We are currently witnessing rapid evolution in minimally invasive and catheter-based atrioventricular valve interventions as acceptable alternatives to classic sternotomy access (CSA). Collectively, minimally invasive atrioventricular valve surgery (MIAS) is associated with significant learning curves and its routine application is met with varying degrees of enthusiasm in view...
Background/Hypothesis: Ventricular septal defect (VSD) is the most common congenital cardiac lesion. Surgical closure is the gold standard, but in an isolated perimembranous ventricular septal defect (PMVSD), percutaneous closure is an attractive alternative, particularly in a limited resource setting. Our experience suggests that percutaneous closure of a perimembranous VSD, in...
Introduction: We describe the largest South African transcatheter aortic valve implantation (TAVI) outcome report of a single team in the Western Cape, over a 7-year period from 2009 - 2016. Methods: All patients who received TAVI at Mediclinic Vergelegen and Mediclinic Panorama were prospectively entered into a database. A total of 244 implants (61 CoreValve and 183 Edwards...
The mission of this declaration is to urge all relevant entities within the international cardiac surgery, industry, and government sectors to commit to develop and implement an effective strategy to address the scourge of rheumatic heart disease in the developing world through increased access to lifesaving cardiac surgery.
Background: Cardiovascular disease is an important cause of morbidity and mortality in South Africa and hyperlipidaemia is a major contributing modifiable risk factor. Objectives: To describe the lipid profiles of patients with acute myocardial infarction and to compare values with recommended target levels outlined in the South African Dyslipidaemia Guideline Consensus Statement...
The South African Heart Association (SA Heart®) was established in 1999. Prior to 1999, 2 professional societies represented the interests of cardiologists and cardiac surgeons in South Africa – the South African Cardiac Society and the South African Society of Cardiac Practitioners. The latter was formed in 1985 by cardiologists in private practice to serve the interests of...
Background: The prevalence of coronary artery disease (CAD) amongst patients presented for valve surgery has important implications for routine angiography. Information on the frequency of CAD in predominantly black patients presented for valve surgery in South Africa has not been published. Methods: A retrospective, descriptive study of 116 patients presented for valve surgery...
Objective: To examine the association of depressive symptoms and contributing psychosocial factors during hospitalisation and 1-month post discharge in patients with acute myocardial infarction (MI). Methods and results: The study population comprised consecutive patients from a multi-ethnic background, admitted June 2015 - November 2015 to the Coronary Care Unit at R. K. Khan...
Objectives: To evaluate the major risk factors for adverse short and long term outcomes in patients with active native valve infective endocarditis needing cardiac surgery and to validate the EuroSCORE II in our cohort of patients. Methods: We retrospectively studied 149 patients who underwent native valve surgery for infective endocarditis in June 2000 - May 2011 at our referral...
Background: There are few data available regarding acute coronary syndrome presenting to emergency centres in sub-Saharan Africa compared to the rest of the world. The aim of this study was to describe the acute coronary syndrome diagnosis and its outcome in an undifferentiated chest pain population when using a troponin assay that predates current reference standards at a public...
Congenital pulmonary stenosis (PS) is one of the most prevalent congenital cardiac abnormalities. A thorough assessment is needed to determine which of the many patients born with PS, will need intervention and further management, and which will only need routine follow up. Accurate non-invasive assessment of the severity of the PS at transthoracic echocardiography is therefore...
Infective endocarditis (IE) is associated with significant morbidity and mortality. Prevention is therefore an important clinical entity. The maintenance of optimal oral health is likely to play the most important role in protecting those at risk for IE. Both patients and health care practitioners must be educated in this regard. Guidelines have recommended that antibiotic...
Introduction and aim: Parents of children with congenital heart disease (CHD) are at increased risk of ongoing stress and psychological morbidity. The aim of this study was to determine stress in parents of children with CHD who underwent cardiac surgery. The levels of stress experienced by parents of children with CHD in South Africa are unknown. Reported parenting stress...
The overall success of coronary artery bypass graft (CABG) surgery is much dependent on the postoperative rehabilitation. Cardiac rehabilitation (CR) programmes should be comprehensive and multifactorial to enhance the education and quality of life of the patient. This was a quasi-experimental and longitudinal intervention study to which 18 patients who had undergone CABG surgery...
Subclinical atrial fibrillation, a commonly encountered entity in patients with implantable devices, has been associated with a number of adverse outcomes – the most important of which is thromboembolism. Through the detection of atrial high rate episodes, implanted devices offer a method to monitor for atrial fibrillation over extended periods of time. Several studies have...
Rheumatic heart disease (RHD) and endomyocardial fibrosis (EMF) are 2 neglected cardiovascular diseases that disproportionately affect young populations, living in poverty. RHD characteristically occurs in low- and middle-income countries, as well as in some disadvantaged populations within high-income countries, such as the Aboriginal peoples of Australia. In contrast, EMF is...
Background: Diagnosis and treatment of paediatric arrhythmias remain challenging. Antiarrhythmic - drugs beta-blockers, class Ic and class III drugs, were the only treatment available for many years. Radiofrequency catheter ablation (RFCA) was introduced for adult patients in 1981 and has been used for children since 1989. Questions remain regarding the efficacy and safety in...
Introduction: Fenofibrate exerts pleiotropic effects on endothelial cells (ECs) by, amongst others, increasing nitric oxide (NO) production. We aimed to investigate fenofi brate’s putative beneficial actions in healthy or TNF-alpha-induced dysfunctional ECs. Methods: Fenofi brate-induced pro-vasodilatory responses were assessed in aortic rings (50 - 125μM; 30min) with and without...