Category: News

Every 10 seconds, two people get diabetes and one person dies from the disease. In Bulgaria, according to statistics, about 500,000 people suffer from diabetes, and 40 per cent of them do not know and are diagnosed too late. Regular self-monitoring is what reduces the complications of diabetes by 35%. That is why it is especially important to have preventive checkups with an endocrinologist, and for patients diagnosed with the disease – periodic checkups with a specialist – endocrinologist are imperative at least once every 6 months and even more often”, advises Dr. Silvia Ganeva, Head of the Endocrinology Department at ‘Heart and Brain’, Pleven. The high-tech hospital is celebrating World Diabetes Day, November 14, with a Diabetes School “How to live with diabetes mellitus”.

“For four weeks, diabetics and their loved ones had the opportunity to meet and talk with the hospital’s endocrinologists. The educational lectures and hands-on activities covered several main topics: ‘What is diabetes’, ‘How diabetes works, chronic complications’, ‘Diet or just healthy eating combined with an active lifestyle’ and ‘Modern treatment options for diabetes mellitus’. The aim is to be useful to people with the knowledge and experience we have, as well as with tips for a healthy lifestyle, prevention and early diagnosis of the disease,” says Dr Ganeva. She points out that there is a genetic predisposition to develop diabetes mellitus in many families, but the main risk factors are excess body weight, low physical activity, overnutrition and chronic stress. In the presence of first-degree relatives with diabetes mellitus, prevention, early diagnosis of the disease and timely treatment are very important to avoid the development of chronic complications. It is the chronic complications such as stroke, myocardial infarction, coronary artery disease and chronic thrombosis of the lower limb arteries that cause earlier and higher mortality among diabetic patients compared to other population groups.

“Today, health professionals, patient and community organizations are making a concerted effort in developing strategies for screening, prevention, early treatment and control of those with diabetes mellitus. The main goal is to improve the medical and social care of people suffering from this chronic disease and to reduce the societal costs of treating the clinically manifest complications”, said the Heart and Brain, Pleven.

Every year, the World Health Community marks 14 November as a day to fight diabetes, a chronic disease that occurs with elevated blood glucose levels. It has been identified as socially significant due to the high frequency with which it occurs. The day was first celebrated in 1991 under the auspices of the WHO, and in 2007, by a special resolution, 14 November was officially recognised by the United Nations. The choice of date is linked to the birthday of Frederick Bunting, who together with Charles Best made the epoch-making discovery in the treatment of diabetes mellitus – insulin.

A rheumatology consultation service, where modern diagnostics and treatment is carried out, is now available to patients in ‘Heart and Brain’ Pleven. The consultation is open every Tuesday and Wednesday from 09:00 to 12:00, the rheumatology clinic informed. Examinations and consultations are carried out by Dr Nikolov after an appointment.

More information about Dr. Martin Nikolov can be found here.

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.

The panel is part of the European Medicines Agency’s (EMA) Expert Council for Medical Devices

Prof. Dr. Iana Simova is the Executive Director of the Bulgarian Cardiac Institute. She is a cardiologist, leading specialist in echocardiography, head of a scientific group on post-COVID syndrome; she is involved in comprehensive investigation, diagnosis and treatment of patients with syncope (transient loss of consciousness), including telemedicine and telecardiology, cardiac stress testing, analysis of vascular function. She has held leadership positions in the European Society of Cardiology and the European Cardiovascular Imaging Association. She has received numerous awards for scientific achievements, including the prestigious High Scientific Achievement Award of the Union of Scientists in Bulgaria. A renowned lecturer and professor, editor of six journals, with over 350 scientific publications.

After an election in August this year and among more than 30 candidates, Prof. Iana Simova was elected chair of the thematic panel “Circulatory System” of the Expert Council for Medical Devices of the European Medicines Agency (EMA). Her mandate is for three years and will end in 2026. Her medical expertise will be applied/useful in the sub-group “Active implantable cardiac devices and electrophysiological devices”. The Medical Expert Panel consists of recognised leading scientific experts appointed by the European Commission, on the proposal of the Medical Device Coordination Group (MDCG), based on their scientific, clinical and technical expertise in different medical fields and specialties. The expert panels currently number more than 200 experts in 12 different panels. They are orthopedics, trauma, rehabilitation, rheumatology; circulatory system; neurology; respiratory system, anesthesiology, critical care; endocrinology and diabetes; general and plastic surgery and dentistry; Obstetrics and gynaecology, including reproductive medicine; gastroenterology and hepatology; nephrology and urology; ophthalmology; in vitro diagnostic medical devices and expert screening group to assess the need for scientific opinions.

