Cardiovascular disease is the world’s leading cause of death and disability. This World Health Day, Friday 7 April 2023, Netcare reflects on the previously unimaginable advances in cardiovascular medicine over the more than 50 years since the world’s first heart transplant was performed in South Africa.
“The incredible progress in medical technology and cardiac medicine since Prof Christiaan Barnard’s historic world first, continues to offer previously undreamt of treatment options where there was little hope before,” says Jacques du Plessis, managing director of Netcare’s hospital division.
According to the World Health Organization, cardiovascular diseases remain the leading cause of death globally. In just one year, approximately 17.9 million people died from cardiovascular causes, representing nearly a third of all deaths worldwide. In South Africa, on average 225 people’s lives are cut short by heart disease every day, according to the Heart and Stroke Foundation, and every hour ten South Africans suffer a stroke.
“While some children are sadly born with congenital heart defects; the likelihood of developing a cardiovascular condition in otherwise healthy individuals unfortunately increases as we age. This World Health Day, greater awareness of heart health, routine screening, and the importance of following a heart healthy lifestyle from a young age is one of the most important ways to safeguard your health and wellbeing,” Du Plessis says.
Cardiovascular specialists, including cardiologists, paediatric cardiologists, electrophysiologists who are cardiologists sub-specialised in heart rhythm disorders, cardiothoracic and vascular surgeons at 20 dedicated Netcare cardiac centres are increasingly working together in multidisciplinary teams to provide person centred cardiovascular treatment with the very latest methodologies for people with heart conditions. With cutting edge technology for diagnosing and treating all types of cardiovascular conditions, Netcare hospitals have introduced many cardiac firsts in our country.
Heart rhythm disorders, where the heart beats irregularly or too fast or slow, can affect adults or children, posing a serious health risk. Today these conditions are treatable, either with medicine, surgically implanted devices or with the aid of electrophysiology studies and ablation procedures, among others.
A pacemaker is an implanted device that helps to keep the heart pumping at a regular pace. Other treatments include medication or an implanted cardioverter defibrillator, which is a special type of pacemaker that can deliver a life-saving shock when the heart is beating too fast or irregularly.
Africa’s first structural heart centre specialising in the percutaneous repair of leaking heart valves and the minimally invasive repair of various other cardiac anatomical abnormalities was established at Netcare Union Hospital, now incorporated in Netcare Alberton Hospital, in 2014.
“One of the most important advances in heart medicine in recent years has been towards less invasive interventions, which involve smaller surgical incisions placing far less strain on the person’s system than traditional open heart surgery for appropriate cases,” Du Plessis says.
Breakthroughs in these ‘keyhole’ heart procedures have revolutionised many aspects of cardiac care. The transcatheter aortic valve intervention (TAVI) procedure replaces a diseased heart valve with an artificial one, implanted through a small incision using carefully guided catheters.
Certain patients with severe coronary artery disease require a procedure to clear a path through the artery before stents can be inserted. In a first for Africa, shockwave intravascular lithotripsy (IVL) was successfully used to ‘crack’ highly calcified deposits and blockages within the coronary arteries with ultrasound shock waves at Netcare Union Hospital, in 2019.
At Netcare Blaauwberg Hospital, the first transfemoral double valve replacement in Africa was performed earlier this year and the team of specialists at the hospital was also the first on the continent to make use of transfemoral shock wave therapy to obtain access for TAVI and to successfully perform the combination of mitral valve TAVI and coronary artery bypass surgery at the same time.
Some 15 years ago, only traditional surgical approaches were used for such procedures, however TAVI is now established at Netcare Milpark, Netcare Alberton, Netcare Sunninghill and Netcare Linksfield hospitals in Johannesburg, Netcare Unitas Hospital in Pretoria, Netcare Blaauwberg, Netcare Kuils River and UCT Private Academic hospitals in Cape Town, Netcare St Augustine’s Hospital in Durban, and most recently Netcare Greenacres Hospital in Gqeberha.
“This offers hope for many seriously ill patients, for whom traditional surgery was previously considered too high risk to even attempt. TAVI procedures can now be performed while the patient is conscious, opening this treatment modality for people who can’t have anaesthesia,” Du Plessis says.
“The effects of other health conditions on the cardiovascular system and reducing the associated heart risks through multidisciplinary care is another important emerging trend. In another pioneering cardiac development, the first cardio-oncology centre of excellence on the African continent, established at Netcare uMhlanga Hospital, recently received international certification.”
World class robotic technology offering less invasive alternatives for procedures involving the chest cavity, including lung cancer and cardiac surgeries among others, has recently been established at Netcare Christiaan Barnard Memorial Hospital. It is the first cardiothoracic robotic assisted surgery programme in Africa.
“Continuing the legacy of Professor Barnard, specialists practising at Netcare facilities, and a dedicated transplant team have been critical in adult and paediatric heart transplantation. Heart and combined heart-lung transplants are undertaken on adult patients at Netcare Milpark Hospital in Johannesburg, while paediatric heart transplants are performed at Netcare Sunninghill and Netcare Christiaan Barnard Memorial hospitals.
“Electromechanical cardiac medicine is also advancing all the time. Mechanical heart pumps, known as ventricular assist devices (VADs), have provided many desperate patients who suffer from end stage heart failure, with an invaluable lifeline until a suitable donor heart becomes available.”
South Africa’s first artificial implantation of a VAD, the Berlin Heart, took place at Netcare Christiaan Barnard Memorial Hospital in 2001. More recently, the Abbot HeartMate 3™ left ventricular assist device, implanted for the first time in South Africa in 2021, offers life-saving technology for people with end stage heart failure when a matching donor heart is not available for a transplant. This device can make it possible for patients with heart failure to regain their mobility and independence, to return to work and participate in family activities, extending their lives for many years.
“Thanks to the pioneering and dedicated specialists introducing advanced heart treatments in South Africa, and increasing public awareness of the risk factors and importance of early treatment of cardiovascular diseases, today so many people can live longer than would have been possible just a decade or two ago,” Du Plessis concludes.
For further information on the cardiovascular treatment services offered at Netcare hospitals please visit https://www.netcare.co.za/netcare-hospitals/specialist-services/cardiac.
Notes to editor
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