Northern Heart Hospital’s achievement in conducting the first-ever endovascular thoracoabdominal aortic repair (TAAA) using a custom-made inner-branch EVAR (i-BEVAR) device in Northern Peninsula Malaysia is a groundbreaking advancement in the field of vascular surgery. This pioneering procedure was successfully performed on 7th March 2025 by Assoc. Prof. Dr. Edward Choke, our Consultant Vascular Surgeon and a leading expert in the field. This milestone not only highlights the hospital’s commitment to cutting-edge treatment but also marks a significant leap forward in cardiovascular healthcare in Penang and the northern region of Malaysia.
Understanding Thoracoabdominal Aortic Aneurysm and Its Treatment Challenges
A thoracoabdominal aortic aneurysm (TAAA) is a complex and potentially life-threatening condition characterised by the weakening and ballooning of the aorta – the major artery that carries blood from the heart to the rest of the body. If left untreated, these aneurysms can rupture, leading to catastrophic internal bleeding and a high risk of mortality.
Traditionally, the treatment options for patients with aortic aneurysms have included open surgical repair or standard endovascular aneurysm repair (EVAR). However, both approaches have limitations. Open surgical repair, while effective, is highly invasive and carries significant risks, particularly for elderly or high-risk patients with comorbidities. Standard EVAR, on the other hand, is a less invasive option but is only suitable for patients whose anatomy aligns with the design of off-the-shelf devices.
In cases where neither of these standard approaches is viable, a custom-made device (CMD) offers a tailored solution. This innovative technology allows surgeons to customise the repair strategy to fit the unique anatomy of each patient, thereby improving treatment outcomes while minimising risks.
What Is Custom-Made Inner-Branch EVAR (i-BEVAR)?
Custom-made inner-branch EVAR (i-BEVAR) is a specialised endovascular technique designed to treat patients with complex aortic aneurysms that extend into the thoracoabdominal region. Unlike standard EVAR devices, which are mass-produced with fixed configurations, i-BEVAR devices are individually designed based on a patient’s specific anatomy. This customisation ensures that the repair device effectively covers the aneurysm while preserving blood flow to vital organs such as the kidneys, intestines, and liver.
The process of creating an i-BEVAR device involves advanced imaging and planning. First, detailed scans of the patient’s aorta are obtained to assess the size, shape, and location of the aneurysm. These images are then used to design a stent-graft with precisely positioned inner branches that align with the arteries supplying the abdominal organs. Once manufactured, the device is carefully implanted through a minimally invasive procedure, significantly reducing recovery time and post-surgical complications compared to traditional open surgery.
The Significance of This Landmark Procedure
The introduction of i-BEVAR at Northern Heart Hospital represents a transformative moment for vascular surgery in Malaysia. Assoc. Prof. Dr. Edward Choke’s expertise in this field brings a new level of precision and innovation to the treatment of complex aortic aneurysms, providing hope for patients who previously had limited or high-risk treatment options.
This landmark procedure holds several key benefits:
- Increased treatment accessibility: With the availability of i-BEVAR in Northern Peninsula Malaysia, patients no longer need to travel for specialised aneurysm treatment. Northern Heart Hospital is now equipped to offer world-class vascular care within the region.
- Minimally invasive approach: Compared to open surgical repair, i-BEVAR involves smaller incisions, less blood loss, reduced risk of infection, and a shorter hospital stay. This is particularly beneficial for elderly and high-risk patients who may not tolerate major surgery.
- Personalised patient care: The ability to customise the device ensures a more precise and effective repair, tailored to each patient’s unique anatomy and medical needs.
- Improved recovery and outcomes: Patients undergoing endovascular repair typically experience faster recovery times, less postoperative pain, and a quicker return to normal activities compared to those undergoing open surgery.
Assoc. Prof. Dr. Edward Choke: Leading the Way in Advanced Vascular Surgery
Assoc. Prof. Dr. Edward Choke is a highly respected figure in the field of vascular surgery, known for his contributions to endovascular innovation and research. With his extensive experience in complex aortic repair, Assoc. Prof. Dr. Choke is at the forefront of bringing cutting-edge treatments. His leadership at Northern Heart Hospital is expected to set new benchmarks in patient care, making the hospital a centre of excellence for advanced vascular surgery.
Assoc. Prof. Dr. Choke has been instrumental in pioneering the use of advanced endovascular techniques for aneurysm repair, publishing numerous research articles and collaborating with international experts in the field. His presence at Northern Heart Hospital strengthens the hospital’s reputation as a premier destination for vascular and cardiovascular care. Patients can now benefit from his vast expertise without having to travel, making high-quality, innovative treatments more accessible to those in need.
What This Means for Patients and the Future of Cardiac Care in Malaysia
The successful introduction of i-BEVAR at Northern Heart Hospital will pave the way for future advancements in vascular surgery. As medical technology continues to evolve, customised endovascular treatments will become more widely accessible, ensuring that patients receive the best possible care tailored to their specific needs.
For patients diagnosed with thoracoabdominal aortic aneurysms, the availability of this groundbreaking procedure means a renewed chance at life with fewer surgical risks. This technique not only reduces the need for highly invasive open surgery but also expands treatment options for individuals previously considered ineligible for conventional EVAR. As awareness grows and more specialists adopt these techniques, the future of aortic aneurysm treatment in Penang looks promising.
Furthermore, the introduction of i-BEVAR signifies a commitment to ongoing medical education and training in the field of vascular surgery. As Northern Heart Hospital continues to establish itself as a centre for excellence, collaborations with international experts, training programmes for surgeons, and research initiatives will further enhance the region’s medical capabilities. This milestone procedure is just the beginning of a new era in advanced cardiovascular and vascular care in Penang.
Expert Care at Northern Heart Hospital
The i-BEVAR procedure at Northern Heart Hospital, led by Assoc. Prof. Dr. Edward Choke, represents a major milestone in Malaysian cardiac healthcare. This pioneering approach to thoracoabdominal aortic repair offers new hope to patients who previously had limited options, reinforcing the hospital’s commitment to medical excellence and innovation.
As we celebrate this historic event on 7th March 2025, Northern Heart Hospital remains dedicated to advancing cardiovascular care and ensuring that patients receive world-class treatment closer to home. With cutting-edge technology, expert leadership, and a patient-centred approach, the hospital is set to redefine the future of vascular surgery in Penang and beyond. This marks the dawn of a new era in personalised and minimally invasive cardiac healthcare, providing hope and improved outcomes for countless patients in the region and beyond.