SA interventional cardiologist demonstrates intricate heart repair procedure to continent’s doctors
Drickus Maartens • November 4, 2019
Educational live demonstration aims to advance cardiac treatment for patients in Africa
Cardiologists and other medical practitioners from around Africa recently had the opportunity to watch a South African professor expertly direct a special repair device via tiny wires and catheters towards a patient’s heart in order to repair a hole in this vital organ.
The live interactive demonstration by local interventional cardiologist, Professor Farrel Hellig, was performed in the cardiac catheterisation laboratory at Netcare Sunninghill Hospital in Johannesburg, from where it was streamed in real time to hundreds of delegates attending the 20th Pan-African Course on Interventional Cardiology
(PAFCIC) held in Tunisia recently.
Professor Hellig, a renowned interventional cardiologist and associate professor at the University of Cape Town’s Medical School, spoke participants through the intricate ‘keyhole’ procedure to close the hole, or flap, in the wall of the inter-atrial septum of the heart. This is known in medical terms as a patent foramen ovale (PFO) repair.
Professor Hellig, who is committed to education in interventional cardiology, and is known for sharing his knowledge widely with his colleagues, says that the heart repair procedure went well and the patient was discharged home from the hospital the following day.
The procedure was followed closely on a large screen by delegates in Tunisia, who were able to interact and engage with the professor throughout the procedure. Professor Hellig says the PFO is a relatively easy intervention for him and his team to perform, as they have undertaken many of them in recent years.
Held under the auspices of the Pan African Society of Cardiology (PASCAR), PAFCIC aims to educate the continent’s doctors on interventional cardiology, thereby aiming to improve cardiovascular care in Africa. Professor Hellig’s procedure was one of 10 performed by experts at centres around the continent to demonstrate to delegates the latest techniques in this sub-speciality. In addition to these live case transmissions, the PAFCIC programme included practical workshops and keynote lectures by international experts.
Professor Hellig explains that interventional cardiology is a sub-specialty of cardiology, and provides minimally invasive, image-guided diagnosis and treatment of cardiac conditions. He is regularly invited to demonstrate such techniques to delegates at the annual PAFCIC Congress as well as at other such international educational meetings. Last year, Professor Hellig demonstrated a live transcatheter aortic valve implantation (TAVI) — a procedure during which a diseased heart valve (aortic valve) is replaced with an artificial valve — to PAFCIC delegates.
“Interventional cardiology is revolutionising heart medicine in many important ways, and is becoming an increasingly critical sub-speciality both locally and around the world. However, the techniques involved can be complex and insufficient cardiologists in South Africa and on the African continent have had the opportunity to acquire the necessary skills,” notes Professor Hellig, speaking during Heart Awareness Month in South Africa.
“As a consequence, these approaches are still not widely available to the many vulnerable patients throughout the continent who could greatly benefit from them. I think that it is therefore of critical importance to familiarise as many of our colleagues as possible with these techniques.”
Professor Hellig has vast experience in interventional cardiology and performs scores of these intricate procedures every year. He also provides clinical training in interventional cardiology to post-graduate Masters’ students at Netcare Sunninghill Hospital through UCT. Netcare Sunninghill Hospital has been recognised as a UCT Medical School interventional cardiology teaching institution.
Highly-trained cardiologists now perform a range of procedures ranging from heart valve replacement and repair to the unblocking of blocked blood vessels with stents using minimally invasive techniques that are far less traumatic to the body than open-heart surgery, where large incisions have to be made to perform surgery.
“These procedures tend to reduce patients’ hospital stays and the recovery period. Moreover, they often enable us to treat highly compromised patients who might not have survived open heart surgery.”
Professor Hellig was also course director for AfricaPCR, the largest interventional meeting in Africa, which ran concurrently with SA Heart Congress and PASCAR, from 31 October to 3 November 2019. Five live demonstration procedures were performed as part of AfricaPCR at Netcare Sunninghill Hospital.
“I am always greatly honoured to be asked to perform such live demonstrations for events such as PAFCIC, which meaningfully contributes to the advancement of cardiovascular medicine, and interventional cardiology in particular, on the continent,” concludes Professor Hellig.
Further reading:
https://www.occlutech.com/int/professionals/products/pfo/
Migraines affect 15% of the global population, causing severe pain and disrupting daily life. Neurologist Dr. Michael Huth emphasises the importance of understanding different migraine types and their triggers.
Dr Michael de Villiers explains why people can become sick every flu season and why the influenza vaccine is generally recommended every year.
Colorectal cancer, one of the most prevalent yet preventable cancers, can develop in the colon or rectum, often starting as small polyps that can quietly become malignant if left unchecked. Dr Mpho Ramabulana, a colorectal surgeon and gastroenterologist at Netcare Akasia Hospital, underscores the life-saving power of vigilance and the importance of early detection.
Cardiologist Dr Robert Routier urges the public to check their personal risk factors regularly to help prevent or manage cardiovascular disease.
The physical strain pregnancy puts on an expectant mother’s body should not be underestimated. An obstetrician gynaecologist offers her insights for alleviating discomfort and promoting wellbeing with exercise and stretching throughout pregnancy.
Dr Patience Sigwadi, a leading paediatric nephrologist practising at Netcare Unitas Hospital in Centurion, has issued an urgent call for increased focus on skills development to address the escalating kidney disease crisis among children in South Africa.
Paediatric Nephrologist Professor Bhimma was recently awarded the Fellowship to acknowledge his extensive work in research, community-based outreach and teaching of paediatric nephrology, among others.
