Blog Updates - Lim Wei Juan

Bifurcation Connect 2025: Sharing “My Best/Nightmare Experience” in Complex PCI

The Bifurcation Connect 2025 (My Best/Nightmare Experience) symposium, part of the MYConnect Series by Boston Scientific, brought together leading interventional cardiologists to share their most memorable successes and toughest challenges in bifurcation PCI. Held on 6 September 2025 at EQ Hotel Kuala Lumpur, the event highlighted cutting-edge strategies, case-based learning, and the importance of international collaboration in complex coronary interventions.

A Global Platform for Experience Exchange

The program was chaired by Datuk Dr Kumara Gurupparan (Institut Jantung Negara, Malaysia), with international faculty Dr Bambang Boediono (Primaya Hospital Makassar, Indonesia) opening the session with his insightful lecture on the Zero Caging Strategy for Bifurcation Lesions. His talk emphasized innovation, precision, and the balance between safety and efficacy when tackling complex anatomy.

Best & Worst Case Sharing: Real-World Lessons

The highlight of the event was the My Best/Nightmare Experience, where Malaysian interventional cardiologists candidly shared their personal experiences. Each case session was moderated by respected faculty, ensuring lively discussions and practical take-home lessons for participants.

Among the presenters was Dr Lim Wei Juan, who delivered My Best/Nightmare Experience Case 2, moderated by Dato Dr Muhamad Ali (Hospital Sultan Idris Shah, Serdang). Dr Lim presented a challenging bifurcation stenting case that underscored the fine balance between technical skill, device selection, and real-time decision-making during complex PCI. The case sparked engaging dialogue on troubleshooting strategies, complications management, and how to turn potential procedural nightmares into successful outcomes.

Other sessions featured speakers including Dr Faten Aqilah Aris, Dr Huzairi Sani, Dr Lee Kuo Ting, Dr Selva Kumar Sivan, and Dr Ramachandran Sathappan, who each shared unique case experiences from different centers across Malaysia.

A Platform for Continuous Learning

The interactive format ensured that participants were not just passive listeners but active learners, gaining insights that are directly applicable in daily practice. From advanced bifurcation techniques to practical complication management, the symposium provided immense value for interventional cardiologists aiming to sharpen their expertise.

Closing with Reflection and Collaboration

The meeting concluded with a Q&A and Closing Remarks by Datuk Dr Kumara Gurupparan, followed by a group photo that captured the collaborative spirit of the day.

Key Takeaways from Bifurcation Connect 2025

Real-world case sharing remains one of the most powerful learning tools in interventional cardiology.
Complex bifurcation PCI requires adaptability, strong technical fundamentals, and teamwork.
Events like these foster cross-border knowledge exchange and strengthen regional expertise in cardiovascular care.

As interventional cardiology continues to evolve, Bifurcation Connect reinforces the importance of shared experience in driving innovation and improving patient outcomes. My Best/Nightmare Experience

SIDAPVIA Train-the-Trainer Launch at Hilton Kuala Lumpur: Empowering Specialists for the Future

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Posted in Workshop

On 6th September 2025, the SIDAPVIA Train-the-Trainer Engagement Meeting for Specialists was successfully held at the prestigious Hilton Kuala Lumpur. The event marked a significant milestone in advancing specialist training and professional development in Malaysia, bringing together a dynamic group of healthcare professionals, educators, and industry leaders.

A Landmark Launch for SIDAPVIA

The SIDAPVIA program is designed to equip specialists with advanced skills, structured training modules, and innovative teaching methodologies to empower the next generation of medical professionals. By adopting a “train-the-trainer” approach, SIDAPVIA ensures that knowledge transfer is not only consistent but also impactful across institutions nationwide.

Highlights of the Engagement Meeting

The event was filled with insightful discussions, interactive sessions, and collaborative networking opportunities. Participants gained exposure to:

Comprehensive training modules designed to standardize specialist education.
Innovative digital platforms that enhance learning and assessment.
Peer-to-peer sharing from experienced trainers who demonstrated real-world applications.
Strategic collaborations between healthcare leaders, aimed at improving training outcomes.

The launch emphasized the importance of sustainable training ecosystems where experienced specialists mentor and guide peers, ensuring that expertise is multiplied across the medical community.

Hilton Kuala Lumpur: A Perfect Venue

The choice of Hilton Kuala Lumpur added prestige and elegance to the launch. Its state-of-the-art facilities provided an inspiring environment for participants to engage, learn, and collaborate effectively.

