Children spared traumatic surgery

A SIMPLE device inserted through the groin by a catheter that winds its way to the heart has saved almost 100 Eastern Cape children the trauma of open heart surgery.

For them, massive scarring, traumatic surgery and long recovery times in hospital have been eradicated thanks to the innovative procedure being undertaken by Bay paediatric cardiologist Dr Lungile Pepeta.

Pepeta, who is the chief of paediatrics at the Port Elizabeth Hospital Complex, said he and his team had performed 84 of these procedures to close holes in children's hearts over the last 12 months.

"On average, these procedures take about an hour or two. We only need to keep our patients overnight," he said.

"Previously, children needed open heart surgery to fix this problem. This is very traumatic for the kids and it leaves scars. It takes several hours and the children have to be placed on bypass. They have to stay in the hospital for a week."

He said waiting lists for cardiothoracic surgery could have up to 200 people on them and his hope was that this surgery could significantly ease the strain on the cardiothoracic team.

Pepeta, who is originally from Bizana, obtained his degree in medicine in 1997 at the University of Transkei (now Walter Sisulu University). He first trained in the procedure while completing his master's degree in paediatrics at the University of the Witwatersrand.

Yesterday, Pepeta and his team, Dr Adele Greyling and Dr Fanie Smit, performed two procedures. In the first case, involving a 10-year-old boy, the team measured the size of the hole in his heart.

"We usually advise parents to have these little defects fixed before the kids go to school," Pepeta said.

Congenital heart defects allow for oxygen-rich blood and oxygen-poor blood to mix in the heart and can in some cases be fatal if left untreated.

In the other procedure, the team closed a hole in the heart of a five-year-old girl within 40 minutes. "This procedure is done by implanting a small device into the heart that closes the hole."

Pepeta said the device was made of metal with shape memory characteristics that returned to its original shape after it had been stretched to pass through a catheter. It was designed to stop blood flowing through a hole in the heart.

Both operations were done at the Cardiovascular Laboratory at Provincial Hospital.

Patients are given anaesthetic and then a catheter containing the device is inserted into the patient's heart through the groin. The process is monitored by doctors and medical technicians on screens in an adjoining room.

Pepeta said they could do, and had done, the procedure on children as young as two months.

"If the heart is too small, and the defect is not too dangerous, we sometimes send them home to grow a little. [If] the defect is too large, we still have to refer them for open heart surgery."