Category: News

Assoc. Prof. Haritonov, why did you decide to devote more time to the patients in Burgas?

I am honoured to be able to contribute to improving the quality of healthcare in Burgas. My decision is based on the desire to provide high quality neurosurgical care to the people of the region and to support the development of medical services here. I see great potential and am convinced that I can help many patients.

What innovations do you plan to introduce in the hospital in Burgas?

-I believe that modern medicine requires continuous improvement and adaptation of the latest technologies and methodologies. I plan to introduce minimally invasive surgical techniques and robotic surgery, both in spinal and cranial surgery, which will reduce recovery time and improve treatment outcomes. I will also work on creating multidisciplinary teams to provide comprehensive patient care.

We already have enough experience and expertise and my teams are the first to apply these innovative treatment methods and most importantly, they are now available in our country thanks to the super modern equipment of the Heart and Brain Hospitals.

People suffering from oncological diseases, degenerative diseases of the spine, vascular diseases of the central and spinal cord, as well as those with traumatic injuries or congenital malformations will receive adequate, high-quality and highly specialized neurosurgical health care at the Heart and Brain Hospital Burgas.

We are talking about an extremely minimally invasive method, where the patient does not feel any pain and can return to his normal rhythm of life hours after the procedure. The indications for the application of this method are mainly aimed at patients up to 45 years of age. The method is mainly recommended for the initial stage of disc disease. The intervention is performed in an operating room, but in practice it is an injection. The injection is placed directly into the nucleus of the intervertebral disc itself, where the appropriate amount of discogen is inserted under X-ray control. Half an hour after the procedure, the patient can get up and move around on his own without the need for any aids. The only restriction is the refinement of physical exertion within 3 to 4 weeks after the procedure. Discogel treatment has been successfully applied in the USA and Europe for several years and now also in our country. At this stage ‘Heart and Brain’ is the only one in Bulgaria where the innovative treatment is available.

– What does disc disease represent?

– Disc disease (discopathy) is one of the most common diseases in human pathology, the main symptom of the disease being recurrent neck, back and low back pain. Usually, the pain is provoked by exertion, sudden movement, weight lifting, cold, and intensifies with movement. At some stage in the development of the disease (onset of disc protrusion or herniation) the pain begins to radiate to the arms and legs, sometimes with numbness and weakness. Diagnosis is made after examination by a neurologist and conducting so-called neuroimaging studies – X-ray, CT scan and MRI. It should be borne in mind that a simple X-ray cannot prove the presence of a protrusion or hernia. For this, it is necessary to conduct a computed tomography or, preferably, an MRI, which has the highest diagnostic value.

– Can everyone develop disc disease or are there more vulnerable groups of people?

-Absolutely anyone can at some stage in their life face this health problem. Disc herniation is one of the most common causes of back pain. It can form between any two vertebrae of the spine and at any age no matter the gender. Since this problem is associated with wear and tear of the discs, its occurrence is typical in people with occupations involving a lot of physical exertion, also in people with frequent injuries. Apart from systematic strain and wear of the discs, the problem can occur after sudden movements or strain that cause tearing of the fibrous ring.

In rare cases, disc herniation is due to congenital anatomical features of the spine.

– How does disc disease manifest itself in its early stages and which symptoms indicate that the disease is progressing?

– In its early stages, disc disease presents with pain in the spine that “descends” to the tailbone. It manifests with prolonged standing upright or with prolonged sitting. In older patients, this problem is also due to the so-called aging process or disc degeneration. The strength of the ligaments decreases and a seemingly small effort or rotational movement can cause a disc rupture.

– What more serious complications can result? Which of these cases in your practice can you share?

– Disc disease cannot lead to serious complications as it is a chronic relapsing disease and develops slowly unless there is a traumatic moment. So, if the patient hasn’t been paying attention for a long time and hasn’t been treated – then he comes to us in a pretty severe condition. After proper surgical intervention, this problem naturally gets under control. So again we come to the most natural and correct advice – seek medical help on time, before the onset of complications.

– From your observations in practice, could you tell us: are patients with this health problem increasing and is there a change in the age limit?

– There has definitely been an increase in the number of people with this health problem in recent years, and I can say that the age limit is dropping dramatically. We have had cases of operating on patients at the age of 19-20 with disc herniation, and this was not the case 10 to 15 years ago. I explain this fact by heredity, which is often underestimated as a factor, and the other by improper lifestyle and improper physical activity.