Dr David Yong from Gleneagles Hospital Kuala Lumpur, Dr Khaw Chee Sin from Sunway Medical Center Penang, Dr Aaron Ong from Penang Adventist Hospital

Building the Future of Specialist Training

With SIDAPVIA, Malaysia takes a bold step forward in shaping a future-ready healthcare workforce. The program is not only about knowledge transfer but also about fostering leadership, innovation, and excellence among trainers.

The SIDAPVIA Train-the-Trainer Engagement Meeting was more than just a launch — it was the beginning of a transformative journey for specialists and the healthcare ecosystem at large.

Complex CTO Workshop with Dr Shunsuke Matsuno: Mastering LAD and RCA Recanalization

omegakimia@yahoo.com

Posted in Workshop

The field of complex percutaneous coronary intervention (PCI) continues to evolve with innovative strategies and advanced techniques. IJN and Asahi proudly hosted a CTO (Chronic Total Occlusion) workshop featuring Dr Shunsuke Matsuno, an esteemed operator renowned for his expertise in complex PCI. The session provided a live demonstration of two challenging CTO cases: one involving the left anterior descending artery (LAD) and another involving the right coronary artery (RCA).

Case 1: CTO LAD – Advanced Antegrade and Retrograde Approaches

In the first case, Dr Shunsuke Matsuno tackled a complex CTO of the LAD. The procedure showcased multiple advanced strategies:

Antegrade IVUS-Guided Proximal Cap Puncture: Utilizing intravascular ultrasound to define the entry point with precision.
Retrograde Septal Surfing Technique: Navigating through septal collaterals to gain retrograde access.
Epicardial Collateral Approach: Attempting collateral channel crossing when septal collaterals proved challenging.
ADR Technique (Antegrade Dissection and Re-entry): Applied as a bailout strategy to re-enter the true lumen with success.

This case highlighted the importance of versatility in CTO PCI, with operators needing to pivot between antegrade and retrograde strategies to achieve optimal outcomes.

Case 2: CTO RCA – Parallel Wiring Technique

The second case demonstrated a CTO of the RCA, where Dr Shunsuke Matsuno successfully applied the parallel wiring technique. By using a dual-wire strategy, one wire maintained position in the subintimal space while a second wire was carefully advanced to find the true lumen. This approach minimized procedural time and improved the chances of successful revascularization.

Key Learnings from the Workshop

The live cases underscored several important principles in contemporary CTO PCI:

The value of IVUS in guiding proximal cap puncture and confirming wire position.
The need for multiple strategies—antegrade, retrograde, dissection/re-entry—to address complex lesions.
The parallel wiring technique as a practical and effective method for RCA CTO recanalization.
Operator expertise and adaptability as the cornerstone of successful outcomes in complex PCI.

Small token of appreciation to sensei Matsuno!

Advancing Complex PCI Skills

Workshops like this are crucial in training interventional cardiologists to manage highly complex coronary occlusions. With guidance from experts like Dr Shunsuke Matsuno, participants gained invaluable insights into advanced CTO strategies, case selection, and complication management.

Conclusion

The CTO workshop with Dr Shunsuke Matsuno was an outstanding educational experience, showcasing cutting-edge techniques such as IVUS-guided puncture, septal surfing, ADR, and parallel wiring. These real-world demonstrations reinforce the importance of continuous skill advancement in achieving high success rates and safer outcomes for patients with challenging coronary occlusions.

BIG Pharmacy and Pfizer Host Educational Webinar on Apixaban

omegakimia@yahoo.com

Posted in Online Webinar

BIG Pharmacy, in collaboration with Pfizer Malaysia, successfully organized an engaging webinar on Apixaban, attracting over 100 participants from across the healthcare community. The session focused on advancing knowledge in stroke prevention for atrial fibrillation (AF) and the expanding role of direct oral anticoagulants (DOACs).

Addressing Stroke Risk in Atrial Fibrillation

Atrial fibrillation is the most common sustained cardiac arrhythmia, associated with a five-fold increase in stroke risk. Early diagnosis and effective anticoagulation are essential in reducing complications. The webinar provided updates on clinical guidelines, real-world data, and best practices for managing AF patients.

Why Apixaban?

