SA boy first in the world to have two mechanical heart devices implanted
Ten-year-old Philasande Dladla from KwaZulu-Natal is the first child on the African continent to undergo a lifesaving operation whereby a ‘mechanical heart’, a heart ventricular assist device (HVAD) was implanted to enable his damaged heart to continue functioning.
Dr Willie Koen, a cardiac and transplant surgeon practising at Netcare Christiaan Barnard Memorial Hospital in Cape Town, and a founding member and vice-president of the Pan African Society of Cardio-thoracic Surgeons (PASCaTS), led the surgical team that implanted the hi-tech lifesaving HeartWare HVAD, says that the operation was successfully completed on Monday.
“Philasande’s journey has been a most remarkable one and we are delighted that he has recovered so well that he is being discharged from hospital with renewed vigour and a smile on his face. Where Philasande’s future was uncertain before, he has now been given a completely new lease on life.
“As far as we have been able to establish, Philasande is the first person in the world to have had both short-term and long-term mechanical heart devices implanted. The young boy had a temporary tandem mechanical heart device implanted at Netcare Milpark Hospital six months ago while his damaged heart valves were repaired,” adds Dr Koen, who pioneered the use of mechanical heart implantation in South Africa.
“These operations were nothing short of lifesaving and demonstrate the massive advances we are continuing to make in this country in the field of heart medicine. We are now able to use devices such as HVAD as a long-term solution to heart failure.”
The young Drakensberg Primary School learner suffered from cardiomyopathy, a chronic disease of the heart, as a result of a viral infection he contracted last year. His parents had thought the infection was just a bout of flu. However, it quickly damaged Philasande’s heart and heart valves, resulting in his heart failing.
The operation to implant the tandem mechanical heart device was undertaken to keep Philasande’s heart functioning until the team at the hospital could perform a further operation to repair his heart valves in May. A prominent team, including cardiologist, Dr Graham Cassel, and cardiothoracic surgeons, Dr Martin Sussman and Dr Agnetha Geldenhuys, managed Philasande’s condition and performed these operations at Netcare Milpark Hospital.
“However, these procedures were not a long-term solution and were designed to win Philasande time, as his heart had been damaged to such an extent that he needed a transplant. Unfortunately, although Philasande is on the transplant list, a suitable matching donor heart for a child is extremely difficult to come by and, as a result, another solution had to be found.
“Three weeks ago the decision was made to transfer Philasande to Netcare Christiaan Barnard Memorial Hospital for long-term HVAD artificial heart implantation and he was flown to Cape Town by air ambulance.”
The team that prepared with Dr Koen for the HVAD procedure included Professor Arnt Fiane from Oslo, Norway, a world expert in artificial heart technology, and cardiothoracic surgeon, Dr Geldenhuys.
Dr Koen explains that HVAD helps to restore normal blood flow by enabling the left ventricle of the heart to operate properly. The right ventricle of the patient’s heart must be able to function if the system is to be used. If not, another device called the Berlin Heart is used instead. HVAD is implanted via open-heart surgery and the patient has to wear a small external battery pack to hold the batteries, which power the device.
“The HVAD device should enable Philasande, who enjoys hockey and swimming, to reach adulthood, when the chances of finding him a suitable heart donor will be significantly enhanced.”
“We have been able to save Philasande thanks to the remarkable partnership that the heart transplant and repair teams at Netcare Christiaan Barnard Memorial Hospital and Netcare Milpark Hospital have forged in recent years. Each of these teams is able to bring together different areas of expertise to deliver medicine that is nothing short of world class.”
Philasande’s mother, Sindi Dladla, was delighted and surprised at her son’s rapid recovery. Previously he had completely lacked energy but is now his old self again, she observed. According to Dr Koen, the fact that Philasande was able to survive is in no small part due to his parent’s determination to find the necessary care for their precious son.
Dr Cassel, who practises at Netcare Milpark Hospital, says that the groundbreaking procedures that were performed on Philasande have been made possible by years of international and local collaboration, and important advancements in cardiovascular medicine on the continent.
“Many South Africans are not aware that we have such active heart transplantation and repair programmes in place, nor that South Africa remains a leader in heart medicine. Philasande’s case once again highlights this fact,” he adds.
Jacques du Plessis, managing director of Netcare’s hospital division, thanked all of the members of the teams at both Netcare Milpark Hospital and Netcare Christiaan Barnard Memorial Hospital for making the procedures possible and saving Philasande’s life.
“These procedures were significant milestones in the history of cardiac medicine in this country and demonstrate what can be achieved with modern medicine when all roleplayers work together to achieve the best possible outcomes,” he concludes.
HeartWare European Union, which developed the state-of-the-art HVAD device, has announced in their internal publication, meanwhile, that the first child in Africa has been implanted with a long-term artificial heart device.