A lifesaving procedure recently undertaken at Netcare Christiaan Barnard Memorial Hospital in Cape Town has given a fresh start to patient Sulizna van Reenen, who for the past decade, has been on the country’s heart transplant waiting list and who had only 13% remaining function in the left chamber of her heart.
With an ongoing scarcity of donor organs, time was running out for her until technology presented a lifesaving gift on her birthday, when she underwent a procedure to implant a mechanical heart pump, known as an Abbot HeartMate 3™ LVAD left ventricular assist device, to take over the failing function of her left ventricle.
“She was in a bad way, and with such a small chance that a matching donor heart could be found, we could not risk waiting much longer because her health was deteriorating fast,” said Dr Willie Koen, world renowned cardiac and transplant surgeon and pioneer of ventricular assist device (VAD) implantation in South Africa.
A motivation for authorisation for the LVAD procedure was submitted to Sulizna’s medical scheme, and approval granted: incredibly, the first theatre date available for the life-changing operation was on her 40th birthday.
“This was a birthday present I will never forget,” said Sulizna who hails from Riversdale in the Western Cape.
A shock diagnosis
She said she first started feeling ill in 2017. “I felt sick, and couldn’t sleep. I felt a weird feeling in my chest. I went to sit on the stoep in the fresh air, but it didn’t help, and I couldn’t settle down.
“Eventually I went to an emergency department and was referred to a specialist who after tests, discovered my heart’s left chamber was enlarged and the heart muscle was losing strength.”
Thereafter, she was in and out of hospital, and in 2019 had to stop working.
“Living with heart failure through the COVID-19 lockdown was the scariest time of my life,” she said.
A shortage of hearts and a mechanical solution
“Finding matching donor hearts has been even more challenging with the restrictions in place due to COVID-19, however, we were lucky to have the option of the LVAD device, which can give a person with this type of heart failure normal quality of life again,” Koen said.
The LVAD device mechanically replaces the function of the failing heart muscle, pumping the blood around the body to provide vital circulation.
Previously, VADs have mainly served as a temporary option to keep a patient alive until a heart transplant could be performed. Technological advances in VADs have increased the longevity of these devices, increasingly supporting their use as a potential long-term solution for heart failure, although for now, recipients remain on the transplant list.
The LVAD component that pumps the blood is implanted within the patient’s chest, connected by a driveline that protrudes through the abdomen to a controller and battery pack outside the body. Several charging options and backup batteries provide power to the Heartmate 3 LVAD device, ensuring that even during load shedding, the patient still has plenty of battery life to sustain the device’s operation.
“Once Sulizna has fully recovered, she will be able to return to work, and be able to walk, drive and travel once more and enjoy the aspects of life that weren’t possible given her weakened heart,” said Koen.
Heart transplants resume
A second patient with heart failure who was scheduled to have the same LVAD mechanical heart pump as Sulizna received the news just before the scheduled procedure that, against the odds, a matching donor heart had been found for him to have a transplant.
“It is wonderful to report that he is recovering well after his transplant. With the advancements in cardiac medicine and technology, in future, devices such as the LVAD may offer an ‘off the shelf’ alternative to donor hearts,” added Koen.
“For now, many South Africans are still struggling with heart failure and our best hope for them is to make more people aware of the living legacy of organ donation, and the great opportunity we have to give another person the gift of life when we pass away.”
Organ donation is free and. For more information contact the Organ Donor Foundation on the toll free number 0800 22 66 11, or visit https://www.odf.org.za.
Issued by Netcare Christiaan Barnard Memorial Hospital