For South African teen, the beat goes on
by Chris WestPublic Relations
It is not unusual to find Brett Kirsten, 17, keeping beat on the cymbals and toms of a drum set. But his drums belie the uncertain beat in his chest.
On May 30, MUSC physicians in the Children’s Hospital performed a delicate procedure so that now Brett’s only concern should be the music.
The
Kirsten family from left: Gail, Brett, Jessica and Mike.
Originally from Pretoria, South Africa, Brett was born with a congenital heart defect known as transposition of the great arteries and intact ventricular system. In this defect the arteries that carry blood to the lungs and body from the heart are reversed. Untreated, the condition is fatal.
The defect was discovered at birth, and it was decided that a balloon septostomy be performed. This allowed Brett to survive, functioning on 80 percent oxygenated blood, until he was older and strong enough to withstand open-heart surgery.
In 1985 at seven months of age, Brett underwent open-heart surgery in Johannesburg, South Africa, to repair the defect. The operation known as a Mustard Repair created an atrial buffer that redirected the blood flow through his weakened heart. Despite the setbacks, Brett was an active toddler, with a scar on his chest as the only evidence of his defect. But eventually one setback of the procedure would rear its ugly head when Brett was told he had a cardiac arrhythmia.
Brett’s weak heart was monitored at regular intervals through childhood and maintained satisfactory progress until July 1994 when he acquired a severe case of pneumonia. Due to the strain on his delicate heart, Brett arrested into congestive cardiac failure and as a result developed a very rapid heartbeat known as tachyarryhthmia. He was treated by electric shock therapy and medication to lower his racing heart, but in October 1995, he was still suffering from a chronic atrial flutter.
In 1998 Brett began to undergo a series of DC (direct current shock treatment) cardioversions in which electrical current is administered directly to the heart. This procedure temporarily stops the heart and interrupts all heartbeat impulses. As the heart begins to beat again, the normal circuit rhythm begins while blocking any abnormal impulses. In the case of Brett, five DC cardioversions from 1998 to 2000 would grant reprieve for a week or two but the arryhthmia would recur. With the medications Capoten, to lower his blood pressure and Cordorone, that blocks the generation of abnormal impulses, his pulse rate is at a resting 120 beats instead of 240. But even with this, the condition leaves Brett in a state of near constant fatigue.
In 2001 Brett’s primary caregiver, Dr. Solly Levin, M.B., recommended Brett travel to the United States for a procedure unavailable in South Africa. The Kirstens were told of a procedure known as radio frequency catheter ablation. In this procedure, multiple electric catheters are inserted into the heart through the veins and arteries of the groin and neck. Pacing from the catheters is used to induce a cardiac arrhythmia and a mapping procedure is done to determine the area of the heart muscles that is most critical to sustaining the arrhythmia. Once identified, radio waves are sent through the catheters that heats up the heart muscle, killing the cells in a small area and eliminating the tachyarrhthmia, in many cases permanently. The ablation procedure boasts a 90 percent success rate.
Levin approached Children’s Heart Program director Philip Saul, M.D. to perform the ablation procedure. In a letter to Mike and Gail Kirsten, Brett’s parents, Saul told the eager parents of the procedure and his recommendation that the surgery be performed.
“Here at the Medical University of South Carolina, we have a particularly large expertise with this procedure and are successful in more than 90 percent of cases,” he said. “...we will be able to dramatically change his life by eliminating his arrhythmia and enable him to come off of medical therapy.”
This began the arduous task of raising the funds necessary for the operation.
Back in South Africa, the Kirstens created the Brett Kirsten Heart Fund Trust that would hold the necessary funds for Brett’s operation. They began the fundraising in December of 2001 and projected a goal date of May 2002. What would transpire in that six-month fundraising period would be an entire South African community coming together for one of their own.
Addressing family, friends and the neighboring Pretoria community of Irene, the Kirstens started the fundraising. Local Irene radio stations beamed his message to the community and it began to react. Brett’s matric school, Cornwall College, and Lyttelton Manor High School, contributed through donations and a Valentine’s Day Ball in which all proceeds went to the trust.
The Irene Primary School donated funds from its casual day, as did Crawford College with its private donations.
But the sense of altruism had already begun to spread outside to the entire community of Irene.
South African Airlines donated four international business-class tickets to the United States, S.A.M. Engineering in South Africa made a healthy cash donation to the fund. Local writers plugged the fund and fundraising events in the community media and local restaurants held champagne breakfasts donating all the received funds. A concert and dance were held and donated proceeds as well. A gracious company that wished to remain anonymous donated a week’s stay at the Church Street Inn to accommodate the Kirstens during their stay in Charleston. Finally, a garden tea party was held in honor of the fund and was attended by more than 200 guests.
In May, with the necessary funds available to them, Gail, Mike, Brett and 12-year-old sister Jessica boarded a South African flight bound for the United States.
They arrived to the balmy Charleston weather on May 26, eager and anxious of the procedure that awaited Brett. The family would spend the first few nights at the Ronald McDonald House.
“It was an incredibly gracious effort that they put forward,” said Mike Kirsten. “They accommodated our entire family of four. It was quite unexpected.”
On May 30, the ablation procedure was conducted successfully at MUSC Children’s Hospital after nearly a 12-hour process. Brett was put under local anesthesia at 8 a.m. and came out at 6:30 that evening after a sedation period of 10 hours.
“Dr. Saul ablated the first arrhythmia that he encountered only to have another small one pop up,” Kirsten said. “But that one was also located and ablated and Brett’s heart rate is now at a good rhythm.”
With the successful procedure behind them, the Kirstens are going to spend the next week setting out and seeing some more of the Lowcountry and checking back in with Saul to monitor Brett’s post-operative condition. Brett said he was feeling much better after the procedure but confessed “I am definitely ready to get back home.”
And while it was a long and arduous task to come here and have the procedure done, the Kirstens feel that with the operation complete and successful they have a new promise of hope for their son. They are also convinced after having come to MUSC, “we came to the best as far as we’re concerned.”
Now hopefully the only beat that the family need be concerned with is
the beat of a drum instead of a heart.