A great feat by the team of Serbian doctors at the Military Medical Academy (VMA) was achieved today, with an operation via pulmonary endarterectomy (PEA).
Interventional cardiologist from the Clinic for Urgent Internal Medicine at the Military Medical Academy (VMA) Lieutenant Colonel Assistant Boris Džudović stated today that four operations for the treatment of chronic thromboembolic pulmonary hypertension (CTEPH) via pulmonary endarterectomy (PEA) have been successfully performed at that medical institution so far.
Džudović told Tanjug that the VMA is therefore being profiled as a true center for the treatment of patients with chronic thromboembolic pulmonary hypertension.
Speaking about chronic thromboembolic pulmonary hypertension, Džudović explained that it is a complication of a previously suffered pulmonary embolism, which develops in a small number of patients when the thrombi do not completely regress, but rather fibrotize and permanently obstruct blood flow through the pulmonary circulation.
Džudović said that doctors at the VMA began to more seriously develop balloon angioplasty 10 years ago, a catheter-based method of treating chronic thromboembolic pulmonary hypertension that is used to open blocked smaller-diameter pulmonary arteries.
He also emphasized that over time, they have achieved an impressive level in these interventions.
“Just to explain the difference, pulmonary angioplasty is specific only for opening smaller blood vessels using cardiological procedures. When it comes to larger clinical problems in that sense, then surgery is actually necessary. That is actually pulmonary endarterectomy, which is performed by cardiac surgeons,” explained Džudović when referring to larger-diameter lung blood vessels.
Help from doctors from Great Britain
When it comes to pulmonary endarterectomy, Džudović stated that during his stay at the Royal Papworth Hospital in Cambridge, Great Britain, he met doctors who are among the world leaders in pulmonary endarterectomy, and that he used the opportunity to invite them to come to Serbia to share the knowledge and skills they apply in this method of treating chronic thromboembolic pulmonary hypertension with their Serbian colleagues.
“In addition to my part of the job there, I also met a cardiac surgeon, Dr. Chu, and asked him to consider helping our cardiac surgeons, to train them. He naturally agreed, and a year later, the entire cardiac surgery team gathered and went for a short training session at the hospital in Cambridge, where Dr. Chu began the first basic steps of education,” he added, emphasizing that the Royal Papworth Hospital in Cambridge is one of the four largest centers in the world where pulmonary endarterectomy is performed.
Speaking about the surgical procedures performed in Serbia, he stated that the first two operations were performed in May this year, and that two more patients were operated on using the same method in November.
“Our cardiac surgeons performed this, and our anesthesiologists performed the immediate operative and postoperative part of the treatment, under the watchful eye of Dr. Chu,” said Džudović.
When asked how the Serbian surgeons understood pulmonary endarterectomy, Džudović stated that it is a very demanding procedure, emphasizing that enthusiasm is the main principle for something to succeed.
“From the start, I immediately saw that our cardiac surgeons, anesthesiologists, perfusionists, i.e., everyone involved in these operations, are very enthusiastic about it, and that is, in fact, the main principle for something to succeed,” he added.
Severe disease
Cardiac surgeon from the Royal Papworth Hospital in Cambridge, Chu Yen, stated that the institution has been implementing a unique national program for pulmonary endarterectomy for 25 years, the only service of its kind in the United Kingdom.
Chu stated that the hospital performs about 200 such operations annually, and more than 3,100 procedures have been performed so far, ranking Papworth among the reference centers in the world.
“This is an operation intended for the treatment of a condition known as chronic thromboembolic pulmonary hypertension. It is a very severe disease, extremely difficult. It can seriously impair the quality of life and threaten the survival of patients. For people with severe pulmonary hypertension, their survival over five years is 10 percent in severe cases,” he added.
He explained that CTEPH is a rare but extremely severe disease that seriously impairs the quality of life and significantly shortens survival, especially in patients with severe pulmonary hypertension.
He pointed out that a combined therapy is available today, which includes pulmonary endarterectomy, balloon pulmonary angioplasty, and modern drugs, which represents a new era in the treatment of this disease.
According to him, the complexity of the operation and the small number of centers that perform it on a large scale have indicated the need to train new teams worldwide for years, which is why a training program was launched at Papworth, as well as direct support to hospitals that want to develop their own program.
He stated that it is a rare disease that affects between five and seven people per million inhabitants annually, which is why it is important to continuously raise awareness among doctors and timely refer patients to specialized centers.
He added that the team from Serbia underwent a two-week training session at Papworth, and that British experts came to Belgrade to supervise the first operations.
Chu assessed that the team from the VMA is excellently prepared, efficient, and well-organized, and expressed confidence that Serbia will succeed in developing a sustainable and long-term program for the treatment of CTEPH, which will enable patients in the region to have access to complete therapy for the first time.
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Source: B92; Photo: Pexels