Netcare congratulates Professor Bhekifa Dube on his invitation to join the European Society for Vascular Surgery's clinical practice guidelines committee. His selection as the only specialist from the continent highlights the significance of this achievement on the global stage.
The lives of millions of South Africans with a litany of rare diseases can be vastly improved, and even saved, by addressing challenges in identifying, studying and treating their conditions. With Rare Disease Day on the 28th of February 2025, the Rare Diseases Access Initiative (RDAI) is driving an evolution of the country’s healthcare, through innovative strategies to better care for over 4.2million people living with an estimated 7000 rare diseases. “As our healthcare system faces significant changes in the years ahead, it is vital that we also advocate for people living with rare diseases in South Africa, especially those with limited healthcare access,” said Kelly du Plessis, CEO of Rare Diseases South Africa (RDSA), a member of RDAI. “As part of our ongoing research and awareness efforts, RDAI has conducted an initial analysis of the incidence and prevalence of rare diseases within the country.” This research will assist in improving access to healthcare, policy development, and patient advocacy, while giving critical insight into the challenges faced by patients. “According to research, some rare diseases affect fewer than 1 in a million people, while others, such as Down syndrome, cystic fibrosis, and haemophilia, have a more recognisable prevalence,” says Dr. Helen Malherbe, RDAI lead researcher on rare disease prevalence data. “Many conditions are undetected, underdiagnosed or misdiagnosed, with too many having no information available about them at all.” The RDAI was formed in 2019 to promote a more favourable environment for those impacted by rare diseases in South Africa. Participants include Ampath, the Board of Healthcare Funders (BHF), Discovery Health, Genetic Counsellors South Africa (SASHG), the Government Employees Medical Scheme (GEMS), Health Funders Association (HFA), Medihelp, Medscheme, North-West University (NWU), Rare Diseases South Africa (RDSA), the South African Medical Association (SAMA) and The South African Medical Technology Industry Association (SAMED). The Council for Medical Schemes (CMS) participates as an observer. In the same year, Rare Disease International signed a memorandum of understanding with the World Health Organisation leading to an international rare disease policy framework. In 2021, the United Nations General Assembly moved to adopt a resolution recognising 300 million people living with rare diseases worldwide. “A general lack of awareness and delayed diagnosis remain major hurdles for those affected by rare diseases. Policymakers and healthcare stakeholders need to prioritise access to treatment, diagnosis, and support for rare disease patients,” says Bada Pharasi, CEO of IPASA, “Through this initiative, working collaboratively with stakeholders at every level of the healthcare supply chain, we can bring real and meaningful change to those affected, including family members and care givers, through smart and efficient strategies.” The globally agreed definition of a rare disease is any medical condition with a specific pattern of clinical signs, symptoms, and findings that affects fewer than or equal to 1 in 2000 persons in a population. “Most are genetic, and some are inherited and passed down in families,” Malherbe says. “Some affect only the patient’s genetic recipe, while others may be acquired during life due to infection, trauma, or environmental effects. For many, the cause is still unknown. “These conditions mainly affect children, as they are largely incurable and many are life-threatening. Some require specialised and co-ordinated care, some have limited and expensive treatment options, while others have no information or effective treatments at all,” she adds. The RDAI is calling for a patient-centred care model built on equitable access, transparency and efficiency. Naturally, this model calls for the open participation of patients, the healthcare industry, health professionals, and the Government. “The most critical elements are robust diagnosis standards, improved access to treatment, data collection and management, co-ordination of care, measurement of outcomes and ongoing collaborative research,” du Plessis says. “We need to establish rare disease advisory committees, map gaps and opportunities, establish system requirements, create a roadmap and plan a phased implementation with clear timelines.” The RDAI states that these policy development steps would be a start in quantifying the disease burden and defining standards of care. This would be followed by building and strengthening the capacity to facilitate appropriate diagnosis, treatment, continuity and data monitoring. Thoneshan Naidoo, Chief Executive Officer of the Health Funders Association noted that, “We appreciate the unique opportunity provided by RDAI which enables stakeholders across the industry to work together and identify strategies that improve equitable access to the appropriate diagnosis, treatment and healthcare services for rare disease patients, in an affordable and sustainable manner, taking account of the other pressing needs across the healthcare system.” “True innovation in healthcare is only possible through partnerships and joint advocacy efforts that raise awareness and improve access to treatment. Our long-term goal is the development of a rare diseases policy framework and guidelines for coordinated care,” says Pharasi. “Our members are united in the commitment to unlocking improved patient outcomes and improving access to services and robust health needs assessment facilities.” he concludes. About RDAI The Rare Diseases Access Initiative (RDAI) is dedicated to advocating for improved healthcare access, policy development, and patient support for those affected by rare diseases in South Africa. The initiative brings together key healthcare stakeholders, including pharmaceutical associations, funders, genetic specialists, and patient advocacy groups, to drive impactful change. About RDSA Founded in 2013, Rare Diseases South Africa (RDSA) is a non-profit organisation advocating to ensure that people living with rare diseases and congenital disorders experience greater recognition, support, improved health service and better overall quality of life. Started out of personal need following the diagnosis of organisation founder, Kelly du Plessis' son, it became evident that there was a lack of awareness and support for rare diseases in general in South Africa. About IPASA The Innovative Pharmaceutical Association South Africa (IPASA) is a voluntary trade association representing 24 leading pharmaceutical companies committed to research, development, and innovation. Our mission is to drive healthcare advancement by advocating for policies that improve patient access to safe, high-quality, and affordable medicines.
Gastroenterologist Dr. Barbara Makumbi discusses common risk factors and offers tips for managing reflux and the longer-term condition known as gastroesophageal reflux disease (GORD).
