A five-year-old KwaZulu-Natal boy made history when he became the youngest person in Africa to receive a mechanical heart implantation.
In what is considered a groundbreaking operation, doctors from the Maboneng Heart Institute, at the Netcare Sunninghill Hospital‚ inserted a heart ventricular assist device (HVAD) into Mnotho Mndebele’s "severely damaged" heart, which helps it to pump blood.
Mndebele‚ from Newcastle‚ weighs about 17kg — making him one of the smallest and youngest people to have undergone this type of operation in the world‚ according to Dr Viljee Jonker‚ a cardiothoracic surgeon who led the implantation team.
He suffered from dilated cardiomyopathy (DCM)‚ a condition in which the left ventricle of the heart becomes enlarged and weakened and is no longer able to pump blood properly.
After being in an intensive-care unit for four months, Mndebele is expected to return home this week, where he should live a "normal life", Jonker said.
"We fully expect him to be able to go to school and do everything a normal young boy would do. However‚ unlike other children, he will carry a small external battery pack for his implanted HVAD mechanical heart either on a belt around his waist‚ or in a small backpack‚" said Jonker.
Mndebele will have to recharge the batteries every eight hours.
"Mnotho had been on the heart transplant list but paediatric heart donations rarely become available. He had also been in and out of intensive-care units at various hospitals in the year leading up to the operation. In his case‚ we opted to use the HVAD as a bridge to a future heart transplant. In reality‚ it is a lifeline until such time as a matching donor heart can be found for him to undergo a biological heart transplant‚" said Jonker.
"It will also enable Mnotho to grow stronger and gain much-needed weight over the next few years‚ so that he will be healthy enough to undergo a heart transplant when a donor heart finally becomes available. While waiting for a donor heart, we expect him to lead a fairly normal life‚ enjoying typical childhood activities." Jonker said HVAD devices were becoming a common "bridge" to a biological heart transplant, as devices got smaller and more efficient with technological progress.
"Tragically‚ many people are not aware that we have world-class paediatric heart transplantation and repair programmes‚ such as that performed at the Maboneng Heart Institute‚ in SA‚" said Jonker.
"Far too many children throughout Africa are sadly still left to die from conditions such as cardiomyopathy‚ a chronic disease of the heart muscle‚ because it is thought that nothing can be done for them.
"In fact‚ as this particular case illustrates‚ with early and appropriate medical intervention‚ the great majority of children suffering from such conditions can be saved‚ often ending up living a normal life‚" he said.