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The Mechanical Heart: a Time-buyer


In 2015, the Cardiothoracic department of the University of Pretoria confirmed a steady and noticeable increase in younger cardiac patients than ever before. The lowered age profile knowledge appears as no surprise when one considers the fact that at least 80% of all premature deaths are often due to Cardiovascular Disease (CVD), whether acquired or inborn. The rise in paediatric and teen heart defects presents itself to be problematic in light of the fact that paediatric heart donations are a rare reality. A high heart demand together with a low heart supply, especially in the paediatric field of heart transplantations, is possibly the cause behind the rise in popularity of the Ventricular Assist Device (VAD). Many families with children who require heart surgery and transplantations are largely unaware of the alternative opportunities that exist. “Far too many children throughout Africa are sadly still left to die from [heart] conditions because it is thought that nothing can be done for them,” explains Dr Viljee Jonker, who performed Maboneng Heart and Lung Institute’s first mechanical heart implantation in August of this year. “There are numerous highly effective technologies and procedures available today to assist in the treatment of [heart] conditions at specialised centres, and more awareness of this should be raised, so that children in need will be able to receive treatment timeously,” says Dr Jonker.

During mechanical heart implantations, the VAD is placed in the upper part of the belly wall and is connected to the heart via a tube. Another tube connects the VAD to the arteries. The VAD acts as a pump - assisting the left ventricle of the heart to pump blood out to the aorta, or other main arteries, to ensure that blood is circulated throughout the body. The ventricles make up the two lower chambers of the heart and act as the main pumping chambers. The device is only viable when the at least one ventricle functions adequately. A third tube connects the mechanical pump to the batteries and control unit, which monitors the device functionality, both of which are situated outside of the body.

To read Dr Viljee Jonker’s first VAD implantation on 5 year old, Mnotho Mndebele, click here. Why is the VAD a medical breakthrough? Dr Viljee Jonker refers to the mechanical pump as a “bridge to a future biological heart transplantation”. The VAD can even act in replacement of a transplantation. - the VAD can offer support during heart transplant recovery - the VAD often acts as a time-buyer - supporting the heart while waiting for a heart donation - when a patient is not eligible for a heart transplant, the VAD can offer assistance VAD Risks: While the VAD offers numerous positive possibilities, there are a few dangers that one need be aware of. - infections are a possibility - a higher chance of blood clots - some patients may experience minor breathing problems - heart attacks or strokes

 

© Maboneng Heart and Lung Institute 2017 | Featured Image: Nucleus Medical Media Images: Netcare, AHA Journals, Dr Saskia Coetzee and Ammy Rodrigues Sources: http://circ.ahajournals.org/content/124/12/e305 https://www.nhlbi.nih.gov/health/health-topics/topics/vad

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