– What is your vision for the development of neurosurgery in Bulgaria?

– My teams in Pleven and Burgas work exactly as they work in the big university clinics in Europe and the USA. I have personally convinced myself during my visits to Switzerland, Germany, Great Britain, USA, etc. Their knowledge and skills are world class. Leading neurosurgeons who have chosen our clinics to present new technologies and innovative approaches regularly come here for inspections. For us, every method we apply must be as atraumatic as possible and the possibility of a rapid recovery for patients is paramount. We believe that only with appropriate investment in training and technology can we maintain a high standard of quality health care. It is important that we encourage young doctors to specialise in this field and provide them with opportunities for professional development.

– What would you like to say to the patients in Burgas who hope for your help?

-It is very important and a matter of honour for me to build trust and be there for them in every step of the treatment. My team and I will work hard to improve the quality of life of our patients.

Thanks to the expert knowledge and skills of specialists, modern equipment and multidisciplinary approach, the high-tech hospital complex ‘Heart and Brain’ in Burgas provides comprehensive care for patients from all over Southeastern Bulgaria

A young patient with abdominal bloating is admitted to the gastroenterology clinic of Heart and Brain Hospital in Burgas. From the examinations carried out – scanner and endoscopy, the doctors found a particular form of oncological disease affecting the stomach, namely non-cohesive carcinoma. At the time of diagnosis the cancer was at an advanced stage, unsuitable for surgery. The doctors immediately sent all the tests for an opinion from an oncology committee.

Two days later, on the eve of May 24, the patient suddenly became short of breath and had palpitations. The cardiology specialists at ‘Heart and Brain’ determined that it was pulmonary thromboembolism, the second leading cause of sudden death after heart attack. A scan confirmed massive bilateral pulmonary thromboembolism.

Given the patient’s condition and the newly diagnosed gastric carcinoma, the invasive cardiologists undertake fragmentation and thrombus extraction (breaking up and removing) of the massive amount of thrombi over a two-hour period. The entire procedure takes place without any blood loss, and the aspirated blood is filtered and returned to the patient’s body. During the procedure, the source of the pulmonary thromboembolism is also identified, namely a venous thrombosis in the patient’s abdomen. Given the location and presence of residual venous thrombosis, an empty vein filter is also implanted to protect the patient from a life-threatening recurrence of pulmonary thromboembolism. The entire vein cava filter extraction, fragmentation and implantation procedure is painlessly performed completely bloodlessly and percutaneously and the patient is fully conscious.

Due to the contraindications and polymorbidity in the young patient, the specialists cannot apply fibrinolytic therapy, which is the gold standard. Therefore, the physicians undertook an unconventional multidisciplinary approach that combined the capabilities of the cardiologists, cardiac surgeons and vascular surgeons teams, and yielded an excellent outcome for the young man.

The first course in minimally invasive gynaecological surgery at the Heart and Brain Hospital in Pleven marks the start of the only Training Centre of its kind in Bulgaria. It will take place on 6 and 7 June 2024 and is under the ‘GESEA4EU’ programme of the European Union and the European Association of Gynaecological Endoscopy.

During the two days, for the first time, 10 gynaecology specialists from Southeast Europe will undergo a theoretical part, live demonstrations and a training part on simulators and boxing simulators, under the guidance of Dr. Alexander Lyubenov, MD, Head of the Gynaecology Department, and Dr. Atanas Alexandrov, Obstetrician-Gynaecologist at ‘Heart and Brain’ Pleven, as well as mentors from a certified diploma centre of the programme in Naples.

The aim is to broaden the knowledge and skills of the young specialists in the field of laparoscopic and hysteroscopic gynaecological surgery and to acquire an internationally recognised European certificate.

The idea is that in the future the Training Centre will also offer courses in other specialties such as urology, surgery, orthopaedics, gastroenterology, and the interest from specialists from South-East Europe is enormous. There have also been many enquiries from international students.

The parient, Dimitar Dimitrov expresses his gratitude to the doctors from both wards after the complicated operation

“I came back to life”: a multidisciplinary team of electrophysiologists and thoracic surgeons at ‘Heart and Brain’ Burgas helped a patient with life-threatening arrhythmia

Dimitar Dimitrov calls April 2nd “The day I came back to life!”. This is the day the specialists carried out the final stage of treatment for his life-threatening arrhythmia. They surgically sever the nerves that stimulate the heart and cause it to go out of rhythm. The team is led by Dr. Dimo Mitev and Dr. Nedyalko Dragnev.

