Author: BCI

The Vascular Surgery Clinic of the high-tech ‘Heart and Brain’ Pleven celebrates its sixth anniversary. The bottom line is nearly 10 000 patients treated, more than 7 100 surgical interventions performed and a place among the three best vascular clinics in the country.

“We have extremely committed and dedicated doctors, nurses and staff who care for patients. Forming and stabilizing a vascular surgery clinic takes time. Over these six years, dozens of young colleagues – the next generation of vascular surgeons – have been trained at , Heart and Brain. Together we have walked this path and today we deservedly are one of the best clinics in the country”, says Dr. Todor Samardzhiev, head of the clinic. He is convinced that a good name is built not only with daily work, but also with constant upgrading of experience and knowledge.

In addition to excellent specialists, the clinic has one of the best facilities in the country, which is in no way inferior to the best clinics in the world. Patients have at their disposal all modern possibilities for diagnosis and surgical interventions of vascular diseases – open surgery, endovascular interventions and conservative treatment.

A team for endovascular surgery has been formed under Dr. Samardzhiev’s leadership – the preferred method of work of modern specialists due to the possibility of applying sparing, bloodless manipulations and faster recovery of patients. Prevention of diabetic foot complications by endovascular procedure prevents and postpones amputations of fingers and limbs in time. The combination of the different treatment approaches guides the team’s work and achieves long-term improvements in patients’ health and lives.

Only doctors nominated by their patients for their extensive expertise, high standard of work and humane treatment make the prestigious list

Nearly 300 doctors across the country who have earned the trust of patients will receive their certificates. Their names have been collected in the almanac “Doctors We Trust” and the theme this year is “Medicine: the Trend and the Bulgarian Experience”.

In the specialized edition are included 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.

Here is a complete list of the BCI specialists featured in Doctors We Trust 2023:

Dr. Yordan Valeshkov, MD – orthopedist and traumatologist in ‘Heart and Brain’ Pleven;
Prof. Dr. Branimir Spasov, MD – hematologist at ‘Heart and Brain’ Pleven, Head of Clinic of Clinical Hematology;
Prof. Dr. Yana Simova, MD – Cardiologist at ‘Heart and Brain’ Pleven, Head of the Cardiology Clinic and Executive Director of the Bulgarian Cardiology Institute;
Dr. Elitsa Becheva-Kraichir, MD – specialist in medical genetics at ‘Heart and Brain’ Pleven and MC “European Cardiology” – Sofia, head of the medical genetics laboratory;
Dr. Yordan Krasnaliev – cardiac surgeon at ‘Heart and Brain’ Pleven, head of the cardiac surgery department;
Assoc. Prof. Dimitar Kharitonov, MD – neurosurgeon at Heart and Brain Pleven, Head of the Clinic of Neurosurgery and Spinal Surgery at Heart and Brain Hospitals and Head of the Department in Pleven;
Prof. Dr. Plamen Bozhinov, MD, PhD – neurologist at ‘Heart and Brain’ Pleven, head of the neurology clinic;
Dr. Svetlana Nyagolova – radiologist at ‘Heart and Brain’ Pleven, head of the imaging department;
Dr. Rumen Lazarov – radiologist at ‘Heart and Brain’ Pleven, head of the radiotherapy department;
Assoc. Prof.  Natalia Chilingirova, MD – Oncologist at ‘Heart and Brain’ Pleven, Head of the Medical Oncology Clinic;
Dr. Velimir Simov, MD – pediatrician at the clinic for maternal and child health ‘Mom and Me’, part of the high-tech hospital complex ‘Heart and Brain’ Pleven. Head of the Pediatrics Clinic;
Dr. Andrey Hristov – neonatologist at the clinic for maternal and child health ‘Mom and Me’, part of the high-tech hospital complex ‘Heart and Brain’ Pleven. Head of the neonatology department;
Dr. Vladislav Genov, MD – anaesthesiologist at ‘Heart and Brain’ Pleven, Head of the Department of Anaesthesiology and Intensive Care;
Dr. Valentin Hristov – invasive cardiologist and executive director of the Hospital of Cardiology and Anesthesiology Pleven;
Assoc. Prof. Dr. Lilyana Mircheva, MD – cardiologist at ‘Heart and Brain’ Burgas, head of the cardiology department;
Dr. Tony Statelov, MD, – urologist at ‘Heart and Brain’ Burgas, head of the urology department;
Assoc. Prof. Dr. Vladimir Kornovski, MD – cardiac surgeon at ‘Heart and Brain’ Burgas, head of the cardiac surgery department;
Assoc. Prof. Milko Mirchev, MD – gastroenterologist at Heart and Brain Burgas, head of the gastroenterology department.

