A multidisciplinary team of ‘Heart and Brain’ Pleven performed a unique cardiac procedure for Bulgaria
A multidisciplinary team from the clinics of cardiology and vascular surgery of the ‘Heart and Brain’ Center of Clinical Excellence in Pleven, performed a unique procedure for the country for the placement of a resynchronizing pacemaker in a patient in whom surgical access by the classical route is impossible. The system was implanted through the left femoral vein (of the leg) instead of through the chest veins as in the standard procedure. The method has been applied only a few times worldwide and never before in Bulgaria, said cardiologist Dr Nikolay Petrov.
The procedure was carried out on a 65-year-old patient with lung cancer squeezing the chest veins to the point where the device could not be implanted. The man was admitted to the cardiology clinic with extremely slow heart rate and severely reduced pumping function of the left ventricle.
“In view of the lack of a standard medical approach to address the patient’s slow heart rate, we determined that a workable solution was to implant a pacemaker. There were two possible options for this – an innovative procedure where the implantation would be done through the femoral vein, and the second option was cardiac surgery where the electrodes would be implanted on the heart. Due to the patient’s severe general condition and his co-morbidities, we judged that general anaesthesia and cardiac surgery would be high risk,” Dr Petrov explained the details of the case.
Dr. Nikolay Petrov and Dr. Georgi Voynov managed to implant a resynchronizing pacemaker by inserting the three electrodes through the patient’s left femoral vein. A challenge in the procedure is the use of consumables and devices designed and adapted for implantation by a classical method – through the chest veins. The complex intervention lasted nearly two hours.
“The fact that no one in Bulgaria has experience with such a procedure did not prevent our team from making the only right decision in this case. I dare to say that in ‘Heart and Brain’, Pleven we have the knowledge, experience and high-tech capabilities to apply innovative procedures and surgeries that have the best effect and with the least risk for patients”, Dr. Petrov is adamant.