Up to this point, the patient had experienced the encounter with death almost daily – his heart worked in a chaotic rhythm and only the electrical impulse from the defibrillator implanted in his body saved him. The implantation was carried out by Dr. Mihail Protic, a doctor with serious experience in charge of electrophysiology at the high-tech hospital complex. Without this device, Dimitri would have lost his life in a second.

Dr. Protic: “A patient was admitted to us with dilated cardiomyopathy, severely depressed cardiac function, an implanted cardioverter-defibrillator resynchronization therapy system and multiple recurrent ventricular tachycardias leading to seizures with activation of the implanted defibrillator. In this patient, we performed catheter ablation, which was able to achieve a significant reduction in cardiac arrhythmia episodes but not complete suppression. According to the state-of-the-art treatment recommendations, a surgical intervention, bilateral sympathectomy, is performed in addition to catheter ablation.”

Dr. Mitev: “The last stage of Dimitar’s treatment was in the thoracic surgery department. It took place surgically. In patients with a resynchronizing pacemaker, it is very dangerous to use a monopolar, and in some cases, when close to the heart, a bipolar current. In this case, it was extremely dangerous because of the high frequency of defibrillations required.  For maximum patient safety, we used high-energy ultrasound equipment at every stage of the operation. The outcome of the procedure exceeded even our wildest expectations. Compared to the daily “restart” of the heart by the implant prior to surgery, the patient has not had a single ICD defibrillator activation in the last 40 days.”

“Patients indicated for ICD-defibrillator implantation have rhythm-conduction disorders and are at risk for abnormal heart rhythms. They have had a heart attack, have a weak heart, or have inherited heart disease,” explains Dr. Protich. “The ICD is as big as the face of a smartwatch. Once implanted under the skin, usually on the left side of the chest, it detects and regulates abnormal, life-threatening rhythm-conduction disturbances and can prevent fainting, even sudden death.”

“If you have an abnormal heart rhythm that the device determines to be dangerous based on established algorithms, it will respond to return the heart rhythm to normal. This may involve receiving an electrical impulse, as in CPR,” the electrophysiology specialist explained. “Rather than being applied externally, the pulse is delivered from the implant into the body immediately. This helps save lives.”

Many of the patients of , Heart and Brain’ Burgas suffer from cardiovascular diseases. The hospital employs some of the best electrophysiologists on the Balkan Peninsula, such as Dr. Mirazciiski, Dr. Protic, cardiologist Dr. Dimov and cardiologist-specialist Dr. Anastasov. This is the only electrophysiology center in Southeastern Bulgaria and provides access to the most advanced treatment of rhythm-conduction disorders. “Instead of patients having to travel periodically to Sofia, ‘Heart and Brain’ provides all care related to the implanted devices here in Burgas. Long-term follow-up is also important because many patients need device-related care for years. We ensure continuity of care: we know the patient before implantation and communicate closely with them and their treating cardiologists afterwards.”

Some of these devices don’t just prolong life expectancy, they also improve its quality. This procedure is minimally invasive and low-risk. In cases such as Dimitri’s, close collaboration between multiple specialists is extremely effective and has the added benefit of improving patients’ quality of life. Video-assisted thoracoscopic sympathectomy has also recently been performed at the hospital to improve the overall treatment outcome for complex and life-threatening arrhythmias.

Habilitated pediatricians and medics to the people

The main question nation before the nation is when will we reduce record infant mortality and very high overall mortality? When will we stem the deepening demographic crisis? Can we achieve good health care without competition on quality and without patients having a wide choice of where to be treated?

The launch of the multi-profile high-tech ‘Mama and I’ non-children’s private hospital in Sofia and the construction of the state-run National Children’s Hospital (NCH) in Gorna Banya go hand in hand towards the solution and are part of the right answers to these questions. So the parties should ask and listen to the voters, who know that no country in the world has achieved high-quality healthcare on its own. This is as true in autocratic regimes as it is in a political democracy with a market economy. It is only possible when domestic investors are not driven away, because without them, foreign investors don’t come either. It is possible when competition on quality is encouraged and the right to a wide range of patient choices is ensured.

