Cape Town in heart valve break­through

In­ven­tion could save mil­lions of lives

Weekend Argus (Sunday Edition) - - HEALTH - WEEK­END AR­GUS RE­PORTER

A TEAM of ded­i­cated heart sur­geons, clin­i­cians and med­i­cal engi­neers in Cape Town have per­fected an ar­ti­fi­cial heart valve that could save mil­lions of lives, par­tic­u­larly in poorer coun­tries.

The break­through comes on the eve of the 50th an­niver­sary of the world’s first heart trans­plant, car­ried out by Pro­fes­sor Chris­ti­aan Barnard at Groote Schuur Hos­pi­tal in Cape Town on De­cem­ber 3, 1967.

Aimed at help­ing mil­lions of pa­tients in de­vel­op­ing coun­tries who would die with­out open-heart surgery, the valve al­lows doc­tors to re­pair or re­place dis­eased heart valves at ru­ral hos­pi­tals with­out the need for ex­pen­sive equip­ment or open­heart surgery.

The valve and the pro­ce­dure to in­sert it, which has been in devel­op­ment for eight years, re­cently re­ceived in­ter­na­tional ac­knowl­edge­ment when Strait Ac­cess Tech­nolo­gies (SAT), a UCT start-up com­pany, re­ceived two pres­ti­gious global awards for in­no­va­tion in car­diac surgery.

“It was amaz­ing to see the en­thu­si­asm with which this in­no­va­tion was wel­comed by so many of the world’s top car­diac sur­geons and aca­demics,” said SAT chief op­er­at­ing of­fi­cer Heather Coombes.

Ac­cord­ing to Pro­fes­sor Bon­gani Mayosi, dean of the Fac­ulty of Health Sciences at UCT, at least 33 mil­lion peo­ple world­wide are af­fected by rheumatic heart dis­ease. Many of th­ese pa­tients will die with­out surgery.

“Rheumatic heart dis­ease oc­curs most fre­quently among peo­ple liv­ing in crowded con­di­tions with lim­ited ac­cess to health care. An ini­tial un­treated in­fec­tion of the throat with strep­to­coc­cal bac­te­ria leads to an im­mune re­sponse of the body that in­ad­ver­tently also at­tacks a pa­tient’s heart valves,” said Mayosi.

Pro­fes­sor Peter Zilla, head of the Chris­ti­aan Barnard De­part­ment for car­dio­tho­racic surgery in Cape Town, who heads the team de­vel­op­ing the valve and pi­o­neer­ing the pro­ce­dure, ex­plained there were nu­mer­ous prob­lems as­so­ci­ated with heart valve re­place­ment.

“Open heart surgery re­quires heart cen­tres, spe­cial­ist car­di­ol­o­gists and heart sur­geons. It also re­quires ex­pen­sive heartlung ma­chines and other med­i­cal equip­ment as well as so­phis­ti­cated the­atre and af­ter-care fa­cil­i­ties. Apart from the high cost of med­i­ca­tion, the re­place­ment heart valves be­ing used are im­ported from North Amer­ica or Europe. They are ex­pen­sive and poorly suited for the af­fected pa­tients.”

The valve and pro­ce­dure for its place­ment pi­o­neered by Zilla’s team ad­dress all th­ese short­com­ings, not least the cost that is a frac­tion of the price of the valves avail­able.

“In essence all a gen­eral sur­geon will have to do is make a small in­ci­sion and in­sert a self-hom­ing hol­low­bal­loon car­ry­ing the valve into the heart. The heart con­tin­ues to beat dur­ing the im­plan­ta­tion of the valve with­out in­ter­rupt­ing the blood flow to the brain and the other or­gans,” he said.

“The valves are made from a novel plas­tic ma­te­rial, and can be mass-pro­duced at low costs. Long-term bench tests show a dura­bil­ity equiv­a­lent to 20 years in a pa­tient.”

Zilla and his team ex­pect to be­gin clin­i­cal tests of the valve and the pro­ce­dure next year.

Once rat­i­fied by global med­i­cal bod­ies, SAT will man­u­fac­ture the valves lo­cally for global dis­tri­bu­tion.

The heart valve be can re­placed or re­paired with­out the ex­pen­sive equip­ment used in open-heart surgery.

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