EMA’s thematic panel on the circulatory system also includes 27 experts from different nationalities, led by Prof. It has five sub-groups:

1. Active implantable cardiac devices and electrophysiological devices
2. Cardiac Surgery
3. Cardiovascular stents (metallic and bio-resorbable) and vascular prostheses
4. Prosthetic heart valves and devices for heart valve repair
5. Structural interventions and new devices

Prof. Iana Simova is the only representative from Bulgaria not only for the thematic panel “Circulatory System”, but also for the entire EMA Expert Council for Medical Devices, as well as the only woman elected Chair in the twelve expert groups.

The event is a collaboration with the University Clinic Stolzalpe, one of the largest orthopaedic clinics in Austria

A course on ‘Problematic Primary Knee Joint Endoprosthesis’, brings together orthopaedic surgeons from across the country in Pleven this week. The organizer of the event is the orthopaedics and traumatology clinic of the high-tech “Heart and Brain”, which is a pioneer in the country in this field.

“The event is a collaboration with the University Clinic Stolzalpe, one of the largest orthopaedic clinics in Austria and a centre where a significant proportion of revision surgeries for knee pathology with problematic endoprosthesis are performed. Guest lecturer and course operator is Dr. Oliver Jahani. Within two days, a program with maximum efficiency has been organized – lecture and discussion part, we have also included two thematic elective surgeries”, informs prof. Asparuh Asparuhov, head of the orthopaedic clinic. He commented that most of the cases, the subject of the course, are in elderly patients who have neglected the problem for years for various reasons, including financial ones. The delay in treatment usually leads to severe deformities and this subsequently requires the insertion of additional implants to the prosthesis in order to compensate for the orthopaedic defect.

The course for the problematic primary knee joint arthroplasty is part of the policy of the Orthopaedics and Traumatology Clinic of the Heart and Brain Hospital to continuously train medical professionals and upgrade knowledge by introducing the best modern technologies.

My name is Rositsa Atanasova and I would like to express my gratitude to some exceptional professionals – my surgeon Assoc. Prof. Dimitar Haritonov and his right hand in this process – Dr. Alan Ibrahim Mohamad,  and their neurosurgery team at the Heart and Brain hospital.

I spent six months unsuccessfully seeking treatment, met with many doctors… I had a problem was my right arm, which was blocked, and for me, as a passionate hairdresser, it was very hard. For my lucky God met me in time with these wonderful people and extraordinary specialists, without whom I would still be wandering around the offices, which in the end would have been disastrous for my arm.

After neck surgery vertebrae with a pinched nerve, made by Assoc. Prof: Haritonov, I feel wonderful and moving my arm. Two hours after the operation I was on my feet and with happy smile on my face!

Thank goodness we have you to help those in need! May God keep you!

Genetics plays a vital role in the field of paediatrics, providing valuable insights into the origins and development of many childhood diseases. A series of analyses conducted over the years at the Cleveland Clinic Children’s Hospital (Ohio, USA) have shown that in nearly one-third of young patients, chronic and frequent hospitalizations were associated with a subsequently identified genetic condition. Although no official statistics are kept in Bulgaria, paediatricians at the Maternal and Child Health Clinic ‘Mama and I’ have similar observations. They say that their immediate collaboration with the specialists from the genetics laboratory at ‘Heart and Brain’ is an invaluable asset for their clinical practice. Working together allows them to diagnose faster, more accurately and provide personalized treatment approaches for their young patients.

When should we seek a consultation with a medical geneticist?

Consultation with a physician geneticist is advisable even before planning a pregnancy, as the primary goal of genetics is to prevent or predict potential genetic diseases and conditions through the information we obtain from a family tree or genetic analyses performed.

Every person carries genetic variations associated with some disease. Usually people do not know they are carriers of an inherited genetic disease because they have no symptoms and are healthy. They only find out after they produce offspring in which one or more children develop signs of some disease. Rarely, this happens when the second parent also carries the same (or similar) genetic variations. Genetic analyses can be performed before, during and after pregnancy, with earlier diagnosis providing more opportunities for targeted action.

With a mission to provide high quality genetic analyses and to support expectant parents with innovative solutions, the genetics laboratory of ‘Mаma and I’ is a leader in the field of molecular genetics and medicine in Bulgaria. The highly qualified team of specialists, advanced technology and ethical approach can benefit all expectant parents and families.