How exactly is the ‘Mom and Me’ project in Sofia preventing the state from “standing its ground” as President Radev wants? We are developing a very young workforce in the state-of-the-art newly built ‘Mama and I’ maternal and child health clinic in Pleven. We accept the most difficult and severe cases. Treatment of children is free of charge. We work on the same undervalued paediatric pathways and show that with good management a paediatric clinic can exist without permanent state subsidies, and when they are provided to the state, they should be there for the private ones, because we treat Bulgarian children too!

Therefore WE ARE FREE TO TELL THE TRUTH: We are not serfs to be “pulled”, “(under)dragged”, “booked” or “taken over”, nor can paid consultants or landed gentry foundations advise us on the feudalisation they serve! Why, being against ‘Mommy and Me’, did the opposition not and have not created cadres for so many years so far? How and why are they reserving cadre potential in deficit for future hospitals for after 6 or more years? The modern medicine we practice is an applied and team science – in constant powerful development. Clearly the opposition is serving competing and other conservative vested interests, orchestrating the blockade of metropolitan patients and suppressing honest competition.

Since Glavchev has repeatedly admitted that Decision No. 318 of 30 April this year was legal and correct, and was indeed adopted according to the established procedure, with a previously published agenda of the Council of Ministers, should the people now tell the parties – should the laws be respected in our European republic, or are we going to listen to self-appointed foundations, networks, platforms and esnafs who scream that the decision was “taken in the dark” and “not coordinated” with them? The exercise of state protectionism in Sofia healthcare and the blocking of patients’ access to quality competition are only the visible dimensions of the double standards in the ‘deep state’. That is why Prime Minister Glavchev refuses to meet, and there is no help for the children who are treated in the private ‘Mama and I’!

The voters should tell the parties that before there are students and teachers at the May 24 celebrations, there must be healthy children and healthy parents. Before we can have a fighting army we must raise healthy children and have enough qualified and motivated medics in the country as well as engineers, pilots, accountants. And how will all this be achieved without , Mama and I’ and without the NDP, and without competition on quality in health care, and without adherence to professional medical standards? The incumbent ‘savants’ and populists did not create the cadres, but drove them out, they do not treat children, and infant mortality is skyrocketing, they serve feudalization against competition, they cannot build modern hospitals, and they do not give the proven investors to build in Sofia – because nowhere in the world the state alone can do everything!

Since the president has no right to interfere in the work of the government, and the prime minister has no right to divide hospitals according to their ownership and children into assisted and abandoned again, let all parties in Sofia ask their voters in election meetings and assemblies:

Do you want a new modern multi-specialty hospital in Sofia to improve the quality of health care? Without it, will the 50 per cent of empty beds in the country’s largest city be filled and how will the severe shortage of staff be overcome? Can a blockade of the capital city and the elimination of quality competition reform and develop healthcare? Do we want to treat our children and families in Romania, Turkey and other private clinics abroad? With ‘Mama and I’ in Sofia, will more young doctors and nurses stay in Bulgaria and more return from abroad?

At ‘Mama and I‘ we invest in the long-term training and development of our specialists.

The full interview can be seen here in Bulgarian.

The birth of every child is a period filled with anxious anticipation and excitement. But when a newborn is one of around 6,500 premature babies born in Bulgaria each year, staying in intensive care is a huge emotional challenge for the whole family. Parents often feel confused and frightened by the long hospital stay. Kangaroo care plays a key role in these moments.

Originating in 1970 in Bogotá, Colombia, it has seen a rapid rise and is gaining popularity among modern professionals. Kangaroo care is a globally recognized practice through which contact is made between parents and the newborn admitted to an intensive neonatal care unit. Through numerous studies, it has been established that mother-baby (or dad-baby) contact is not just a hug, but a set of multiple beneficial effects that follow from these contacts.

Since the opening of our newest maternal and child health clinic ‘Mama and I’ one year ago, a dedicated kangaroo room has existed in the neonatology department – an integral part of the holistic care we aim to provide to our young patients and their parents. Once premature (and sometimes “normally” delivered) newborns are removed from the intensive highly specialized environment, a kangaroo room is provided for parents. It is useful for both the baby and the parents, who are given the chance to be part of the hospital stay and actively participate in their child’s upbringing.

Here, through the advice and practices of the medical professionals, not only are parents educated in the care of their children, but a strong and meaningful bond is built, often practicing the kangaroo-contact right down to the couch itself. On a daily basis, the midwives and doctors help the mother with advice related to breastfeeding, daily toileting and individual features related to the child’s condition. We welcome and encourage the equal participation of both parents as a unit, and increasingly actively involve the dad in the overall care of both premature and term babies.

