
“I was told I had stage four heart failure and would not leave the hospital without a heart transplant. During the following days, I was on the urgent transplant list. This meant the first heart that became available and could satisfy the risk factors would be mine,” he said.
However, because of his length and oversized heart, there was a very low probability of finding a suitable match.
“The doctors were desperately fighting to keep me alive and to get my condition to respond to the isotropic drugs while also treating some infections from my previous lengthy hospital stays. Two weeks later, I suddenly started responding to the isotopes and shed about 25kg in fluid in under 10 days.”
He said his liver and kidneys were much better without fluid load, which did not change his end-stage heart failure.
LVAD was then suggested as a bridge to transplant treatment.
“Fourteen days after the operation, on 4 August, I could march in one spot for 15 minutes without getting breathless. On day 21, I was roaming around the hospital, climbing stairs. I was discharged after 35 days.”
He said he spent a month recuperating with family before returning to business.
Lead surgeon Dr Pravin Maharaj said the LVAD procedure began a new era in cardiac care, offering renewed hope for countless patients and their families.
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