Category: News

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.

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.