Month: July 2023

The team says that with this new step, the high-tech hospital complex already has all the valves available for transcatheter implantation. This allows for the most suitable valve to be selected for each patient according to their anatomy

Aortic stenosis is a disease in which a narrowing of the valve, which is located at the outlet of the heart, develops. Until recently, the only method of treatment for this valvular malformation was surgery. For several years, as an alternative for high-risk patients, non-operative transcatheter aortic valve implantation (TAVI) has been used, which is performed through a small opening in a peripheral blood vessel. This method is routinely applied in ‘Heart and Brain’ Burgas and Pleven.

In TAVI, two basic types of valves are implanted – self-expanding and balloon release. So far, valves of the first type have been used, but in the last three patients a new type of balloon-release valve has been implanted.

The interventions were performed by a multidisciplinary team including the invasive cardiologists Dr. Plamen Penchev and Dr. Krasimir Trifonov, as well as the cardiac surgeons Assoc. Prof. Dr. Vladimir Kornovski and Dr. Petar Petrov. One of the leading European specialists in this field, Dr. Daniel Unic from the University Hospital “Dubrava” in Zagreb, Croatia, was also involved as a consultant.

The full article is available here in Bulgarian.

Rapid intervention and teamwork of cardiac surgeons, invasive cardiologists, resuscitation and imaging specialists saved a human life through a hybrid method of aortic vessel debranching, extra anatomical bypass and TEVAR (endovascular implantation of vascular prosthesis).

A 64-year-old patient with acute dissection (wall rupture) of the distal aortic arch and the descending aorta was admitted as an emergency to Heart and Brain Burgas.

The Heart Тeam was quickly built – Assoc. Prof. Dr. Vladimir Kornovski, Head of the Cardiac Surgery Clinic, Dr. Plamen Penchev, Head of Invasive Cardiology, and Dr. Tsvetan Gradinarov, Head of Cardiac Resuscitation, decided that the patient was indicated for an emergeny hybrid procedure – aortic arch debranching and TEVAR.

Read the full story here in Bulgarian.

When it comes to cancer, most of us think of patients at a very advanced age, usually retirement age, who have been exposed to harmful factors for many years – in their personal and professional lives. Recent epidemiological data from countries in the European Union and the United States over the last 2-3 decades show a worrying steady trend of increasing numbers of cancer patients at a much younger age – so-called adolescent and young adult (AYA) cancers. The concern is not only medical and scientific, but also social and economic.

These are people aged between 15 and 39 (by definition, adolescence covers the teenage years, and young adults are those in the third and fourth decade of life), who according to population data comprise approximately 40% of the world’s population.

After a gradual increase in the number of newly diagnosed cancer cases in AYA in recent decades, these patients currently (2023) represent about 4% of all new cancer cases in countries with high socioeconomic standards. This implies the occurrence of 50 000-70 000 new cases of AYA cancer in Europe per year (according to EUROCARE-5). The good news is that cancer mortality in this age group does not follow the trend of incidence. Five-year survival in Europe for the most common tumours is around 87% (calculated for 30 187 cancer patients treated between 1994 and 2002, according to data from 83 cancer registries in 23 European countries). Unfortunately, Bulgaria is among the EU countries with the most negative indicators in this category, with one of the highest AYA mortality rates in Europe (ca. 11 per 100,000).

The full analysis is available here in Bulgarian.

Fluids should be taken even at times when we are not thirsty, so that we can keep our body hydrated, thus subjecting ourselves to less stress. More tips from cardiologist Dr. Ventsislav Grigorov in the interview.

an interview with Dr. Elitsa Becheva-Kraichir

During their studies, future doctors learn some basic rules about cancer, which each of them, regardless of their specialty, will inevitably encounter professionally and, unfortunately, often personally. The first thing medics understand is that this is not a single disease, but is one of the largest groups of diseases in modern man. What these diseases, also called malignant neoplasms or neoplasms, have in common is the abnormal and uncontrolled growth of various cells in the body that have the potential to invade (penetrate and take over) the structures around them and spread to distant parts of the body.

In recent decades we have learned that cancer has a genetic basis – it is linked to various errors in the genetic information of the cell. Doctors know that this usually happens as a person’s body ages, under the influence of harmful external factors, over a long period of time, when our defence mechanisms become “tired”.