Speakers highlighted the clinical benefits of Apixaban, a direct Factor Xa inhibitor, widely recognized as a preferred DOAC for AF and venous thromboembolism (VTE). Key points included:

Proven Efficacy: Superior protection against stroke and systemic embolism compared to warfarin.
Lower Bleeding Risk: Favorable safety profile, especially in elderly and chronic kidney disease patients.
Patient Convenience: Fixed dosing without the need for routine INR monitoring.

Empowering Pharmacists and Healthcare Professionals

The webinar emphasized the role of pharmacists in ensuring treatment success:

Educating patients on medication adherence and correct dosing.
Identifying drug interactions and monitoring renal function.
Supporting lifestyle modifications to optimize long-term outcomes.

Strong Engagement and Knowledge Sharing

With more than 100 participants, the interactive session showcased the enthusiasm of pharmacists, doctors, and healthcare providers in expanding their clinical knowledge. The Q&A segment allowed participants to clarify practical challenges and share real-world experiences.

BIG Pharmacy’s Commitment to Education

This event reflects BIG Pharmacy’s dedication to continuous professional development (CPD) and its mission to support healthcare providers with the latest evidence-based updates. Partnering with global leaders like Pfizer ensures that the pharmacy community is well-equipped to deliver better patient care.

Conclusion

The Apixaban webinar by BIG Pharmacy and Pfizer was a resounding success, enriching participants’ understanding of anticoagulation therapy in atrial fibrillation and VTE. With strong participation and expert insights, the event reinforced the importance of ongoing education in improving cardiovascular outcomes.

Advancing Complex PCI: CTO Workshop with Dr Alan Chan at IJN

omegakimia@yahoo.com

Posted in Workshop

The Chronic Total Occlusion (CTO) Workshop held at the National Heart Institute (IJN) brought together interventional cardiologists to learn advanced techniques in complex coronary interventions. The workshop, chaired by Datuk Dr Kumara, featured Dr Alan Chan, a renowned interventional cardiologist from Hong Kong, who demonstrated the latest strategies in CTO percutaneous coronary intervention (PCI).

About Dr Alan Chan

Dr Alan Chan obtained his medical degree from the University of Hong Kong in 2002. After his residency at Queen Elizabeth Hospital, HKSAR, he achieved MRCP (UK) in 2005 and completed his cardiology training in 2006. By 2009, he was awarded FHKCP and FHKAM, establishing himself as a specialist in both cardiology and internal medicine.

In 2012, Dr Alan Chan received the Hong Kong Heart Foundation Scholarship, allowing him to further refine his expertise in advanced interventional cardiology during a fellowship at Case Western Reserve University, Ohio, USA. Currently a full-time cardiologist at Queen Elizabeth Hospital, he is recognized for his special interest in complex PCI, primary angioplasty (primary PCI), and intracoronary imaging.

Live CTO Case Demonstrations

The workshop featured three highly educational CTO cases that highlighted advanced procedural strategies and the importance of imaging and support techniques in achieving success:

Case 1: CTO LAD

Parallel wiring technique successfully used for crossing the lesion.
IVUS-guided ostial LAD stenting ensured precise stent placement and optimal results.

Case 2: CTO RCA

Demonstrated the importance of strong guide catheter support.
The balloon-anchored technique was utilized to facilitate device delivery across the occlusion.

Case 3: Complex CTO Case Discussion

Additional focus on decision-making strategies, case selection, and integrating intravascular imaging to improve outcomes in difficult CTO interventions.

Key Learning Points

Parallel wiring and advanced crossing strategies remain essential in LAD CTO interventions.
Guide support and anchoring techniques are critical for RCA CTO success.
Intravascular ultrasound (IVUS) plays a pivotal role in guiding stent optimization and reducing complications.
Complex PCI requires a combination of technical skill, imaging expertise, and strategic case planning.

Conclusion

The CTO Workshop with Dr Alan Chan provided valuable insights into tackling complex coronary occlusions with precision and safety. By sharing his vast experience and demonstrating advanced techniques, Dr Alan Chan empowered participants to enhance their practice in the evolving field of interventional cardiology.

Workshops like these reaffirm IJN’s commitment to continuous education and innovation in cardiovascular medicine, ensuring that patients with the most challenging coronary disease can benefit from the latest advancements in PCI.

Empowering Heart Health – IJN PharmaVia Symposium with Viatris in Johor Bahru

omegakimia@yahoo.com

Posted in Drug Talk

On 16th August 2025, I had the privilege of speaking at the IJN PharmaVia Healthy Conversations Symposium – Southern Circuit, proudly held at the Renaissance Hotel Johor Bahru and broadcasted live to over 200 virtual attendees via Zoom.

