Philasande Dladla has been given a new lease on life after having a heart ventricular assist device (HVAD) implant to enable his damaged heart to continue functioning.
A remarkable journey
The ten-year-old, who enjoys hockey and swimming, 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 Dladla’s heart and heart valves, resulting in his heart failing.
Dr Willie Koen, who pioneered the use of mechanical heart implantation in South Africa, led the surgical team that implanted the hi-tech lifesaving HeartWare HVAD.
“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,” said Koen, who is a cardiac and transplant surgeon practising at Netcare Christiaan Barnard Memorial Hospital in Cape Town.
“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.”
Dladla’s mother, Sindi, was delighted and surprised at her son’s rapid recovery, who previously had completely lacked energy. He is now his old self again, she observed.
According to Dr Koen, the fact that Dladla was able to survive is in no small part due to his parent’s determination to find the necessary care for their son.
Dr Koen explained that Dladla had a temporary tandem mechanical heart device implanted at Netcare Milpark Hospital six months ago while his damaged heart valves were repaired.
A string of lifesaving operations
“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 operation to implant the tandem mechanical heart device was undertaken to keep Dladla’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 Dladla’s condition and performed these operations at Netcare Milpark Hospital.
However, these procedures were not a long-term solution as heart transplant was needed.
Dr Koen said although Dladla 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,” he said.
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.
How the HVAD works
Dr Koen noted 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 Dladla to reach adulthood when the chances of finding him a suitable heart donor will be significantly enhanced.
South Africa remains a leader in heart medicine
Dr Cassel, who practises at Netcare Milpark Hospital, said the groundbreaking procedures that were performed on Dladla 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.”
Jacques du Plessis, managing director of Netcare’s hospital, said these procedures were significant milestones in the history of cardiac medicine in South Africa and demonstrate what can be achieved with modern medicine when all roleplayers work together.
HeartWare European Union, which developed the 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.