“For us it is an honour and a great recognition – valuable because it comes from our patients”, said the leading specialists of ‘Heart and Brain’ Pleven and Burgas.

“The quality of medical care, the respect for the patient, the constant upgrading of knowledge and skills, the cooperation with doctors from different specialties are the basis of this success.”

Just four months after opening, the team at the country’s newest maternal and child health clinic “Mama and Me” welcomed its 100th baby. The baby girl was born on October 11 and is the first child in the family of a young couple originally from Pleven, who successfully made it abroad. The parents decided to have the little lady in their homeland and chose “Mama and I”. The birth was led by Assoc. Prof. Yordan Popov – Head of the Obstetrics and Gynecology clinic, Dr. Majed Alkara, obstetrician-gynecologist together with the neonatology and anesthesiology team. The baby and the mother feel well, the proud dad has been by their side since the first day, the specialists said.

“We are happy with all our babies born so far. We are glad that more and more parents choose the clinic for one of the most important moments of their lives. We take this trust as the most accurate assessment of our work, and we thank you,” said the team.

The clinic is also proud to have begun expanding its existing medical genetics laboratory by introducing technological capabilities for molecular genetic diagnosis of rare diseases in children. The team, led by a medical genetics expert with experience from Germany, now conducts specialized medical genetics consultations for children and families.

Patient aged 41: “The cardiac surgeons restarted my life completely, I’m now living fully”

Assoc. Prof. Kornovski, according to the National Health Insurance Fund, Heart and Brain Burgas is the leader in cardiac surgery and the first choice of patients in the country for 2022. Tell us a little more about the experience of the clinic.

Assoc. Prof. Vladimir Kornovski, MD: There is undoubtedly no more impartial and accurate testimonial to the professionalism of the teams of the modern hospital complexes in Burgas and Pleven. As the head of the Cardiac Surgery Clinic, I am extremely proud of the results achieved and the trust gained. Since the launch of ‘Heart and Brain’ the standard in valve pathology has been the minimally invasive surgical approach. Over 90% of our valve operations are performed in this way. Standard access to the mitral and tricuspid valves is endoscopic through a 3-4 cm skin incision. Recently, the clinic has also been performing total endoscopic aortic valve replacement through a 4 cm incision – just enough to pass the implant. Currently 92% of mitral valves are also reconstructed minimally invasively, which is in line with European statistics. It is important to note that in mitral valve disease, our primary goal is to preserve the patient’s own valve, i.e. to perform a valve reconstruction or repair, this is the “gold standard” in global medical practice. But it should also be known that not every valve can be reconstructed, especially when valve changes cause stenosis. In our clinic, for patients with degenerative mitral insufficiency (mitral valve prolapse), we use a technique with so-called neo-chords (special sutures) to restore normal valve closure without the need to cut any part of the valve.

