Multidisciplinary team at UMBAL "Sofiamed" discharges 103-year-old patient

A multidisciplinary team of specialists from UMBAL “Sofiamed” successfully performed high-risk complex treatment on a 103-year-old patient with a femoral neck fracture, who underwent a severe cardiac complication involving a myocardial infarction followed by orthopedic surgery. This was announced by the medical institution.

Radka Smilkova was admitted to the Clinic of Endoprosthetics and Orthopedic Traumatology, headed by Assoc. Prof. Biser Bonchev, following a domestic accident. She presented with a fractured femoral neck in a severe general condition—with significantly reduced oxygen saturation (approximately 40%) and critically low arterial pressure of 70/40.

“During the stay in the Clinic of Endoprosthetics and Orthopedic Traumatology, clinical, electrocardiographic (ECG), and laboratory data for acute anterior myocardial infarction were established, which necessitated an immediate consultation with a cardiologist and the transfer of the patient to the Clinic of Cardiology and Invasive Cardiology,” commented the orthopedists from the medical institution.

There, specialists conducted invasive diagnostics (coronary angiography), which revealed a blockage in one of the coronary arteries. They performed an interventional procedure with balloon dilation to restore blood flow.

“This is an invasive medical procedure that uses a small balloon, introduced into the body via a catheter, to dilate (widen) narrowed or blocked arteries. Following the intervention, the patient was prescribed medication therapy, which led to the stabilization of her condition, allowing the orthopedic surgery to proceed,” commented Dr. Nikolay Serafimov, an invasive cardiologist from the medical institution’s team.

“On March 9, surgery was performed to replace the hip joint with a unipolar prosthesis (hemiarthroplasty). This method is preferred for elderly patients as it is associated with a shorter surgical duration, less operative trauma, and a lower risk of complications. The intervention involves removing the damaged part of the femur and replacing it with an artificial implant that restores the stability and function of the joint. The operation was successful, and physiotherapy and recovery are now forthcoming,” says Dr. Panayot Temelkov, the orthopedist who performed the surgery in a team alongside Dr. Teodor Ivanov and Dr. Plamen Petkov.

In the postoperative period, specialists provided complex care for Mrs. Smilkova, including pain management, prevention of thromboembolic events, cardiac monitoring, and gradual mobilization.

“Usually, after a hip replacement, patients are verticalized the day after surgery, but in this case, due to her age and cardiac condition, recovery had to be more gradual and individualized, under constant medical supervision. The restoration of motor activity and the achievement of the maximum possible independence proceeded smoothly, with the primary goal being the prevention of complications related to immobilization,” commented the rehabilitation specialists at the Clinic of Endoprosthetics and Orthopedic Traumatology.

As of today, the patient has been discharged. She is in a stable general condition, conscious, and communicating freely.

Mrs. Smilkova repeatedly expressed her gratitude to the specialists at UMBAL “Sofiamed” and the cardiology and orthopedics teams who cared for her.

The successful treatment of 103-year-old Radka Smilkova is proof that when medicine, experience, and teamwork go hand in hand, the possibilities are far greater than the limitations.