| Azlan Othman |
THE Ministry of Health and Gleneagles JPMC (GJPMC) Cardiac Centre made history by successfully implanting a Left Ventricular Assist Device (LVAD) into the heart of a local patient, the first such procedure done in the country as well as Borneo.
LVAD is a mechanical device that helps to pump blood from the left ventricle to the rest of the body.
Pehin Orang Kaya Johan Pahlawan Dato Seri Setia Awang Haji Adanan bin Begawan Pehin Siraja Khatib Dato Seri Setia Awang Haji Mohd Yusof, the Minister of Health, who visited the patient, Awang Mumtazali bin Md Abd Aziz, 51, yesterday at GJPMC Cardiac Centre, expressed his satisfaction over the success of the procedure, which was done on November 11.
“With such medical advancements, and the presence of local and foreign specialists working together as a team, anything undertaken will bear fruit,” he said.
Awang Mumtazali, a staff from the Ministry of Culture, Youth and Sports from Belait District, who has had four heart attacks since 2002, said he has noticed positive developments since he had the LVAD procedure done.
“As (the procedure) was successfully done on me, other heart patients could follow suit,” he said, noting that his movements are now no longer limited because he does not get exhausted as often as before.
“I would also like to extend my gratitude to the Government of His Majesty the Sultan and Yang Di-Pertuan of Brunei Darussalam, the Ministry of Health, as well as Gleneagles JPMC doctors and staff,” he added.
The surgical team involved in Awang Mumtazali’s procedure were: Dato Dr Isham Jaafar, Consultant Cardiothoracic Surgeon; Dr Eugene Sim, Chief of Cardiac Surgery; Dr D Moorthi, Consultant Anaesthetist; Dr Sofian Johar, Consultant Cardiologist; and Dr T Ganesan, Consultant Cardiologist.
The procedure was proctored by Prof Dr Jaap Lahpor from the Netherlands, one of the world’s most renowned surgeons in mechanical heart device implantations.
The surgery took six hours and the patient was then transferred to the ICU for monitoring and recovery. The patient is now mobilising with assistance and is able to walk with the help of a walking frame. Patients with LVAD implantation have been able to achieve a near normal lifestyle after surgery.
Prior to this, the team from JPMC underwent training in LVAD surgery and post operative patient in various places including Institute Jantung Negara in Malaysia under the guidance of Prof Dato Dr Ezani Taib.
Awang Mumtazali was selected through a rigorous process by a team of doctors from the Ministry of Health and GJPMC. Numerous tests were done including a right heart study and MRI of the heart to ensure suitability.
Awang Mumtazali was also screened by clinical psychologists and medical social workers. As the LVAD runs on rechargeable batteries, his house also needed to be inspected to ensure that that the electrical system and the wiring were suitable.
LVAD programme leader, Dato Dr Isham, looks forward to introducing this surgical option to more patients in the Sultanate.
Hailing the implantation of the LVAD as a significant milestone in the treatment of patients with heart failure, Dr Sofian said: “Before this option was made available, patients with severe heart could only be treated with lifestyle modification and medication or pacemaker/defibrillator devices, which were sometimes only partly successful.
“This device allows the patient to lead an almost normal life.
“With around 7,000 heart failure patients in Brunei, only a small proportion of them are suitable for this treatment. Patients with severely heart failure, we have no other options but to carry out this LVAD.
“In other countries, they carry out heart transplant. But as we don’t have heart transplant here, we … (carry out procedures to insert) the mechanical device. We anticipate three to five such operations here in the Sultanate provided they (the concerned patients) meet certain criteria.”
According to him, patients at GJPMC receive advance medical treatment comparable to developed nations.
With the LVAD procedure, Dato Dr Isham expressed his optimism that Awang Mumtazali would be able to support his family again and become the breadwinner.
The CEO of GJPMC, Dr Peter Tay and Chief of Surgery, Dr Eugene Sim, meanwhile, expressed their thanks to the Ministry of Health for their unwavering support, saying that the introduction of this cutting-edge surgical procedure is testament to the emphasis placed on healthcare and well-being of Bruneians by His Majesty.
Heart disease remains the leading cause of death worldwide. In Brunei, it is the second most common cause of death after cancer. The most common form of heart disease in the country is coronary artery disease, which is the blockage of the arteries supplying the heart.
Coronary artery disease has many causes including smoking, being overweight or obese, having high cholesterol levels, diabetes mellitus and adopting a sedentary lifestyle.
Heart attacks strike when the blood supply to the heart is blocked, causing damage and death of heart muscle. Often patients who survive a heart attack will suffer from heart failure subsequently as the heart is not pumping as efficiently as before.
There are an estimated 7,000 patients suffering from heart failure in the Sultanate. Coronary artery disease is the most common cause of heart failure but other causes include heart muscle damage from infection or drug abuse, hypertension, heart valve or thyroid diseases.
Patients with heart failure typically experience breathlessness on exertion, swelling on the lower limbs, fatigue and also breathlessness at night. In the later stages of this disease, the breathlessness may worsen and they may find difficulty even walking short distances.
Patients with severe heart failure have been treated with medications to control fluid balance, strengthen the heart and to treat underlying causes of the disease such as hypertension.
More recently however, mechanical devices have been implanted into patients with severe heart failure to assist the heart in its function of pumping blood.
The mechanical heart device was first introduced in the United States, and LVAD procedures have been done in other Asean member countries, including Malaysia and Singapore.