MR Vindan Sahadevan, 46, knows he's one lucky man.

The father of two has survived four heart attacks in the last decade.

The latest one in April this year destroyed so much of his heart muscle that doctors had to implant a palm-size plastic pump to take over for his ticker.

Fortunately, a donor heart became available and in July, he had a transplant.

And again, he pulled through.

In fact, he has recovered so well that last month - less than three months after his discharge - he returned to his job as a lift technician.

Mr Vindan is one of just three people here who have successfully received a transplant after getting the heart pump, first used here in July 2001. And he is the only one of the three to return to work.

'Most people would have just died after the heart attack. For him to survive everything, he's really very lucky,' said one of his surgeons, Dr Lim Chong Hee, senior consultant at the National Heart Centre's cardiothoracic surgery department.

'Every step of the way, he was at high risk of death.'

The other two patients who got new hearts after using the pumps - a 64-year-old man and a 56-year-old man - both later died of pneumonia.

The heart pumps are used in patients suffering from an advanced stage of heart failure. They are designed to keep patients alive while they wait for a transplant.

The devices, which cost $45,000 to $120,000, work well for six months to two years, although one type has sustained patients overseas for as long as four years.

In five patients here, the pump gave their damaged hearts time to recover so that they no longer needed the pump, nor a transplant.

But despite the device, another 12 patients died of complications, mostly infection.

Mr Vindan suffered his first heart attack 10 years ago, after which he stopped smoking and took medication for high cholesterol.

But four years later, influenced by his colleagues, he started puffing away again.

His heart problems returned with a vengeance this year.

He had a heart attack in February, and then again in March. Both times, he underwent a procedure to unclog blocked arteries.

But in April, he collapsed. One moment, he was talking to his wife, the next moment, he felt pain in his chest and blacked out.

'It was one shot, bang. I knew I was in hospital only after two months,' he said.

In an emergency procedure, a team from the heart centre hooked him up to a machine that took over the functions of his heart and lungs.

Dr Lim and his colleagues then performed a heart bypass, but it did not work; too much of Mr Vindan's heart had been damaged.

The doctors implanted a heart pump four days later.

The pump, a plastic box about the length of a hand, was implanted under the skin of Mr Vindan's abdomen, and tubes running from it - like arteries - were connected to his heart.

'Mentally, I was in pain. I didn't know what to do,' he said. 'I was scared, and worried about my family, if anything happened to me. We prayed very hard that I could get a new heart.'

Mr Vindan and his 42-year-old housekeeper wife have a 17-year-old daughter and a 16-year-old son.

And in about 10 weeks, their prayers were answered.

He said: 'I'm very happy, and very grateful to the donor. Now, I've really got to take care.'

FIVE years after a heart pump was removed from his body, Mr Loa Nguang Peng is now working nine hours a day as a driver for a nursing home.

He has come a long way since 2000, when his heart began failing, leaving him breathless, in constant pain and barely able to walk.

While he was waiting for a transplant, doctors implanted a palm-size pump in his chest.

The device gave his heart time to rest and when it was removed 11 months later, Mr Loa, now 47, made medical history.

In September 2002, he became Singapore's first pump recipient to recover without a heart transplant. 

The time on the device allowed his heart to recover sufficiently to start beating on its own again. He spent about 19 months in hospital before he was finally allowed to go home.

The exact cause of Mr Loa's heart failure was not known, although a viral infection was suspected.

That turned out to be a saving grace; hearts damaged by viruses have a chance of recovery. But heart attacks usually permanently damage the muscle, said Dr Lim Chong Hee, senior consultant at the National Heart Centre's cardiothoracic surgery department.

Since his discharge, Mr Loa has been hospitalised only once, for three days over a leg injury that became infected.

He now sees the doctor every three months, and is on lifelong medication.

His cholesterol and blood pressure are well-controlled. But he is overweight at 103kg, something he attributes to genetics.

He said: 'I was very lucky to escape a heart transplant. Now I'm not what I used to be - I'm older, not as strong - but I'm doing okay.'

His heart's still going strong.

Source: The Straits Times © Singapore Press Holdings Limited. Permission required for reproduction.