Since 2013, the three major hospitals in the Western Cape, Tygerberg Hospital (TBH), Groote Schuur Hospital (GSH) and Red Cross War Memorial Children’s Hospital (RCWMCH), have collectively performed close to 10 000 heart surgeries.
World Heart Day, observed on 29 September, is a stark reminder that heart disease remains one of the primary causes of death in South Africa. Many of these conditions could be prevented through healthier lifestyle choices, while medications are available to manage them if they do occur.
However, for some advanced and complex cases, particularly those necessitating the repair or replacement of damaged heart valves or the correction of abnormal heart rhythms, surgery at a tertiary hospital becomes a viable option. Recovery times can vary depending on the nature of the heart surgery, but in most instances, patients need to remain in the hospital for several days before being discharged.
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The heart, often described as the hardest-working muscle in our body, beats approximately 115 200 times a day. By the time an individual reaches 80 years of age, their heart has executed roughly three billion beats, tirelessly transporting nutrient-rich blood throughout the body.
The three provincial tertiary hospitals play an indispensable role in addressing heart disease. While prevention remains crucial, the incidence of acquired and congenital heart diseases is on the rise due to the province’s fourfold disease burden.
Tygerberg Hospital has gained recognition for its Mitral Valve Repair surgery, involving procedures like reconnecting valve leaflets, patching heart valve holes or removing excess tissue. In 2015, the hospital performed the first mitral valve repair in the province using the patient’s own blood vessels from the leg (the saphenous vein) to mend a valve damaged by infection. Since then, the facility has initiated a minimally invasive mitral repair program. Nonetheless, the majority of patients still require open surgery.
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Professor Jacques Janson, the head of the division of cardiothoracic surgery at Tygerberg Hospital, said that the growing complexity of these surgeries is due to an ageing patient population with more intricate medical conditions. Despite the overwhelming caseload and severe illnesses, the hospitals consistently deliver outcomes that stand up well to global standards.
‘We find encouragement and motivation to continue our work when we see patients given a second chance in life,’ remarked Professor Janson.
Tinotenda Naini, a 23-year-old from Hermanus, faced a dire health crisis with an acute aortic dissection while 30 weeks pregnant. Her premature baby was delivered at TBH in September 2023, and immediately after, surgeons repaired her aortic valve and replaced her aorta (the body’s largest artery carrying blood from the heart to the circulatory system). This surgery spared her a prosthetic aortic valve replacement, eliminating the need for lifelong blood thinners.
Naini expressed her gratitude, stating, ‘This surgery changed my life for the better, and my baby is doing well, and I feel relieved knowing I will not have any breathing problems again.’
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Professor André Brooks, the head of the clinical unit of cardiothoracic surgery at Red Cross War Memorial Children’s Hospital and a cardiothoracic surgeon at Groote Schuur Hospital, leads specialised cardiac surgeries at both tertiary healthcare facilities.
Groote Schuur Hospital distinguishes itself with its expertise in adult congenital surgeries, while RCWMCH was the pioneering paediatric unit in the country, performing specialised procedures like the REV (Reparation a l’Etage Ventriculaire) procedure for nearly a decade.
Although surgeons carry out the procedure, successful surgeries are the result of teamwork amongst multi-disciplinary teams at their hospitals.
‘Our dedicated team of specialists is what allows us to carry out these procedures. Without the collaboration of a cardiology team, anaesthetists, perfusionists or the ICU team, we would not be able to do what we do,’ said Prof. Brooks.
Zukiswa Mnukwa, a resident of Parow, is the mother of a 5-year-old patient who recently underwent a ventricular septal defect repair at RCWMCH, addressing a hole between the left and right ventricles of the heart.
‘It is a very difficult time in our lives, but the surgeons and the nurses at the hospital have been extremely supportive and transparent. They see both the medical and human sides of our family, and that makes a difference,’ Zukiswa said.
At the age of 35, Melanie Petersen from Mitchells Plain received a diagnosis of an atrial septal defect, a congenital heart condition she had unknowingly lived with since birth. Petersen sought medical attention when she began experiencing shortness of breath and an increased heart rate during everyday tasks.
After being referred to Groote Schuur Hospital, she underwent surgery in June 2023, and her life has since been transformed.
Petersen joyfully reported, ‘I can feel the difference in my life since I got the surgery. I no longer feel tired when I work, and I do not get tired when I walk or go to my everyday activities. I can now live a normal life.’
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Picture: Jesse Orrico / Unsplash
