Heart line

Belarus features among the top 20 countries in the world in terms of the number of heart transplants per 1 million population. Bioprosthetic valves, minimally invasive operations and the spread of high technologies across the regions — let’s see what new heights Belarusian cardiology has reached so far.

This year, for the first time in Belarus, the Cardiology Republican Scientific and Practical Centre (RSPC) has launched clinical trials of a new generation of Belarus-made bioprosthetic heart valves (BHV) made from calf pericardium, with the use of nanotechnology. The first patients implanted with a BHV are in satisfactory condition. After the successful completion of clinical trials, it is planned to start mass production of Belarusian BHVs, which will make it possible to abandon the purchase of Western prostheses and to increase the availability of high-tech cardiac surgery. 

YURY MOZOLEVSKY

Made in Belarus

Belarusian cardiac surgeons have been using domestic mechanical prosthetic heart valves since 1993. These are constantly being improved and modified. Mechanical prosthetic heart valves are mainly implanted in patients younger than 60 years old. Bioprosthetic heart valves allow preserving the quality of life of elderly patients for a long time.  
“For many years, Belarusian cardiac surgeons only had bioprosthetic heart valves of foreign manufacture at their disposal,” noted Natalia Mitkovskaya, Director of the Cardiology RSPC, Doctor of Medical Sciences, Professor. 
“The domestic innovative development of a bioprosthetic heart valve manufactured at the Electronmash Plant required many years of bilateral co-operation between technical specialists and cardiac surgeons. Belarusian prostheses have a lot of beneficial features. Thus, they allow successfully eliminating clinical manifestations of heart disease and, most probably, they will have a fairly long service life.”    
Seven operations performed to date have demonstrated good clinical results and ensured full satisfaction of specialised doctors with the results of medical interventions. If the clinical picture remains to be as positive in the future as in the early post-surgical period, it will be possible to state the fact — Belarus has developed domestic BHVs of excellent quality, competitive not only on the CIS market.

The Cardiology Republican Scientific and Practical Centre (RSPC) ALEKSEY MATYUSH  

At the global level

Belarus is among the top 20 countries in the world in terms of the number of heart transplants per one million inhabitants. About 50 medical interventions of that kind are carried out per year, amounting to a total of over 550 since 2009, when the first heart transplant was made. This is an astonishing result. Especially when you consider that a ten-year survival rate of heart transplant recipients has reached 73–75 percent. These indicators match the level of many world centres. 
High technologies make it possible to treat patients as quickly and effectively as possible, with minimal post-surgical complications. The advancement of all stages of medical care for patients with heart conditions is the goal of modern cardiology and cardiac surgery. 
The Cardiology RSPC specialists provide world-class medical care to patients with pulmonary hypertension enabling them to return to an active and full-fledged life after surgery. 
Another state-of-the-art technology for the treatment of heart failure is currently undergoing clinical trials — using an X-ray endovascular method, a device is installed in the patient to reduce the heart size, increase cardiac contractility and even cause the reverse process of pathological changes. This project is led by Deputy Director for Therapeutic Care of the Cardiology RSPC, Doctor of Medical Sciences, Professor Yelena Kurlianskaya.  
This development of the Cardiology RSPC team and some other innovative achievements of the Centre’s staff were presented with the National Academy of Sciences Award.    

ALEKSEY VYAZMITINOV

 Adopting Belarus’ experience

Cardiology medical science in our country is represented at a decent level. Specialists from Russia, Uzbekistan, Turkmenistan, Tajikistan, and Kazakhstan come to Belarus for internships and training. We have established strong and long-term relationship with our Japanese and Canadian counterparts. 
“An educational centre has been established and is successfully operating at the Cardiology RSPC. We are the clinical base for two departments of the Belarusian State Medical University — the Department of Cardiac Surgery, and the Department of Cardiology and Internal Diseases,” pointed out Natalia Mitkovskaya. “The possibilities of modern Belarusian cardiology and cardiac surgery are demonstrated to specialised doctors from the regions of our country and abroad when conducting more than 30 types of educational cycles, internships and advanced training courses.”  
When performing a heart transplant, the priority always remains with our fellow countrymen. Yet, when there are no Belarusian candidates on the waiting list or a foreign patient has a life-threatening condition, they are saved out of turn.  

The regions — up to the mark

With the adoption of state programmes in the field of healthcare in 2008, the development of cardiac surgery reached a new level. The implementation of high-tech surgical interventions began to be introduced in the regions. Every year, the volume of medical assistance is increased, the latest methods and technologies are developed and implemented, and the list of operations in regional centres is expanding. 
Surgical units are available in every region. They perform at least 70 percent of the volume of all heart and vascular surgeries in the country.
There are ten inter-district X-ray endovascular centres in the republic.
Almost all heads of cardiac surgery departments in our country are students of Academician Yuri Ostrovsky, Deputy Director for Innovative Development and High Technology of the Cardiology RSPC. According to Natalia Mitkovskaya, “Specialists of the Cardiology RSPC, who head departments and scientific laboratories of chronic coronary heart disease, arrhythmology, emergency cardiology, arterial hypertension, regularly travel to the regions to conduct master classes, carry out advisory work, and provide organisational and methodological assistance to specialists in the field.”

Double success

In 2016, the heart–lung complex was transplanted for the first time at the Cardiology RSPC. A duel organ transplant is an extreme measure that is used in very severe patients and gives them a chance to survive. 
“The risks of an unfavourable outcome for such people increase many times during surgery and in the post-surgical period,” clarified Natalia Mitkovskaya. “Therefore, we have created a special care and rehabilitation system for such patients. In addition to powerful intensive care units equipped with state-of-the-art technology, intensive care wards have been opened, where patients can stay until they are transferred to the general clinical department.”  
It is planned to open a cardiogenic shock care centre on the basis of the Cardiology RSPC intensive care units by the end of 2024. The implementation of this groundbreaking project will allow bringing back to life the most severe category of cardiac patients.  


By Yelena Basikirskaya