The ‘heart’ of the nation
IN JULY 1992, Institut Jantung Negara (IJN) started operations on a 60,300sq m plot of land in Jalan Tun Razak, Kuala Lumpur.
It was initially part of Kuala Lumpur General Hospital (now known as Hospital Kuala Lumpur), and was a dedicated medical facility for heart, vascular and thoracic care.
However, it wasn’t long before it was corporatised.
In 1995, the IJN Foundation was established to fund treatment for poor, deserving and needy patients, including heart surgery and purchase of devices such as pacemakers and valves.
Today, IJN has 122 doctors and more than 2,000 support staff on its payroll.
Through the years, IJN has achieved various milestones that reflect its excellence of care:
In March 1995, IJN acquired a new technique that protects and preserves the heart during openheart surgery.
The method, acquired from thoracic and cardiac surgeon Dr Gerald D. Buckberg from the University Of California Los Angeles Medical Centre, ensured a much faster recovery rate, with patients depending less on intensive care and drugs.
Dr Buckberg visited IJN for a five-day visit, and together with IJN surgeons, performed coronary artery bypass operations successfully on five patients using the technique.
In December 1997, IJN successfully carried out the country’s first heart transplant, on a 51-year-old male patient. The four-hour operation was undertaken by a 17-member team headed by IJN’s then cardiothoracic surgery chief Datuk Dr Yahya Awang, who eventually became the recipient of the Merdeka Award in 2013 for pioneering the development of clinical research and cardiac surgery in Malaysia.
In March 2005, IJN notched another milestone by being the first medical institution in SouthEast Asia to successfully perform coronary bypass surgery on “awake patients”.
The surgery was conducted on three patients, aged 54, 58 and 66, who were all suffering from severe single vessel coronary artery disease and had their bypass operations while awake – the first time in Malaysia such a surgery was performed without general anaesthesia.
The team was led by then chief and consultant cardiothoracic surgeon In 2013, IJN introduced the Parachute Ventricular Partitioning Device, an alternative non-surgical solution for treating congestive heart failure, a serious disease which occurs when the heart is unable to pump sufficient blood to meet the body’s requirements. — Sin Chew
Datuk Dr Mohamed Azhari Yakub, consultant cardiothoracic surgeon Dr Jeswant Dillon, chief and consultant anaesthesiologists Datuk Dr Mohamed Hassan Ariff, and Dr Mohamed Shariff Shafie.
In July 2005, IJN became the first heart institution in Asia and Australasia to implant a mechanical heart device on 16-year-old Muhammad Fikri Nor Azmi, who was diagnosed with dilated cardiomyopathy, a heart disease which can lead to heart failure.
The teenager finally got a new heart in December 2005 from a 21-year-old donor who had suffered head injuries in an accident. He went home after spending seven months and a week at IJN, and is now leading a normal life.
In December 2009, IJN performed the first heart valve implant in Asia without the need for an open heart surgery. Known as trans-catheter aortic valve
implantation, or Tavi, the procedure allows for problematic valves in the aorta to be replaced with an artificial one by using a catheter, a tube 6mm in diameter.
IJN’s senior consultant cardiologist Tan Sri Dr Robaayah Zambahari was part of the consultant team that performed the procedure on two male patients – a 73-year-old and a 77-year-old, both of whom had severe narrowing of heart valves. The third patient was National Laureate Datuk Shahnon Ahmad, who was 76.
In 2010, IJN was the first in Asia to introduce the “Watchman”, a device to prevent blood clots from causing stroke in patients with atrial fibrillation (AF). This is an irregular, disorganised, electrical activity of the upper chambers of the heart (atria) resulting in ineffective pumping action of the atria.
AF is the most common rhythm disorder affecting over five million
people worldwide. This ineffective pumping action can cause blood to stagnate or pool in the left atrium, placing patients with AF at a sixfold increased risk of stroke compared to patients with normal sinus rhythm.
In 2013, IJN scored another first in Asia by introducing the Parachute Ventricular Partitioning Device, an alternative non-surgical solution for treating congestive heart failure, a serious disease which occurs when the heart is unable to pump sufficient blood to meet the body’s requirements.
The device, which looks like a parachute, is folded and introduced through a plastic tube called a guiding catheter via a sheath in the femoral artery at the groin under local anaesthesia and conscious sedation with X-ray guidance, very similar to a coronary angiogram procedure.
The guiding catheter is then positioned
in the left ventricle, which is the lower chamber of the heart that pumps blood to the rest of the body. The device is than deployed in the left ventricle where it is expanded with balloon inflation to partition off the dilated or aneurysmal apex of the heart, which will in turn restore the left ventricular size and function and enable it to pump blood more efficiently.
In August 2016, IJN successfully placed an implantable cardioverter defibrillator (ICD) in a 45-year-old company executive, making it the first case in the country.
Two cardiologists and an anaesthetist performed the hour-long procedure on the patient. ICD is a device implanted in patients suffering from life-threatening ventricular tachyarrhythmias, a condition where the heart beats fast and irregularly, and can lead to sudden cardiac death.