Dr Assen Keltchev is a cardiac surgeon with experience in minimally invasive and endoscopic cardiac surgery. He is Head of the Cardiac Surgery Department at Acibadem City Clinic University Hospital Vitosha in Sofia, Bulgaria. He consults patients with heart disease and provides expert second opinions on treatment options.
When facing a decision about heart surgery or another intervention, patients and their families often have many questions. What are the treatment options? When is the right time for treatment? What are the risks, and what can be expected during recovery?
Dr Keltchev offers expert consultations for patients who need an assessment of their treatment options or are seeking a second opinion.
Through i-Health, you can receive assistance with organising your consultation and preparing your medical records.
Treatment tailored to each patient
Choosing the right treatment begins with a careful assessment of the heart condition and the patient’s overall health. During the consultation, Dr Keltchev reviews the available medical records and discusses:
- The type and severity of the heart condition;
- The condition of the heart, valves and coronary arteries;
- Heart function and any other medical conditions;
- Options for surgical, minimally invasive, endoscopic or catheter-based treatment;
- The expected benefits, risks and recovery;
- Long-term outcomes and the patient’s personal preferences.
The aim is to provide a clear, evidence-based recommendation tailored to the patient’s individual needs.
Heart Team: a collaborative discussion among specialists
In more complex cases, or when several treatment options are available, the case may be discussed by a Heart Team — a multidisciplinary team of specialists.
Depending on the case, the discussion may involve a cardiac surgeon, a clinical cardiologist, an interventional cardiologist, a medical imaging specialist, an anaesthesiologist and other specialists.
The team may discuss, for example:
- Repair or replacement of a heart valve;
- Surgical or catheter-based treatment, including TAVI;
- The possibility of a minimally invasive or endoscopic approach;
- The choice between a mechanical and a biological valve prosthesis;
- Treatment of atrial fibrillation and options for reducing the risk of stroke;
- The choice between coronary artery bypass surgery and stent placement for coronary artery disease.
The recommendation is discussed with the patient so that they can take an informed part in the decision.
Assessment of surgical risk
When planning heart surgery, EuroSCORE II may be used where appropriate. This is a tool for estimating the risk of death associated with cardiac surgery.
It takes into account factors such as age, heart and kidney function, other medical conditions, previous operations and the complexity of the procedure. The result serves as a guide and is considered alongside the medical information and the specialists’ clinical judgement.
Who may benefit from a consultation?
The consultation is suitable for patients:
- With aortic, mitral or tricuspid valve disease;
- With coronary artery disease for whom bypass surgery or a stent is being considered;
- With diseases of the aorta or atrial fibrillation;
- With certain congenital heart defects or cardiac tumours;
- With complex or combined heart conditions;
- Who have ongoing or new symptoms after heart surgery;
- Who have received different recommendations or would like an expert second opinion.
What can you discuss during the consultation?
After reviewing your available medical records and talking with you, Dr Keltchev will discuss questions related to your condition, including:
- What is the diagnosis, and are further tests needed?
- What are the treatment options?
- Is surgery or a catheter-based intervention necessary, and when?
- What are the expected benefits, risks and alternatives?
- What can be expected during recovery?
- What might be the risks of delaying treatment?
How to prepare
To make the consultation as helpful as possible, please prepare any available medical records and test results, including:
- Echocardiography results;
- The report and images or recording from a coronary angiogram, if performed;
- CT scans and other imaging studies, if available;
- Discharge summaries and records of previous treatment;
- Recent laboratory results;
- A list of current medications and their doses;
- Information about previous operations, allergies and other medical conditions.
You do not need to undergo all the listed tests in advance. If necessary, the specialist will advise you on any additional investigations.
Book a consultation with Dr Assen Keltchev
The i-Health team will assist you with booking an appointment and preparing your medical records for the consultation.
🌍 Patients from Bulgaria and abroad can contact us:
📞 Telephone, Viber and WhatsApp: +359 894 531 553
📧 Email: contact@i-health.bg
📲 Book an appointment online through Book a Doctor, available in Bulgarian and English: book.i-health.bg
i-Health — support and guidance on your journey towards an informed decision about your health.