Hospital performs first heart stone-breaking procedure in WV

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By Rjay Zuriaga Castor

The Medical City (TMC) Iloilo has successfully performed Western Visayas’ first intravascular lithotripsy (IVL), marking a significant advancement in cardiovascular care in the region.

The landmark procedure, conducted on July 23, 2025, involved a 66-year-old woman with severe three-vessel coronary artery disease, including blockage in the critical left main coronary artery.

She also had hypertension and a strong family history of heart disease, according to TMC.

IVL is a minimally invasive technology that uses high-frequency sonic pressure waves—similar to those used in kidney stone treatment—to fracture hardened calcium deposits in the arteries of the heart.

These acoustic shockwaves create micro-fractures in calcified plaques within the artery wall, making the vessel more compliant and allowing safe balloon dilation and stent placement.

The procedure eliminates the need for more invasive approaches such as open-heart surgery, which is particularly beneficial for high-risk patients.

Specifically, the IVL catheter delivers unfocused, pulsatile mechanical energy circumferentially to the calcified lesion after balloon inflation.

This energy causes multiplanar fractures in the calcium, enabling vessel expansion and improved blood flow with reduced risk of vessel injury.

The pioneering procedure was led by a collaborative team: Dr. Kristy Garganera-Tugbang of TMC Iloilo, Dr. James Diaz of TMC Ortigas, anesthesiologist Dr. Felix Ruzen Fandinola, and the Cardiac Catheterization Laboratory team.

The use of intravascular ultrasound (IVUS) was integral to the procedure’s success.

IVUS provides real-time, high-resolution images of the artery’s interior structure, including plaque buildup, vessel diameter, and lesion characteristics, enhancing IVL precision.

The patient was referred by Dr. Regina Elena Bisnar-Regalado following a dobutamine stress echocardiogram, which showed reduced blood flow to the heart.

This prompted the team to proceed with a complex percutaneous coronary intervention using IVL and IVUS-guided stent placement.

With this development, patients in Iloilo and nearby provinces with complex heart conditions now have access to cutting-edge cardiovascular procedures without needing to travel to Metro Manila.

As cardiac care technology continues to evolve, TMC Iloilo said it remains committed to expanding access to life-saving procedures in the region.

“By expanding capabilities in interventional cardiology, the goal is to provide patients with timely, high-quality care, helping them return to their loved ones stronger and sooner,” the hospital said in a statement.