I greatly appreciate the knowledge and experience of our team – Dr. Peter Uzov is a highly specialized heart surgeon who operates entirely with a minimally invasive approach and has mastered the techniques to perfection. We approach all patients with left coronary artery disease with a minimally invasive approach (MIDCAB), performing the surgery on a beating heart without cutting the sternum. Also, this method is part of the so-called hybrid revascularization, in which the left internal carotid artery is used for bypass to the anterior descending artery, and a stent is placed in the remaining coronary arteries by an invasive cardiologist. This requires excellent collaboration with the invasive cardiologists, which is routine in our practice and we achieve excellent results. Last but not least, I would like to share that my entire team at the clinic is training and upgrading their knowledge in minimally invasive cardiac surgery on a daily basis. At ‘Heart and Brain’ Burgas we are creating a school for our future followers to learn from.

Dr. Uzov, how does minimally invasive surgery work?

Dr. Peter Uzov: In all minimally invasive procedures, the heart is accessed through a small incision on the side of the chest or in the upper part of the sternum. During part of the surgery, the function of the heart is taken over by a heart-lung machine that maintains the normal functioning of all the organs in the body. Endoscopic (minimally invasive) surgery uses a thin, high-resolution video camera that is inserted through a small incision in the chest. With this camera, every part of the heart can be visualized, even many times better than with the open approach. The surgeon reconstructs the valve using endoscopic instruments, the operation is performed through a working channel of about 4 cm. After the intervention, rehabilitation begins as early as possible with the patient standing up a few hours after the operation. After the stay in intensive care, the patient spends several days in the cardiac surgery unit, where his condition is constantly monitored by telemonitoring. Before discharge, patients are completely independent and do not need specialized care. A week after leaving the hospital they have no restrictions and can return to their usual activities, work and sports. We return fulfilled people to their families.

What are the benefits of minimally invasive heart surgery?

Dr. Peter Uzov: The minimally invasive approach is appropriate for any patient with valvular disease; there are very few limitations that we exclude when we admit the patient. The valve surgery is the same as the patient receives in open surgery. The advantages are: no pain, significantly less blood loss, lower risk of surgical wound infection, shorter hospital stay, quick recovery and return to normal activities and last but not least, a better cosmetic result.

Dr. Uzov, we have been contacted by your patient Miroslava Mikhailova, who is only 41 years old and was operated by you with a minimally invasive technique. In her words – you have saved her from disability and “restarted her life completely”. She described you as an outstanding doctor and expressed her immense gratitude to the clinic and to you personally. “If I didn’t know I was being operated on, I wouldn’t have known in any way. I am living fully again and feel wonderful,” she said. Please tell us more about her case.

Dr. Peter Uzov: Miroslava came to the clinic with Barlow’s disease, a heart condition that occurs in young people. It is a prolapse of all segments of the mitral valve and high-grade insufficiency, which requires complex valve reconstruction. In Miroslava’s case, the complex valve reconstruction was performed completely endoscopically. The intervention went smoothly and at the very first follow-up she felt excellent. I am happy to hear her high evaluation.

I recommend that anyone who has complaints of palpitations or shortness of breath have their heart checked for structural disease by echocardiographic examination. My observations are that Bulgarians are a patient people and tend to neglect their cardiac discomfort for years. It is important to know that if heart surgery is done in time, the life of those operated on is no different from that of healthy people. After endoscopic heart surgery is performed, patients can play sports again within just a week after being discharged from the hospital.

Assoc. Prof. Dr. Vladimir Kornovski, MD: Since we are talking about Miroslava, who is a very young woman, I would like to give an example of a case of a significantly older patient that we operated on with Dr. Uzov. He is 84 years old and he underwent a total endoscopic aortic valve replacement. The patient was contraindicated for TAVI and was offered endoscopic minimally invasive surgery. Recovery was similar to the TAVI intervention. Surgery was performed on a 4 cm access port. The patient was ambulated 4 hours postoperatively with no restriction in movement. He is currently discharged and enjoying a normal lifestyle.

Assoc. Prof. Kornovski, do patients need to pay extra for minimally invasive surgery?

At Heart and Brain, all cardiac operations, including minimally invasive ones, are fully covered by the NHIF and I stress that patients pay absolutely nothing extra.