By her mid-thirties, Sulizna van Reenen was already on the heart transplant waiting list and had only 13% remaining function in the left chamber of her heart. With an ongoing scarcity of donor organs, time was running out for Sulizna until technology presented a life saving gift on her birthday.
“I’m not used to having so much energy,” Sulizna says, just a few weeks after the 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 the left ventricle of her heart.
“Sulizna 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,” says Dr Willie Koen, a world renowned cardiac and transplant surgeon and pioneer of ventricular assist device (VAD) implantation in South Africa.
|Pic: When Sulizna van Reenen was discharged from Netcare Christiaan Barnard Memorial Hospital after her mechanical heart pump implant surgery, the staff who cared for her during her stay in Ward Surgical 2 gathered to see her off with their best wishes for the future. Pictured from left to right are care worker, Nazo White; transplant coordinator, Helena Williams; Sulizna; registered nurses, Sr Dalene Horak and Sr Dolindsay Sauls; (back) ward administrator, Elizabeth Frick; and (front) enrolled nurse auxiliary (ENA), Asipe Ntshunsthe.
|Pic: Sulizna is now continuing her recuperation back home in Riversdale, Western Cape. Once Sulizna has fully recovered from the operation, she will be able to return to work, and also to walk, drive and travel once more and enjoy the aspects of life that weren’t possible for her before the LVAD mechanical heart pump device was implanted.
|Pic: Sulizna van Reenen and Dr Willie Koen.jpeg: “This is a birthday present I won’t forget, that’s for sure,” says Sulizna van Reenen, pictured here with Dr Willie Koen, a world renowned cardiac and transplant surgeon who performed the left ventricular assist device (LVAD) implant surgery. The surgery happened on the same day as Sulizna’s birthday.
A sign it was meant to be
A motivation for authorisation for the LVAD procedure was submitted to Sulizna’s medical scheme, and approval was granted on the Friday before Sulizna’s birthday. It just so happened that the first theatre date available for the life changing operation was on the day of her 40th birthday.
“They told me I could have the operation on the Tuesday, and I said, ‘It’s fine, that’s my birthday, but I can’t wait any longer’. This is a birthday present I won’t forget, that’s for sure,” says Sulizna who hails from Riversdale in the Western Cape.
“What a coincidence that all the arrangements came together for the operation to happen on her birthday, it seemed like a sign that it was meant to be,” Dr Koen adds.
A shock diagnosis
“I worked in a bank, and before I even realised there was anything wrong with my health, some of the concerned customers started asking if I was OK, because they noticed I was often breathless when talking to them. Then one night in 2017, I felt sick, and I could not 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 felt so bad that I had to go to an emergency department. I was referred to a specialist who ran some tests and discovered my heart’s left chamber was enlarged and the heart muscle was losing strength. Before my diagnosis, I had noticed that I always felt tired, but I thought I just needed to improve my fitness – I never expected it to be something so serious,” she says.
“I was in and out of hospital, and in 2019 I had to stop working. It was a lonely time because I could not get close to people, as I was at increased risk if I caught an illness like flu. Living with heart failure through the COVID-19 lockdown was the scariest time of my life, but I am extremely lucky to have three sisters and a brother who were wonderful and supported me throughout.”
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,” Dr Koen says.
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. This is connected by a driveline, which 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 in the event of loadshedding or power cuts the patient still has plenty of battery life to sustain the device’s operation.
“I want to see my people – not just over video call”
“Once Sulizna has fully recovered from the operation, she will be able to return to work, and also to walk, drive and travel once more and enjoy the aspects of life that weren’t possible given her weakened heart.”
“I have really missed spending time with my friends. If you feel well enough to accept an invitation, you never know if you will actually have the energy to make it on the day. I want to see my people – not just over a video call – and I want to enjoy life again,” Sulizna says.
Heart transplants resume
Dr Koen adds that a second patient with heart failure who was scheduled to have the same LVAD mechanical heart pump as Sulizna implanted, received the news just before the scheduled LVAD procedure that, against the odds, a matching donor heart had been found for him to have a transplant.
“It is wonderful to report that the 51 year old male patient is recovering well after his heart transplant, and that it is becoming possible to resume heart transplants once more. 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.
“For now, many South Africans are still struggling with heart failure and our best hope for them is to make more members of the public 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,” Dr Koen adds.
If you would like to consider becoming an organ donor, be sure to discuss your wishes with your family as they will need to give final permission. Organ donation is free and donors’ next-of-kin don’t have to worry that they will have to carry any cost associated with the donation of their loved ones’ organs. For more information contact the Organ Donor Foundation on their toll free number, 0800 22 66 11, or visit https://www.odf.org.za.
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