An outreach by Stellenbosch University's (SU) Division of Cardiology has brought hope and a life-saving procedure to patients in Zambia who suffer from rheumatic heart disease.
According to Dr Helmuth Weich, cardiologist of the Division based in SU's Faculty of Medicine and Health Sciences (FMHS), this disease is caused by a throat infection during childhood that affects the heart valves. Patients then usually present years later with irreversibly damaged heart valves and subsequent heart failure.
It usually affects young adults and more often women and it affects about 30 million people world-wide, mostly in the developing world.
“Untreated valve lesions can cause death and significant morbidity and require surgical replacement," says Weich. Most African populations do not have access to valve replacement surgery, and post operative care (including lifelong use of blood thinners) is usually sub optimal.
“For some patients, it is possible to do an alternative minimal invasive procedure where the narrowed valve is stretched with a balloon," says Weich. The procedure, percutaneous mitral balloon valvotomy (PMBV), is technically very demanding and done on mostly awake patients via a vein in the groin.
Weich says Zambia's first cardiologist (Dr Lorrita Kabwe) was trained at the FMHS and Tygerberg Hospital, and maintains close ties with the Division of Cardiology.
“I set up an outreach to establish PMBV in Zambia. The technique I use was developed by myself and is less costly than the standard one and in my opinion much simpler.
“It requires a number of consumables for which I applied to the suppliers (Boston Scientific, who sponsored 20 kits of steerable catheters, transseptal puncture kits and Safari wires and Vertice MedTec, who sponsored 20 valvuloplasty balloons). The kit donated is worth around R900 000."
SU covered the travel and accommodation costs for Weich and Sr Magda Petersen to travel to the National Heart Hospital in Lusaka.
“Other groups from all over the world have travelled to Zambia in the past to do procedures on Zambian patients, but our intent was to make them independent."
Weich says Kabwe did the first few procedures with a lot of input from him, but he gradually stood back. “Dr Kabwe is a natural and did the last case without any input from either myself or Sr Petersen. The plan was to do a second visit, but this is not necessary – she is more than capable to take this forward on her own.
“We were able to leave behind the 14 unused kits and she has already done her first case after we left."
Weich says the people of Zambia now have access to this life saving procedure and it is very easy to continue providing virtual input if Kwabe has problems with patient selection, etcetera.
“It took more than a year to set up, but we have now completed the outreach. This sponsorship involves a large sum of money but much more importantly, many, many hours of work and a willingness to make it happen."
According to Weich he is already in discussion with another SU trainee, who is the first cardiologist in Zimbabwe, to set up a similar outreach in that country.