Month: August 2023

A 46-year-old man with symptoms of a myocardial infarction was admitted as an emergency to ‘Heart and Brain’ overnight and was seen by Dr. Halit Choban and Dr. Martin Koreykov. Already in the emergency room the patient fell into clinical death. A resuscitation team was immediately assembled.

“We immediately started full resuscitation measures, including over 30 defibrillations and cardiac massage for an hour and a half. We placed a temporary pacemaker,” said Dr. Nestor Petrov, a resuscitation physician. After stabilizing vital signs, the team of Dr. Kamelia Krasteva, an interventional cardiologist, performed an emergency coronarography with ventilator and placed two stents.

After one week of treatment in the intensive care unit and cardiology clinic, the patient was discharged with preserved heart pump function and no complaints.

Despite modern methods of diagnosing and treating ischaemic heart disease, the mortality rate from acute coronary syndrome remains high, mainly due to patients’ neglect of symptoms and late seeking medical help. Acute myocardial infarction can also affect patients at a young age, so prevention and timely medical care are particularly important.

The Comprehensive Cancer Centre at ,Heart and Brain’ is the only one of its kind in the country and increasingly preferred by Bulgarian and foreign patients.

Radiosurgery is a bloodless medical method, a type of radiotherapy in which high single doses of precisely focused external ionising radiation are applied to a small volume of the body. In radiosurgery, the goal is to achieve a “surgical” result (hence the name), but without direct access, no anesthesia, no incisions or stitches, and no pain. The method blocks pathological processes and “eradicates” malignant growths in the diseased tissues. After radiosurgery, tumor cells gradually die and malignant tumors shrink or disappear, with their place partially taken by connective tissue. This bloodless alternative to standard surgical interventions treats not only oncological diseases (malignant tumours and their metastases) but also a range of non-oncological diseases – benign tumours, vascular and functional conditions such as neuralgia.

In the last 8 years (since 2015), especially after the reimbursement of the method by the NHIF, radiosurgery is becoming more widespread. Since 2021, , Heart and Brain’ has been operating a unique high-tech centre for the most precise radiotherapy and radiosurgery at a level only offered by world-leading centres in the USA and Western Europe.

The full article is available here in Bulgarian.

In the operating theatre, the team found that the cause of the massive bleeding was an advanced tumour formation in the pelvis

A multidisciplinary team from the urology and surgery clinics performed a unique life-saving operation. The case is extremely rare and probably unique in the country, the specialists said.

The patient was admitted to the urology clinic of ‘Heart and Brain’ in Burgas in hemorrhagic shock and life-threatening bleeding. Thanks to the adequate and timely intervention of the doctors from the anesthesiology and resuscitation clinic, the patient was stabilized and immediately referred for surgical treatment.

In the operating room, the team determined that the cause of the massive bleeding was an advanced tumor formation in the small pelvis that was affecting a large arterial vessel (iliac artery). Doctors were able to control the bleeding, which saved the patient’s life. The multidisciplinary team includes Dr. Tony Statelov – head of the urology clinic, urologists Dr. Angel Kirov and Dr. Alexander Dimitrov and surgeons Dr. Ventsislav Krusharsky and Dr. Zornitsa Rusinova. All the necessary care has been taken for the patient so that he could successfully go through the difficult recovery period. This extremely difficult operation, which lasted more than 8 hours overnight, was successful thanks to the highly qualified medical staff and modern equipment at ‘Heart and Brain’.

The son of an 89-year-old woman, a patient of ‘Heart and Brain’ Burgas, tells about his family’s excellent impressions of the work of the specialists, the organization and the conditions in the high-tech hospital center of clinical excellence.

The full article is available here in Bulgarian.

A multidisciplinary team of invasive cardiologists and cardiac surgeons at ‘Heart and Brain’ helped an 83-year-old patient from Gabrovo, admitted to the hospital in Pleven with serious narrowing of the heart vessels, to lead a normal life again. The highly theological treatment applied gives a chance to people who otherwise would not endure open heart surgery, informed the head of the department of invasive cardiology – Dr. Pavlin Pavlov.

The 83-year-old man was admitted to the hospital with complaints of shortness of breath and chest pain when performing minimal physical effort. The symptoms had been progressively increasing, and over the past month had also limited his ability to self-care. The situation became a problem for him and the patient’s family. In the tests performed at ,Heart and Brain’, the specialists found that the man had serious narrowing of the heart vessels, with massive calcium deposits that made it impossible to implant a stent. The patient also had a narrowed aortic valve.

“The usual method of treatment for these diseases is surgery, but our patient’s disabled condition and advanced age make such surgery high-risk. Therefore, after analyzing the situation together with prof. Iana Simova – Head of the Cardiology Clinic, and Dr. Yordan Krasnaliev – Head of the Cardiac Surgery Clinic, we made the decision to apply a bloodless method of treatment, which is more sparing for the patient, but therefore technically more difficult. Stents were gradually implanted in the vessels of the heart using a rotabulator – the high-tech device is used in many hardened arteries and is the only alternative for their treatment. In a second stage, we treated the narrowed heart valve using the TAVI method, where the valve is introduced to the heart through the leg artery, using a small incision,” Dr Pavlov explained about the treatment process.

The patient was discharged on the third day after the procedure with improvement, no shortness of breath and able to return to his normal lifestyle.