This insightful symposium, organized in collaboration with Institut Jantung Negara (IJN), IJN First Pharmacy, and Viatris, brought together over 60 healthcare professionals on-site to engage in meaningful dialogue around cardiovascular and metabolic health challenges.

As a featured speaker, I delivered a session titled:

🔬 Know the SWEET Spot for the Heart

In this talk, I discussed the intricate link between diabetes and cardiovascular disease, exploring strategies to optimize heart health in patients with metabolic disorders. Prevention, patient education, and multi-disciplinary collaboration were key themes.

🔎 Symposium Highlights:

Dr. Afif Ashari opened the forum with a talk on the growing burden of cardiovascular disease.
Dr. Jessie Teo Yeh Lin shared insights into diabetic neuropathy pain management.
Dr. Lee Wei Liang tackled the challenge of managing blood pressure fluctuations.
Dr. Low Ming Yoong addressed hypercholesterolemia in clinical practice.
RPh. Lim En Ni emphasized pharmacist-patient communication for heart health.

The event also featured two dynamic forum discussions moderated by leading experts, providing both physician and pharmacist perspectives on patient care.

📈 Why This Matters:

Events like IJN PharmaVia are essential platforms for knowledge sharing, interdisciplinary collaboration, and empowering pharmacists and healthcare professionals to make informed decisions for better patient outcomes.

As we face rising rates of hypertension, diabetes, and cardiovascular diseases, forums like this play a critical role in strengthening Malaysia’s healthcare ecosystem—both in the clinic and the community.

💬 Thank you to all participants, both in-person and virtual, for making this symposium a resounding success. Let’s continue advancing heart health—together.

The real slim shady!

Glad to be back to Johor Bahru, my hometown for this health talk with my IJN colleagues! Hope more to come soon in future!

Mastering CTO PCI: A Day of Three RCA Cases with Dr Lee Hsin Fu at IJN

omegakimia@yahoo.com

Posted in Workshop

Datuk Dr Kumara, Consultant Cardiologist from National Heart Institute (IJN), Malaysia recently hosted a dedicated CTO workshop led by renowned interventional cardiologist Dr Lee Hsin Fu from Taiwan, showcasing real-time expertise, strategy refinement, and advanced techniques in chronic total occlusion (CTO) PCI.

This full-day educational event focused on three complex RCA (right coronary artery) CTO cases, attracting fellows, cardiologists, and interventionists eager to sharpen their skills in tackling one of interventional cardiology’s toughest challenges.

Case 1: Reverse CART Success

The first live case demonstrated the effectiveness of the reverse Controlled Antegrade and Retrograde Tracking (reverse CART) technique. Meticulous planning and precision led to successful recanalization of the RCA CTO, highlighting the importance of controlled subintimal dissection and re-entry.

Case 2: From Gaia 3rd to Retrograde Knuckle Wiring

This challenging second case began with antegrade wiring using a Gaia 3rd, which navigated to the right ventricular (RV) branch. The team then switched to a Sasuke microcatheter, but antegrade attempts failed to penetrate the hard mid-RCA CTO cap.
A direct retrograde approach was attempted but resulted in a vessel perforation. Undeterred, Dr Lee Hsin Fu adapted by employing a retrograde knuckle wire technique, followed by antegrade re-entry and reverse CART, ultimately achieving procedural success.

This case illustrated the importance of flexibility, technique mastery, and managing complications in complex CTO PCI.

Case 3: Septal Surfing to Success

In the final case, only one visible apical epicardial collateral was present — but it was not suitable for access. Despite initial failed attempts through three different selective septal branches, the team succeeded using a septal surfing technique, demonstrating creative retrograde channel navigation when conventional access options are limited.

Hands-On Learning with a Regional CTO Master

Dr Lee Hsin Fu’s live case commentary, troubleshooting insights, and dynamic teaching style offered participants valuable real-world pearls — from equipment selection to escalation strategy and bailout options. Each case reinforced different facets of contemporary CTO intervention, making it a high-impact workshop for all attendees.

Conclusion: IJN’s Commitment to Complex PCI Education

The CTO workshop at IJN with Dr Lee Hsin Fu reaffirmed the institute’s role as a regional leader in complex coronary interventions and advanced training. With growing demand for CTO PCI, such hands-on, case-based teaching is essential to elevate operator confidence and improve patient outcomes.