Durban — Lenmed Ethekwini Hospital and Heart Centre has inserted a revolutionary heart device in a patient, ushering in a new dawn in cardiac care.
In a first for KwaZulu-Natal, the Lenmed Ethekwini Hospital and Heart Centre in Durban successfully implanted its first left ventricular assist device (LVAD), which marks a giant leap in the treatment of heart failure.
Riaan de Winnaar, 43, was diagnosed with stage four heart failure and could not leave the hospital until he was able to receive a heart transplant.
“Cindy Goldie, Lenmed’s transplant co-ordinator, had me listed on the urgent transplant list for several weeks. This listing means that the first heart that would become available and would satisfy all the prerequisites for implantation would then be allocated to me,” De Winnaar said.
“Unfortunately due to my height, 1.95m tall, and my already oversized heart, finding a suitable match in time would prove to be a difficult proposition.”
De Winnaar became the ideal candidate for the state-of-the-art LVAD, offering him a second lease on life. The LVAD is a medical marvel – it is connected to a power supply and keeps your heart going.
While it does not replace the heart, it works in tandem with it, assisting the heart’s left ventricle — the primary pumping chamber — circulate blood in the body. For patients with weakened hearts, the device is a game-changer.
“The way I see it is that this is a life-changing technology for patients suffering from terminal heart failure. From research, one in two people die from heart complications and there just aren't enough donor hearts available. I love the technology and enjoy explaining how the device works to family and friends,” De Winnaar said. “When you are given another chance as I have, you realise more than ever that time with your loved ones can never be replaced.
“For other possible recipients of the LVAD, I would urge them to do research. There is plenty of information and social media communities online, and at least as far as Lenmed eThekwini Hospital and Heart Centre is concerned, they’re in great hands.
“These communities show many individuals living near normal lives. Basically, my only restrictions are no contact sports and no swimming, but I had not been able to do any of those during my three years of heart failure either. Recovery from surgery is quick and mostly painless,” De Winnaar said.
How the LVAD works:
- The LVAD draws blood from the left ventricle using an inflow cannula, accelerates it through a pump, and then directs it to the aorta, the body's main artery, via an outflow cannula.
- The settings are adjusted on an app that can be connected to the controller.
- There are two options for power supply. Either connected to AC power or a set of batteries which allows the patient to leave home and continue a normal life.
Why the LVAD is revolutionary:
- Patients who once struggled with debilitating symptoms of heart failure, such as breathlessness or extreme fatigue, can now hope for significant relief.
- For those on the heart transplant waiting list, the LVAD can serve as a vital bridge, ensuring they remain healthy until a donor heart becomes available.
- For patients who aren't transplant candidates, the LVAD isn't just a temporary fix — it's a long-term solution, a testament to how far medical science has come.
The successful completion of this pioneering procedure offers a beacon of hope for those grappling with severe heart ailments.
It is also a testament to the collective endeavour of a diverse team of cardiothoracic experts, spearheaded by Dr Pravin Maharaj. This team was further bolstered by the expertise of Dr Rahim Khan, Dr Shiraz Gafoor and the anaesthetist, Dr Chris Nurse. The nursing and auxiliary staff also played a pivotal role, in ensuring the utmost safety and welfare of the patient.
Under the guidance of the renowned cardiothoracic transplant surgeon and LVAD mentor, Dr Willie Koen, the medical team showcased their unparalleled proficiency and the hospital's unwavering dedication to health-care excellence, research, and ingenuity.
Lead surgeon Dr Maharaj said: “The entire medical brigade is brimming with pride over this success. The LVAD procedure symbolises the dawn of a revitalised epoch in cardiac care, illuminating a path of hope for numerous patients and their kin.”
Reflecting on this journey, Group CEO Amil Devchand said: “Our preparations for this inaugural case began in December 2022. Today, we stand immensely gratified with this landmark in cardiac medicine under the Lenmed banner.
“This feat, and the collective efforts behind it, epitomise our resolve to deliver cutting-edge, patient-focused care, positioning us at the pinnacle of medical innovation.”
How does an LVAD work?
- The LVAD doesn’t replace the heart. Instead, it assists the heart in pumping blood. The device takes over some of the workload of the left ventricle, ensuring that oxygen-rich blood circulates throughout the body.
Parts of the LVAD:
- Inflow Cannula: This is a tube that is inserted into the left ventricle. It draws blood from the ventricle into the pump.
- Pump: The actual device that accelerates the blood flow. It can be placed inside or outside the body, depending on the design.
- Outflow Cannula: This tube directs the blood from the pump to the aorta (the main artery that carries oxygen-rich blood from the heart to the rest of the body).
- Driveline: This is a cable that exits the body and connects the pump to the external controller and power source.
- Controller: An external device that powers the LVAD and allows health-care providers to monitor and adjust the pump's settings.
- Power Source: The LVAD can be powered by batteries or electricity. Patients usually wear batteries during the day and connect to electricity at night.
Operation:
- Blood flows into the inflow cannula from the left ventricle.
- The pump accelerates the blood.
- Blood is then pushed out through the outflow cannula into the aorta.
- The speed of the pump can be adjusted based on the patient's needs.
Benefits:
- The LVAD ensures that vital organs receive the necessary oxygen and nutrients.
- Many patients experience relief from symptoms of heart failure, such as shortness of breath or fatigue.
- For some patients, an LVAD serves as a temporary solution while waiting for a heart transplant.
- In other cases, especially when a patient isn't eligible for a transplant, the LVAD can be a long-term solution.
Considerations:
- Patients with an LVAD need to make certain lifestyle adjustments, such as avoiding water immersion to prevent driveline infections and carrying back-up batteries.
- Regular check-ups are essential to ensure the device is working correctly and to monitor the patient's overall health.
The LVAD procedure follows Lenmed Ethekwini Hospital and Heart Centre successfully performing a transcatheter aortic valve implantation (TAVI) procedure.
Lenmed Ethekwini Hospital and Heart Centre stands as a state-of-the-art, digitally integrated facility, renowned for its comprehensive adult and paediatric cardiac and cardiothoracic services.
Notably, it remains the sole institution in KwaZulu-Natal offering the invaluable service of paediatric cardiac surgery.
The hospital holds the unique distinction of being the sole African facility accredited by the American College of Cardiology, a recognition stemming from a stringent assessment of the team's prowess in heart attack patient care.
Spanning the African continent, Lenmed proudly oversees eighteen hospitals across four nations. The Lenmed Group epitomises a global standard in private hospital care, consistently delivering top-tier health care across African communities.
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