Multi-million-rand grant to fast-track heart valve research

The Chris Barnard Division of Cardiothoracic Surgery at the University of Cape Town (UCT) has received a multi-million-rand international research grant to fast-track the development of a novel surgical heart valve. It complements the existing transcatheter valve – and is designed specifically for young patients who suffer from rheumatic heart valve disease.

This condition affects patients who have suffered permanent damage to their heart valves. And it is caused by rheumatic fever – an inflammatory autoimmune response to untreated streptococcal infections (strep throat), which often affects younger populations in regions with limited access to advanced follow-up infrastructure.

Synthetic-leaflet heart valve

The division has now been awarded a R13 million grant from the Leducq Foundation – a non-profit organisation whose mission is to improve human health through international efforts and to combat cardiovascular disease and stroke. The grant will support the development of a synthetic-leaflet surgically implantable heart valve and follows in the footsteps of the transcatheter heart valve – designed by UCT spin-out company Strait Access Technologies (SAT). SAT is a Cape heart centre-based medical technology company led by UCT’s Emeritus Professor Peter Zilla and is embedded in the Faculty of Health Sciences (FHS).

“The commitment of one of the world’s most respected foundations signals continued confidence of the US research community in South Africa.”

“At a time when the Faculty of Health Sciences has lost approximately 40% of its grant income due to the withdrawal of the United States (US) federal funding, the commitment of one of the world’s most respected foundations signals continued confidence of the US research community in South Africa. This is both scientifically and psychologically important,” said Emeritus Professor Zilla.

Zilla and Associate Professor Jaco Theron will lead the valve design and development process. Both scholars are based at the Chris Barnard Division of Cardiothoracic Surgery; a division that already boasts an impressive track record in polymer-based cardiovascular innovation. Over the years, Zilla said, they have been committed to advancing a new generation of heart valve prostheses that offer improved durability and superior blood compatibility compared to conventional biological implants.

Translational research trajectory continues

According to Zilla, their efforts to develop the new heart valve demonstrates the division’s commitment to continue its translational research trajectory. This endeavour catapulted in 2012 with the launch of SAT. The business spearheaded synthetic leaflet transcatheter valve technologies to expand access to life-saving heart valve interventions, particularly in underserved populations, with limited access to open heart surgery. He said these technologies have advanced to early clinical application in sub-Saharan Africa. In addition, its endovascular platform has achieved regulatory clearance and first clinical use of the unique hollow-balloon catheters is taking place in leading centres in the US, including Harvard University and Jefferson University.

Since its inception, SAT has developed into a multidisciplinary organisation comprising over 60 engineers and scientists. To date, the business has attracted more than R500 million in funding.

“The [latest] funding from the Leducq Foundation supports a new iteration of UCT’s plastic heart valve concept, originally developed by SAT, and affirms its intrinsic health relevance beyond commercial considerations,” Zilla said.

Expanding the concept

Initially, the concept of the polymer-based transcatheter heart valve was developed to address a unique African clinical reality and improve the quality of life for African patients.

Zilla explained that African patients with rheumatic heart disease require valve replacements decades earlier than their counterparts in western countries. And conventional tissue valves, designed for older populations, don’t work as well because they degenerate rapidly in younger patients. This, he said, necessitates repeated high-risk interventions. But the synthetic-leaflet heart valve offers the potential of substantially improved durability.

“The support of the Leducq Foundation now enables the expansion of this project to surgically implanted valves – recognising its academic and societal importance in settings where limited commercial incentives have historically constrained innovation,” he said.

Supporting teaching and learning

Additionally, the research will be conducted as a complete academic initiative, rooted in the FHS, and will enable fundamental research, design optimisation and preclinical validation in a rigorous university setting.

“The close alignment between academic research and real-world patient needs – exemplified by SAT – has proven highly effective in engaging students. Through internships and thesis work, this model demonstrates that African universities can generate innovation and directly address the continent’s clinical needs.”

The current award will be structured as a pilot feasibility phase, with the objective of establishing key technical and translational milestones. Subject to its successful completion, the project will be positioned to form the basis for consideration of a substantially expanded funding programme in its subsequent phase.