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The difference lies in what the balloon does. Rather than relying primarily on physical expansion to push plaque aside, the IVL balloon generates sonic pressure waves. These sonic waves are designed to break down hard calcified plaque that is difficult to modify with balloon pressure alone.
In IJN’ s description, the intended
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clinical impact is clear: The calcified plaque is disrupted. The vessel lumen expands more effectively, and Stent deployment is optimised at the narrowed segment.
Put simply, IVL helps make a difficult calcified segment more workable, supporting the broader goal of restoring blood flow with angioplasty and stenting.
IJN clarified that IVL is part of the coronary angioplasty process, rather than an alternative that replaces the overall treatment pathway.
LESS TRAUMA, MORE PRECISION
Severe calcification not only makes lesions harder to treat; it also raises concerns about tissue stress and procedural trauma.
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IJN stated that IVL reduces trauma because it selectively pinpoints the blockage. Dr Amin further explained that this selectivity helps minimise the risk of complications after the procedure compared with other debulking devices currently available.
In practice, the goal is to modify the calcified target while minimising collateral damage to surrounding tissue.
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ADVANCING CARE AT IJN
IVL offers a targeted approach to severe calcified artery disease. By using sonic waves through a catheterbased balloon system, IVL is designed to break down hard calcified plaque, improve arterial expansion, and support more effective stent deployment, while operating within the coronary angioplasty pathway.
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As cardiovascular care continues to evolve, technologies like IVL reflect a broader shift towards more precise, patient-centred interventions, especially for complex cases that once left limited room between standard angioplasty and open surgery.
At institutions such as Institut Jantung Negara( IJN), the adoption of IVL demonstrates how targeted innovation can expand treatment options for patients with severe calcified arterial disease.
While not every patient requires or is suitable for this approach, IVL strengthens the cardiologist’ s toolkit and underscores an important direction in modern medicine: addressing not just the presence of disease, but its underlying characteristics, with solutions tailored to the specific challenges they present.
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AT Institut Jantung Negara( IJN), innovation in cardiovascular care is not a one-off achievement but a sustained journey. Over the past few years, IJN has consistently introduced cutting-edge technologies and minimally invasive procedures, positioning Malaysia at the forefront of cardiac care in the region.
Just months after becoming the first hospital in Malaysia to perform intravascular lithotripsy( IVL) in February 2021, IJN achieved another milestone in May 2021, by performing Asia’ s first TricValve ® Transcatheter Bicaval Valve system procedure for patients with severe tricuspid regurgitation.
This minimally invasive therapy targets individuals who are unsuitable for conventional
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open-heart surgery. By implanting a dual-valve system via a catheterbased approach, the procedure helps alleviate symptoms such as fatigue and breathlessness while enabling faster recovery. The breakthrough reflects IJN’ s commitment to expanding treatment options for high-risk patients who previously had limited solutions.
In 2023, with the introduction of the Navitortm transcatheter aortic valve implantation( TAVI) system, the first of its kind in Malaysia.
Designed to treat aortic stenosis, the device enhances precision and reduces complications such as blood leakage around the implanted valve. Its advanced features, including a fabric cuff and smaller delivery profile, allow cardiologists to treat a broader range of patients, including the elderly,
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and those requiring future coronary interventions.
This advancement further strengthens IJN’ s long-standing leadership in TAVI, dating back to its early adoption of the technology in Asia.
In June 2024, IJN marked another regional first with the implantation of the Aurora extravascular implantable cardioverter defibrillator( EV-ICD). Developed by Medtronic, this nextgeneration device represents a significant departure from traditional defibrillators.
Unlike conventional systems, which run leads directly through the veins into the heart, the EV-ICD is implanted outside the vascular system, reducing the risk of infection and vascular damage.
Capable of delivering life-saving shocks and pacing therapy, while also
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enabling remote monitoring, the device offers new hope for patients at risk of sudden cardiac arrest.
Together, these milestones illustrate a clear trajectory: from plaque modification and valve innovation to next-generation cardiac rhythm management. Each advancement not only introduces new technology but also expands the boundaries of who can be treated safely and effectively.
Through this steady progression of first-in-country and first-in-region procedures, IJN continues to redefine cardiovascular care, delivering more precise, less invasive, and increasingly patient-centred solutions that improve both survival and quality of life.- The HEALTH
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