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SINCERE CARE OF OTHERS

SINCERE CARE OF OTHERS

One of the most difficult directions of medicine, cardiology, is now in active development in Russia. Thanks to talented and non-indifferent doctors and scientists, people with heart diseases can live without fears about their health. Journalists of the news agency of the Eurasian Women’s Community interviewed one of the remarkable specialists in cardiology. 

Olga Bokeria is a corresponding member of the Russian Academy of Sciences, Doctor of Medicine, chief researcher of the Bakulev Scientific Center of Cardiovascular Surgery. She deals with patients of all ages having cardiac arrhythmia. A small wireless pacemaker developed by Olga Bokeria is the most serious achievement in this aspect of her scientific career. 

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This pacemaker is only 11 grams in weight. It became the winner of contests held by the Federal Agency for Scientific Organizations, Skolkovo Foundation, and Bortnik Foundation. Olga received one of the most prestigious awards in cardiosurgery, the Burakovsky Prize, for developing such a device. She also got patents for its software and programmer unit. The patent for an industrial sample received a golden medal of the International Salon of Inventions and Innovative Technologies ‘Archimedes-2016’. This pacemaker is the first in the world in its type, it passed the preclinical test phase and was implanted during open-heart procedure. Its implantation has several advantages. For example, the patient experiences only one heart operation instead of two. He or she doesn’t need to take blood thinners, since there is no foreign body inside the heart. There is no risk of intravascular thrombosis, which develops in almost all patients with cardiac pacemakers implanted through the vessels, especially if the diameter of these vessels is small (for example, in children, adolescents and subtle women). 

Olga Bokeria together with her colleagues also developed a device that is able to collect the energy of heartbeats and transform it into electricity necessary for the work of the pacemaker. Thus, it is a self-charging technology. This highly promising solution will prevent patients from many repeated operations needed to change a pacemaker caused by discharge of the battery. Usually the battery is enough for 7-12 years of the device’s operation, depending on the stimulation regime. This invention was patented in Russia as well. It was studied in animals. Now Olga works on improving those models and development of pacemakers with various functional capabilities. 

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A full-cycle treatment program for patients with chronic cardiac insufficiency is Olga’s another important achievement. This program includes all directions of treating such patients starting with the most common therapeutic medical methods and finishing with the most complex and promising ones including surgery, for example, the implantation of ancillary blood circulation devices, stem cells administration into the muscle of the heart, or other surgical procedures with high-risk patients. This program is implemented at the Department of Surgical Treatment for Interactive Pathology, where Olga Bokeria is a chief researcher, and also in a number of clinical tests developed and conducted by this department. For example, a test called ‘Renaissance’ will provide indications for transmyocardial laser revascularization in patients with ‘non-shunted’ coronary arteries. Now 30-35% of patients are not allowed to experience heart revascularization using standard techniques (coronary stenting and coronary bypass). Sometimes performing these procedures is impossible due to the absence of distal coronary artery areas or significant lesion, excluding operations on them. Thin diameter of coronary arteries because of which patients are predisposed to early thrombosis of the shunts or stents is the second reason for the denial of such an operation. Laser revascularization is an alternative way in these cases. But Olga’s research group went further in this direction and now in this method mesenchymal stem cells are introduced in the myocardium in addition to laser effects. In the current research, the research group is to analyze the effectiveness of different methods of laser revascularization. This will allow to assess the use of combining stem cells and laser revascularization. This is an extremely promising field of activity. Now Olga takes part in the preparation of a similar research related to a gene-therapy drug called Neovasculgen developed by the Human Stem Cells Institute in Russia. 

The problem of cardiac insufficiency is becoming more relevant. The Earth’s population is getting older. 80% of people suffering from arterial hypertension then have cardiac insufficiency. Other heart diseases also result in it. This problem hasn’t been solved yet, and new promising methods of treatment are needed. Minimally invasive methods are more preferable in this regard, since complicated operations go together with a high mortality rate. Professor Olga Bokeria is now working on such problems. 

