Emergency cardiac care

Belarusian cardiologists work real miracles. What transformations in the medical sector does government support prompt?

About fifty heart transplants per year, the latest minimally invasive and hybrid technologies, the most complicated surgeries, high-precision diagnostics — which are implemented and available in our country — allow saving a lot of patients, prolonging their lives and making them as comfortable as possible.

Belarus' Cardiology Republican Scientific and Practical Centre  In the photo: Dmitry Goncharik, X-ray endovascular surgeon Daria Titova

Catching arrhythmia by the tail

Until the age of 53, Svetlana, a resident of Grodno, did not even suspect that she had a severe congenital disease — arrhythmogenic cardiomyopathy (ACM). The insidiousness of this pathology is that it may not manifest itself in any way for a long time, except for periodically increasing shortness of breath. However, Svetlana also had sudden fainting spells. As the rest of the story will show, it was this fact that triggered a chain of events that eventually saved the woman’s life.
“Our colleagues from Grodno carried out all possible medical diagnostic procedures at the regional level, but no alarming changes were found on the cardiogram. The ultrasound of the heart also turned out to be normal,” recounted Candidate of Medical Sciences, Associate Professor Dmitry Goncharik, Head of Arrhythmology Department at the Cardiology Republican Scientific and Practical Centre (RSPC). “However, the doctors were alarmed by the fact that the patient repeatedly lost consciousness. It was decided to send her to our centre for examination. Thanks to this, Svetlana got to the operating room on time, and the doctor, X-ray endovascular surgeon Andrei Tsyrkunov, conducted a complex diagnostic study and established the arrhythmic cause of fainting — ventricular fibrillation. This is the most dangerous condition of all arrhythmias, which could lead to death at any moment.”  
“We decided to implant a special pacemaker in the patient. This device has the function of a stun gun: it ‘charges’ the heart muscle when the heart beats too slowly while the rhythm reaches 200-300 beats per minute. The built-in device causes a discharge and restores the normal functioning of the heart muscle. The operation was performed in a new hybrid operating room, which began functioning at the Cardiology RSPC in 2023. I would like to add that around 4,000 pacemakers are implanted in Belarus every year. Domestic technologies help people to return to a full-quality life,” Dmitry Goncharik summed up.
“I still can’t believe that the terrible time of heart attacks, when I was afraid to fall asleep and not wake up, is over,” Svetlana confessed. “Many thanks to the doctors of the Cardiology Centre, their golden hands and caring attitude to patients — they treat not only with deeds, but also with words.”  

Belarus' Cardiology Republican Scientific and Practical Centre         Aleksandr Kulevsky

Roadmaps in hand

In 2023, 241.7 coronary artery bypass graft surgeries per one million population were performed in Belarus (in 2022, this figure was 227.5, the data for 2024 is being updated) and slightly more than 200 surgeries per one million population using artificial blood circulation, as noted by Doctor of Medical Sciences, Professor Natalia Mitkovskaya, Director of the Cardiology RSPC, Head of Cardiology and Internal Diseases Department at the Belarusian State Medical University, Chairperson of the Belarusian Scientific Society of Cardiologists, and chief freelance cardiologist of the Healthcare Ministry.

— These figures are comparable to those reflected in the reports of our colleagues from the Russian Federation, where cardiology and cardiac surgery are developing at a very active pace. Moreover, we have achieved very good results in X-ray endovascular surgery: in 2023, 15,000 heart vessel interventions were carried out in 36 centres across the country, including 10 inter-district facilities. 
Now we need to work on the patient routing optimisation in accordance with the developed roadmaps so that any person with acute coronary syndrome or acute cerebrovascular accident is brought to the operating table as early as possible. Huge amounts of state money have been invested in this; there have been trained a significant number of specialists who went to study in Russia and other European countries. I can say that we are keeping pace with the world’s major clinics by many indicators, and by some — we are even ahead of them.

— Earlier, it was said at a meeting with the President on topical health issues that RSPC specialists can and should train their colleagues from the hinterland so that they could provide high-tech medical care to patients on the ground. In addition, the international experience of co-operation cannot be ignored.

— This is a very important part of our activity. At least 1-2 times a week, employees of the Cardiology RSPC travel to the hinterlands, to regional and central district hospitals, conduct examinations of serious patients, perform surgeries, organise practical workshops and seminars for doctors at their workplace. 
Every year, we introduce new methods of treatment of cardiovascular diseases. Belarusian doctors have been engaged in transcatheter heart valves implantation for more than 10 years. The first valve that our X-ray endovascular surgeons mastered was the aortic valve. We have extensive experience in the treatment of mitral valve pathology, being one of the leaders of MitraClip technology among the CIS countries. Two months ago, two complex TriClip operations were performed for the first time on the tricuspid heart valve, with no large incisions made on the patient’s body, which means the person recovers many times faster. Thanks to the high professionalism of our X-ray endovascular surgeons, both operations were successful. Now we intend to introduce this method of treatment more widely and develop such a technique in the regions.  

— In Belarus, such a serious branch of the healthcare system as cardiology and cardiac surgery carries out its activities mainly on a budgetary basis. What is the main advantage of this approach?

— Today we have the opportunity to compare our realities with what is happening in many other countries, including the countries of the former USSR, and we understand that, unfortunately, patients there often find themselves in a desperate situation: insurance policies do not always cover all expenses, and family savings are not enough for expensive treatment. We have the opportunity to provide assistance to Belarusian citizens at any time and under any circumstances on a gratuitous basis. In cardiac surgery, these are sometimes extremely expensive operations. For example, a heart transplant costs more than $100,000. By the way, every year we operate on 5 to 10 foreign patients for whom this intervention is on a fee basis. 
In addition, we have a unique joint project with American colleagues in the treatment of chronic heart failure, within which a patient with cardiomegaly (enlarged heart) is implanted with a special device that supports the heart structure. As a result, its function improves, and this, in turn, improves the patient’s quality of life. We have started performing surgeries on patients with severe pulmonary hypertension. These are very complex and quite expensive interventions, which, of course, are carried out for our citizens free of charge.


By Lyudmila Konopelko