• A secondary two Chinese boy with heart failure went into cardiogenic shock, with heart function at a critical 10 to 15 per cent
  • Doctors at National Heart Centre Singapore (NHCS) saved his life with short-term life support system and heart-assist device
  • The heart-assist device will help to prolong and improve the young boy’s quality of life while he waits for a heart transplant
Doctors at the National Heart Centre Singapore (NHCS) saved Charles Choong, a 14-year-old boy with a mechanical heart-assist device known as HeartMate II on 14 September 2011. This makes him the youngest patient supported on the heart-assist device in Asia. With the heart-assist device, Charles will be able to return to school soon and resume his Dr Lim Chong Hee, Director, Heart and Lung Transplant Programme, NHCS said, “ECMO is a modified version of our heart-lung machine used in heart surgery. It takes over functions of the heart and lungs for up to several weeks. Since 2003, we have implanted ECMO as a resuscitative measure for over 210 critically ill patients. Functioning as temporary support, these patients have a chance to recover.”

Five days later, on 14 September 2011, the NHCS medical team implanted the HeartMate II LVAD in Charles. His condition stabilised a month later and he was discharged. “I feel a lot better now physically than before the implantation and would like to say a big thank you to the medical team at NHCS for their dedication and support,” said Charles Chong, Asia’s youngest patient on HeartMate II.

Dr Tan Teing Ee, Senior Consultant, Department of Cardiothoracic Surgery, NHCS who implanted the HeartMate II device in the boy said, “Charles had dilated cardiomyopathy. He was chronically short of breath even with light exertion for the past year. When he went into cardiogenic shock in September 2011, he would have died that same day if we had not implanted the IABP and ECMO. However ECMO is only for short-term support. We subsequently implanted HeartMate II, a heart assist device that can last for many years, and gives an excellent quality of life while he waits for a heart transplant.”

NHCS introduced HeartMate II in Singapore in 2009. The device with a much smaller pump is fully implantable in the patient’s body. Unlike the older generation of heart pumps, this makes it suitable for Asian patients with smaller build. It is also more durable and can potentially be used for chronic long-term support for patients with irreversible heart failure. The first case was done in May 2009 on a 32-year-old Malay lady. She continues to do well and has rejoined the workforce.

2011 marks the 10th anniversary of the NHCS Mechanical Heart Device Programme. The programme started in 2001 as a five-year pilot project funded by the Ministry of Health to support patients with end-stage heart failure for recovery or as a “bridge” to heart transplant. Prior to its inception, approximately 30 per cent of the patients died while waiting for a heart transplant due to lack of suitable heart donors. The same situation is faced by other countries as well. To date, 49 mechanical heart devices have been implanted including 15 HeartMate II. 

Celebrating its revolutionary journey, NHCS held an appreciation ceremony at the MEGU Event Hall at the Singapore Flyer on 22 October 2011. The event served to show appreciation to staff, patients and partners, who have played an important part in the programme’s success. The guest-of-honour, Mr Gan Kim Yong, Minister for Health, presented a token of appreciation to each of the 10 healthcare representatives. Over 120 attendees were at the ceremony.

As part of the programme lineup, heart patients shared anecdotes on their winning battle against a failing heart. They also staged a runway show to show their successful integration back to the society.

“Although Asia supports about 60 per cent of the world population, it only does about four per cent of the heart transplants. Whereas North America which has about eight per cent of the world population, it performs about 70 per cent of the heart transplants done in a year. Hence it appears that heart transplantation will not be the answer to patients suffering from end-stage heart failure. We are in fact going to see more and more patients living with mechanical heart devices in time to come,” said Dr C Sivathasan, Co-Director, Heart and Lung Transplant Programme, NHCS.

About the National Heart Centre Singapore
The National Heart Centre Singapore (新加坡国家心脏中心) is a 185-bed national and regional referral centre for cardiovascular diseases. A one-stop facility with the largest heart specialists group in Singapore, NHCS treats complex cases and sees the highest volume of heart patients locally.

Each year, the centre handles over 100,000 outpatient consultations, 7,000 interventional and surgical procedures and 10,000 inpatients. Its outcomes for heart attack treatment, balloon angioplasty with stenting and coronary bypass surgery have been shown to be equivalent to international standards.

NHCS is the first heart centre outside USA and in Asia to receive the prestigious Joint Commission International (JCI) since 2005, which is an assurance for safe and quality patient care for the patients.