Complex Cardiac Care, Closer to Home

JSH’s Heart and Lung Centre of Excellence is developing its ability to manage increasingly challenging cardiac conditions. One such milestone was the hospital’s first Complex High-Risk Indicated Percutaneous Coronary Intervention (CHIP PCI) using intravascular lithotripsy (IVL), led by Dr Mohd Shahrom Ujang, Consultant Cardiologist at JSH.

The procedure was supported through structured proctorship by Dr Zul Hilmi Yaakob, Head of Specialty for Cardiology at KPJ Healthcare Berhad and Consultant Interventional Cardiologist at Tawakkal Specialist Hospital.

For Dr Shahrom, the significance lies in what this development means for patients who may previously have had limited treatment options. With the appropriate facilities and specialist support, more challenging cases can now be considered at JSH.

When Coronary Treatment Becomes More Complex

Calcium deposits can make coronary arteries rigid and difficult to treat. In more severe cases, this can complicate procedures to widen a narrowed artery and insert a stent, a small device used to keep it open.

Such interventions require considerable experience and specialised equipment. Depending on the patient's condition, treatment may not be available at every hospital.

“For patients who have been told their cases are too difficult, having access to the right facilities, technology, and experienced operators can make a significant difference,” says Dr Shahrom. “With appropriate tools and careful planning, we are able to offer a safe alternative and achieve good outcomes.”

Having this service available locally also allows patients to remain closer to their families and receive follow-up care from the same clinical team.

The Expertise Behind the Procedure

High-risk cardiac interventions require more than advanced equipment. They depend on experienced clinicians who can assess risks, consider alternative approaches, and make sound decisions throughout the procedure.

For JSH’s first CHIP PCI, Dr Shahrom worked closely with Dr Zul Hilmi, whose experience provided an additional clinical perspective during the planning and execution of the intervention. Their discussions helped inform procedural decisions, particularly where alternative approaches needed to be considered.

“Through collaboration, we build experience and deliver better outcomes for patients,” Dr Shahrom says. “When complex procedures are done locally, we are also able to respond quickly to any post-procedural needs.”

For JSH's cardiac team, the procedure also provided valuable practical experience in managing a demanding case with specialist guidance.

Building Expertise Across the KPJ Health System

JSH's first CHIP PCI demonstrates how expertise available at one hospital can support the development of specialist services at another. Through Dr Zul Hilmi's proctorship, the JSH team was able to undertake a challenging intervention with guidance from an experienced colleague at Tawakkal Specialist Hospital.

This is a practical example of Practice and Education, two of the KPJ Health System's core pillars. Clinical knowledge is developed not only through formal training, but also through direct experience, where specialists share their judgement and support colleagues in managing complex cases.

For the wider Health System, the value lies in making specialist expertise available across its hospitals. Rather than developing their capabilities independently, hospitals can benefit from the knowledge and experience already established within the network.

The Next Challenge in Cardiac Care

Dr Shahrom sees opportunities for the Heart and Lung Centre of Excellence to expand its services, particularly in structural heart interventions for conditions such as aortic valve disease.

As the population ages, less invasive treatment options are becoming increasingly relevant for patients who may face greater risks with conventional surgery. Developing the necessary skills and experience will be important as the Centre considers these procedures.

He also sees value in working with experienced overseas consultants to learn advanced techniques and support the team’s professional development.

For Dr Shahrom, JSH's first CHIP PCI provides a foundation for the Centre's next stage of development. The experience gained from this milestone can help the team prepare for more challenging interventions, with the longer-term goal of offering patients a wider range of advanced cardiac treatments.