The 75-year-old German citizen was discharged in good condition after a short stay at the high-tech hospital

A 75-year-old German national was admitted as an emergency to , Heart and Brain’ with the complaints of persistent headache, dizziness and difficulty walking. After consultation with a specialist, she was admitted to the neurosurgery clinic.

The patient underwent all the necessary investigations, and the result of a scan showed a brain tumour with a rare localisation and the appearance of benign (falx meningioma), measuring 7 cm. This type of tumors make up about 8% of the meningioma population. The patient was transferred to the operating room where a team of neurosurgeons with Dr. Plamen Simeonov as the lead operator performed a complete removal of the brain tumor under microscopic and neuronavigation control.

The operation went smoothly and the tumor was removed without any complications. The histological result confirmed that the tumor was benign of this type. After a short postoperative stay, the patient was discharged with improved general condition and hemodynamically stable and afebrile.

Physicians from across the country are honored in the annual “Doctors we trust” Almanac for 2023. Among them are the names of 19 specialists from Heart and Brain Pleven and Burgas and the specialized cardiology hospital in Pleven. The prestigious ranking includes only doctors nominated by their patients for their extensive expertise, high standard of work and humane treatment.

The national campaign “Doctors we trust” is an annual initiative of the newspaper “24 hours”. In addition to a prestigious ranking, the almanac is also an accessible navigation for the scientific interests and achievements of the best doctors with their current positions and contacts.

Excellent outcomes and approach to patients were confirmed in FDA report

Second place in the world for care and follow-up of patients in a clinical trial is another recognition for the Cardiology Clinic of , Heart and Brain Hospital’. The high ranking comes exactly two years after the clinic began participating in a number of clinical trials in 2021. The success was reported by prof. Iana Simova – Executive Director of the Bulgarian Cardiology Institute and Head of the Cardiology Clinic at ‘Heart and Brain’ Pleven.

The clinical trial covers patients with established vascular disease who, despite drug therapy, continue to have high cholesterol values. Lowering LDL-cholesterol has been shown to reduce the risk of death, myocardial infarction, stroke and peripheral vascular disease. Patients should therefore be carefully monitored to select the most appropriate medication. If LDL levels remain high on the background of antilipid therapy, an upgrade of therapy is necessary. CETP inhibitors aim to block cholesterol ester transfer protein, which will result in a reduction in bad cholesterol levels and an increase in good cholesterol. This would avoid future cardiovascular events. All this with just the addition of one tablet daily to the concomitant therapy. Through their active work, Prof. Dr. Yana Simova’s team, composed of cardiologists and nurses, provided round-the-clock access to medical care for the enrolled patients, ensuring the possibility of new treatments and last but not least – contributed to the development of science.

“The good results are based on the dedication of the team, continuous communications and international meetings in order to exchange experiences, as well as on the good organisation in the follow-up of the patients – all visits ensure a comprehensive examination, and further tests and consultations are carried out on site if necessary. This is also possible thanks to the fact that the Centre is part of the Heart and Brain Hospital, where multidisciplinarity and high technology are at the heart of patient care”, said Prof. Simova. Thanks to its continuous work and development, the centre has already established itself as a leader in a number of clinical trials.

The good results and excellent approach to patient have been inspected and confirmed by the FDA (US Food and Drug Administration), the world’s most prestigious institution for quality and safety control related to public health.

A 74-year-old patient from Gabrovo with severe abdominal pain and general impairment was admitted to the Vascular Surgery Department of ‘Heart and Brain’ on an emergency basis. After a contrast scan, a rupture (tear) of an abdominal aortic aneurysm was found. This is a life-threatening condition in which a large amount of blood pours into the abdominal cavity and the only treatment is surgical intervention.

The risk of a fatal outcome in classic open surgery for ruptured aneurysm is over 90%. Endovascular aortic aneurysm repair (EVAR) is routinely performed at Heart and Brain Hospital in Pleven, both in elective and emergency patients. The challenge in this case is that the aneurysm involves both renal arteries and the main artery feeding the bowel, and therefore standard endovascular surgery cannot be applied. The only option is to insert a fenestrated endograft, which is not available in the country and whose cost exceeds BGN 70 000.

After a lengthy analysis and a consilium between doctors from different fields, the specialists decided to apply a new approach for our country – a personalized and physiologically modeled prosthesis. This technique has been applied only once in Bulgaria, but not in emergency conditions.

With a series of measurements and precise calculations, vascular surgeons modify the implant for the specific needs of the patient through 3D imaging, followed by the fabrication of the fenestrations (holes) of the endoprostheses in a sterile environment, through which blood supply to the vital organs is ensured. This is followed by the extremely delicate process of inserting stents into the renal arteries and the mesenteric artery (the artery that supplies blood to the intestines). The operation is minimally invasive, lasting 10 hours. Through a small incision in the femoral arteries, under X-ray control in a hybrid operating room, the vascular surgery team was able to save the patient’s life. This highly complex, complex and multi-step procedure requires careful advance preparation, a lot of knowledge and additional skills of the doctors.

“We can count on the fingers of our hands the hospital centres around the world that have successfully implemented this type of surgery. The fabrication of a finished custom prosthesis would take a lot of time and money. Thanks to the teams of ‘Heart and Brain’ and my colleagues from the capital – Dr. Nikola Kolev and Dr. Dimitar Nikolov, we successfully modified an existing graft, which is covered by the NHIF. The patient was in good general condition, up on his feet the very next day,” said vascular surgeon Dr. Todor Samardzhiev, who supervised the surgery.