Then, spontaneously, a series of somatic DNA mutations occur in a cell and it transforms into a cancer cell. Because of this, the doctor expects to diagnose cancer at an advanced age of the patient – after the sixth or seventh decade. Medical textbooks teach that cancer can be detected in younger people, but very rarely (in up to 5-10% of cases), and then the specialist must suspect an inherited predisposition to cancer due to germline (inherited) mutations. These basic principles of cancer development are the basis of the mass screening and prevention measures offered by health systems around the world, with the commonality of starting at a specific but more advanced age (e.g. after the age of 50 (an exception is made for hereditary forms).

The full article is available here in Bulgarian.

This week marks the 75th anniversary of the introduction of the Beveridge model (named after its author), which established a state monopoly over the UK’s healthcare system and central funding through the public purse. A rare paradox – at the heart of the world’s cradle of modern industrial and finance capitalism, a retrograde system of national centralised and state monopolised healthcare (the NHS) continues to languish. In my view, the NHS is a bigger and worse long-term mistake of generations of British politicians, and even of otherwise intelligent voters, than Brexit voted 7 years ago. The anniversary provides an excellent opportunity to acknowledge the truth about Bulgaria and look forward.

Taking away the right of private hospitals to use the public resource, forcibly collected from the whole population, is the grossest form of violation of the right to choice and basic human rights – the right to life and medical care.

See the full analysis here in Bulgarian.

Recently published scientific data reveals an alarming trend of increasing colon cancer cases under the age of 50. This represents a serious health and socio-economic problem. Early colorectal cancer differs from ‘classic’ later cases in terms of its epidemiological and pathological characteristics, as well as its metabolic and molecular genetic features. Increasingly, different teams of scientists are concluding that changes in the gut microbiome are involved in the development of colorectal cancer at an early age. This is shared by Dr. Lidiya Dimova, a specialist in molecular genetics and oncogenetics at ‘Heart and Brain’ Pleven. She has extensive experience in research on the impact of the microbiome on individual susceptibility to some of the most common diseases in the elderly – cardiovascular disease, cancer and diabetes, and in developing strategies for practical application of the findings in clinical practice. “Our genetics laboratory team is in constant contact with the world’s leading centres and is very motivated for great development,” she says.

The original article is available here in Bulgarian.

A specialised ambulance and a team from the Maternal and Child Health Clinic ‘Mama and I’ travelled from Pleven to Sofia to take two children in life-threatening condition and treat them back in Pleven. The little patients, a boy and a girl aged two months, were initially admitted to the neonatology ward of the state-run specialist children’s hospital in Sofia. Due to the inability of the hospital in Sofia to provide them with the necessary intensive monitoring and care and with the argument that they have already exceeded the age for neonatology, they turned for assistance to their colleagues in Pleven. The doctors from Pleven set up an organization and the children were transported urgently and placed in the intensive care unit of ‘Mama and I’, where the head of paediatrics, Dr. Velimir Simov, and his team took care of them.

The children were diagnosed with hypoxic-ischemic encephalopathy, an impairment of brain function due to reduced oxygen flow to the brain, and with oesophageal atresia, a condition in which the oesophagus does not connect to the stomach, but ends in a “blind pouch” and the ingested food cannot reach the child’s stomach. The rich clinical experience of the Pleven pediatricians, the high-tech equipment with the most advanced capabilities to support and preserve the life of children makes ‘Mama and I’ the only place in the country where adequate intensive, long-term and free care can be provided for children with such severe diagnoses.

“At ‘Mama and I’ we work well with colleagues from all over Bulgaria, no matter whether the hospital is private, municipal or state-owned. We do not hesitate to provide transport and medical team at our own expense, to travel to the farthest point of the country to help our children,” said Dr. Velimir Simov. He specified that the case with the children from the Children’s Hospital in Sofia is not the first for the paediatricians of ‘Mama and I’. Just a few days ago the team in Pleven had also provided assistance to their colleagues from ‘Maichin Dom’ hospital, and young patients from the National Cardiology Hospital in the capital are to be transported to the clinic.

The original article is available here in Bulgarian.