The next direction she is interested in is care of pregnant women or those who wish to become pregnant, but suffers from serious cardiovascular diseases or has undergone heart surgery. Many believe that women with heart defects or with artificial cardiac valves must not give birth to children. This is a mistake. However, such patients require special preparation and care during pregnancy, as well as during and after delivery. 

“I am always open to such work. It is great when it seems you help one person and then it turns out that you help two or more people”, she said. 

Many women come to Moscow from other federal regions of Russia to consult to Olga Bokeria regarding this issue. She always helps her patients feel the joy of being mother. It is important to note that the number of patients with this problem will constantly increase because of the desire of women to delay pregnancy to a more mature age, in which women experience more health problems including those of the cardiovascular system. 

Over 95% of girls with inborn health defects, operated in the first years of life, reach the childbearing age, and their number will also grow due to the high rate of development of high-tech cardiosurgery. Olga Bokeria created a comprehensive program for such girls and women. She implements it jointly with Leyla Adamyan, Chief obstetrician-gynecologist of the Russian Federation, on the basis of the Department of Cardiovascular Surgery and Interventional Cardiology and the Department of Obstetrics and Gynecology of the A.I. Evdokimov State University of Medicine and Dentistry. This program includes a full range of health examinations, observations, and consultations, including remote ones, preparation for pregnancy, pregnancy follow-up, and delivery. 

A car trailer ‘Mobile Cardiologist’ is Olga’s another significant achievement. It is proposed and designed by Olga Bokeria. The mobile trailer contains the full range of expert class equipment necessary for non-invasive diagnosis of cardiovascular pathology (electrocardiography, echocardiography, including transesophageal one, functional tests with physical activity), as well as a full-fledged X-ray operating room. The operating room has equipment for intracardiac electrophysiological research. It allows diagnosing and treating most heart arrhythmias. Immediate implantation of pacemakers is also possible. 

The Mobile Cardiologist team leaves for different places of the Moscow region and during 3-5 days assists from 750 to 1200 patients of all ages and with any cardiovascular diseases. Health examination is paid from the Compulsory Medical Insurance Fund. Thus, every person who has the Moscow region’s compulsory medical insurance policy, can be examined there for free. This project has broad prospects. It allows to significantly increase the availability of highly qualified cardiosurgical care, to ensure early detection of diseases and timely referral of patients for being followed up by a doctor at the place of residence or hospitalization as an in-patient. 

Olga Bokeria is a socially active person who is always ready to help others. Within the framework of a project called ‘Walking With a Doctor’. She regularly meets with her colleagues and communicates with people who need a cardiologist consultation. 

“First we conduct an examination. We add information about the patients who come to us to a special database. Our next meeting with them is even more effective. We check blood pressure, blood glucose, take patient’s pulse, etc. After that, we exercise, we walk and talk, then we check all the indicators again. Our meeting ends with lectures on healthy lifestyles, risk factors of cardiovascular diseases, their treatment, how to correctly measure pressure, take pulse, etc. In a word, we try to inform people as much as we can about everything related to the cardiovascular system”, she said. 

The specialists not only answer all questions of the participants of the program, but also tell how to get to a consultation or hospitalization at the Bakulev Scientific Center of Cardiovascular Surgery. The program is free to join it. 

Olga is a caring mother of four children who from the vey childhood understand how important it is to take care of health. 

“We regularly organise Walking With a Doctor for children. I try to involve my children in such projects. They deliver lectures in a language understandable to other children. I hope this will help them understand why I spend so much time on my work and sometimes take time for that from them”, she finished. 

In fact, Olga acquired many attitudes and values from her parents. Her father, Leo Bokeria, is an academician of the Russian Academy of Sciences and one of the most famous cardiosurgeons. Following in her father's footsteps, Olga has become a real professional and a person who not only loves her work, but also treats patients with sincere care. It is so important that a person with a big heart treats other people’s hearts. 

Viktoria Yezhova, news agency of the Eurasian Women’s Community

Translated by Nikolay Gavrilov


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