The Kangaroo Corner of ‘ Mama and I’ implements world-renowned recommendations and builds confident and calm parents who will provide better quality care for their children. In this room we have successfully completed the diagnostic and treatment process and care for the youngest patients born with us and in Bulgaria in general – Sashko weighing 630 grams, Petya weighing only 600 grams, Rayan…. and many other children who are now healthy and with their parents.

The fine size of the equipment allows the diagnosis of some rarer conditions in the pancreatic duct

Since the end of April 2024, the Gastroenterology Clinic at ‘Heart and Brain’ Burgas has a cholangioscope. This is a thin endoscope that is inserted into the bile duct and allows accurate diagnosis of biliary tree tumours as well as extraction of concrements by laser destruction.

The fine size of the device also allows it to enter the pancreatic duct, which can diagnose some rarer conditions of this important and sensitive organ.

“The cholangioscope enables the clinic’s gastroenterologists to perform a complete diagnosis of biliopancreatic diseases. This type of research and diagnostics is unique for the region of Eastern Bulgaria” – reports Assoc. Prof. Mirchev.

We are happy to announce the global achievement of Prof. Iana Simova and her team in the field of clinical trials!

In the middle of last month a research team led by prof. Iana Simova, successfully randomized the first global patient, marking a key milestone in clinical trials.

This success earned them a prestigious place in the global pharmaceutical giant Novo Nordisk, which honoured them for their dedication to advancing the treatment of chronic diseases.

Undoubtedly, Prof. Simova and her team are distinguished by their dedication to the advancement of medicine, holding leading positions in patient recruitment and for various other clinical trials, related to cardiovascular disease. Their outstanding professionalism and unwavering dedication continue to support innovation in medicine and bring hope to patients around the world.

“We are a highly sought-after center and an extremely desirable partner in conducting clinical trials, both by leading, established and emerging pharma industries as well as by CRO companies. We are typically among the first companies with patient enrollment, we very often recruit the most participants not only in Bulgaria, but also in Europe and worldwide. Auditors are delighted with us, we even had an inspection by the FDA, and the agency was impressed with  our good organization”, said prof. Simova. “When it comes to innovation, development of medical science and new opportunities for patients, with us”NO” is not an answer!”.

Two days ago, PM Glavchev promised BGN 1.3 million of targeted state aid for the existing state paediatrics in Sofia

Mr Prime Minister, it is commendable that the government has decided to allocate funds for the children of Bulgaria. But state financial aid should be distributed equally among all medical institutions – whether they are state, private or municipal – it is enough that you have identified the acute needs for improvement. And that is why you should visit all paediatric clinics as you go – in Sofia and across the country – because you are the Prime Minister of the whole of Bulgaria and because all of us across the country are treating Bulgarian children. We in Pleven, it is well known, accept the worst cases!

In all Bulgarian paediatrics we need constant modernization of equipment, new investments in continuing education of our specialists, including specializations and gaining experience in the best clinics abroad. Because we all treat the children of Bulgaria and our goal is common – the constant improvement of the quality of treatment and health care for all our Bulgarian children.

Mr Prime Minister, the inequality in your actions makes your otherwise solemn words “the priority of priorities is the health of Bulgarian children” lighten when you visit one hospital and only give it targeted state financial aid! This course of leadership of the state and health care is one-sided, divisive and empty.

I fought my way, through recommendations from Germany and France, to work in one of the most modern hospitals in the Balkans, where we treat the most severe cases from Sofia, North and South Bulgaria, including individual patients from all Balkan countries, but even in my department we need to upgrade the existing high-tech equipment to deal even more successfully with orthopedic and traumatic diseases in small patients. You can probably imagine that if we left these malformations and abnormalities after puberty, we would not have fully fledged young people, neither soldiers nor accountants.

When will you visit us in Pleven – we made a public invitation to you already on May 4 – we will be glad to acquaint you on the spot with our plans for development and the need for new investments in order to make the most rational use of the state aid which is due to us on an equal footing. Because – you have said – you understand that the health of Bulgaria’s children is of the utmost political, social and economic importance for the nation, so that we have healthy citizens tomorrow – teachers, doctors, police officers, administration and civil servants in all sectors.

Mr. Prime Minister, it seems that this most important topic – “priority of priorities” – will haunt you for the rest of your term, and its resolution will determine how you yourself will remain in history as Prime Minister of the Motherland.