Transplant trailblazer Chris Barnard, the Karoo lad who became the world's most famous cardiac surgeon - and broke hearts as well as mended them - died alone in a foreign land, aged 78.
He suffered an asthma attack at a resort on Cyprus, but did not have his asthma pump at hand. Doctors had warned him he faced death if he did not carry his pump at all times.
Barnard, who was on a business trip to Cyprus, suffered the attack shortly after a swim in the hotel pool at the island's western resort of Paphos. A manager at the Coral Beach Hotel said Barnard had collapsed while reading one of his own books.
A doctor in the hotel tried in vain to revive him.
His agent, Walter Lutsehinger, said: "It was always his biggest fear was that he would die like that."
This fear was so great that when Lutsehinger and Barnard went to meet former Russian president Mikhail Gorbachev, Barnard had insisted on turning back to fetch his asthma pump, which he had left in his hotel room.
Susan Vosloo, cardiac surgeon, chairperson of the Organ Donor Foundation and a friend of Barnard, said she had seen him shortly before his departure to Cyprus and apart from asthma, he appeared well.
Barnard had gone to Cyprus on business connected to his work with his charity, the Christiaan Barnard Foundation in Austria.
"I am really shocked at his sudden passing. We lost someone who made the greatest contribution to medical history. We will remember him as a brilliant and innovative mind," Vosloo said.
Barnard's elder daughter Deirdre , 51, from his first marriage to Louwtjie Barnard , said his death came as a surprise.
"We are all shocked by the news. It was unexpected," she said.
She confirmed Barnard had been battling with asthma but had appeared "very fit" during his visit to South Africa last month.
"He was exercising regularly and seemed full of energy. We suspect that the hot weather in Cyprus brought on the asthma attack," she said.
Barnard's third wife, Karin, whom he divorced last year, was too upset to talk to the press, a relative said.
Tributes poured on Sunday night. Nelson Mandela said: "His death is a great loss to the country after all the contributions he made. He was also very vocal against apartheid."
President Mbeki's spokesperson, Bheki Khumalo, described Barnard as a symbol of excellence and humanism.
Khumalo said the president was shocked to learn that South Africa had lost a person who was dedicated to serving others.
"South Africa has lost a great man who made an outstanding contribution to the country," he said.
Health Minister Manto Tshabalala-Msimang said in a statement that her department recognised the significant contributions he had made to the advancement of medicine and the medical profession in both South Africa and throughout the world.
Groote Schuur spokesperson Philippa Johnson said the hospital had produced many exceptional leaders in medical science - one of the most remarkable was Barnard.
"In the course of his work he became famous as a practical surgeon and teacher. He inspired and taught many surgeons from all over the world."
SA Medical Association president Bernard Mandell, who knew Barnard , lauded him as the first to have the "courage" to go ahead with a heart transplant.
Although others had the technology, they had lacked the courage and held back, he said from East London.
Describing Barnard as an extrovert with an "exceptional personality", Mandell said the medical association was immensely proud of his achievements.
He said it was odd Barnard had never been awarded a Nobel Prize. But Barnard had once admitted to him that had he been offered a choice between a gorgeous woman and the Nobel Prize, he would have chosen a woman.
Barnard's funeral arrangements have not yet been finalised, but he is to be buried in South Africa.
Barnard leaves his first wife Louwtjie and daughter Deirdre and his sons Frederick and Christiaan, from his second wife, Barbara Zoellner, and his youngest son Armin, 11, and daughter Lara, 4, from third wife Karin Setzkorn. Barbara Barnard, later Da Silva, died of breast cancer in 1998 at 48 and his eldest son, Andre, committed
suicide in 1984.
Fame and publicity and Barnard's self-confessed weakness for women led to the split in his first marriage to Louwtjie.
Barnard and Louwtjie had married in 1948. Deirdre was a Springbok waterski champion, and Andre a
doctor.
Barnard married Barbara Zoellner, daughter of Johannesburg industrialist Fred Zoellner, in 1970, when the surgeon was 48 and Barbara was 19.
Barnard was notorious for a string of sexual liaisons, which he described in detail in his autobiography The Second Life.
In 1989 Barnard married 23-year-old model Karin, 41 years his junior.
Referring to his penchant for younger women, he once said in an interview: "Why eat biltong when you can have fillet steak?"
Sapa reports Barnard, who had carried out more than 160 life-saving
operations, retired from active surgery in 1983 because of arthritis, but his efforts to save lives did not cease.
The Chris Barnard Foundation, set up in Austria, was dedicated to promoting paediatric medicine throughout the world.
The foundation facilitates medical care and operations for sick children from developing countries.
In the most recent case, Barnard stepped in earlier this year to facilitate an operation at Cape Town's City Park Hospital for a two-year-old Russian boy with a congenital heart problem. Gleb Evdokimov's operation was courtesy of a joint effort by the foundation and hospital surgeons led bySusan Vosloo.
Barnard was among three men honoured on Men's World Day last year.