Few health threats loom larger in the U.S. than heart disease. is left over the leading cause of death in the country, killing more than 900,000 people in 2023According to the Centers for Disease Control and Prevention. However, despite what is at stake around the world, the cardiovascular technology sector responsible for the development of treatments and devices remains overwhelmingly led by men. This imbalance is important: when leadership and R&D teams do not reflect the diversity of the patient population, blind spots can arise in design and decision-making.
One exception is FastWave Medicalwhere women play critical roles in both operations and technology, shaping the company’s next-generation intravascular lithotripsy (IVL) platforms for calcified arteries. It’s a model that remains relatively uncommon in cardiovascular device development and is influencing how the technology itself is designed.
Why representation is important in cardiovascular innovation
How did that composition come about? It wasn’t the result of deliberate targeting, as FastWave co-founder and CEO Scott Nelson explains. “At FastWave, we have a majority female leadership team, not because of quotas, but because they were simply the best people for the job,” she says. That framework (merit first, diversity second) reflects a hiring philosophy that prioritizes environment over intent. “Our philosophy is simple: create a great place to work and you will attract the best talent. That’s exactly how we ended up with such a strong team.”
The benefit extends beyond the hiring philosophy. When team members bring different perspectives, questions arise that more homogeneous teams may not think to ask. In cardiovascular innovation, where patient needs vary widely by gender, age and anatomy, that breadth of knowledge shapes everything from device design to workflow integration.
Building technology through diverse perspectives
The company is advancing a dual-platform approach to IVL, with two devices designed to address the limitations of first-generation systems: Sola, its coronary laser IVL platform, and Artero, its electric IVL platform for peripheral arterial disease. But technology is not being shaped just by leadership on paper: it is being built every day by women with decades of experience developing devices.
Tristan Tieso, Chief Operating Officer of FastWave, brings more than 20 years of experience in cardiovascular and neurovascular devices to her role, including leadership positions at Vention Medical, where she led more than 50 professionals, and at Worrell, a global healthcare strategy and design firm.
At FastWave, he oversees preclinical, regulatory, quality and engineering operations, and his leadership has been instrumental in building the company’s intellectual property portfolio. “When you consider that FastWave is only four years old, obtaining nine US patents is truly remarkable – it speaks to the innovative capabilities of our team and the seriousness with which we have approached building our intellectual property portfolio from day one,” says Tieso. “It’s not just about collecting patents for the sake of it. We are strategically protecting the core technologies that differentiate our platforms.”
What drives those technologies is “problem-first design.” Tieso explains: “Our entire development approach has been based on spending a lot of time with interventional cardiologists, vascular surgeons, and interventional radiologists to understand their daily frustrations with existing IVL technology and then designing backwards from those pain points,” he explains. A clear example: doctors constantly reported problems with reusable devices and loss of time charging the generator. “That direct input led us to make some compelling improvements to the user experience,” says Tieso, resulting in an AC-powered plug-and-play system with one-click activation that eliminates reusable keys, generator charging, and the need to hold down buttons during procedures.
Sukanya Iyer, Chief Technology Officer, leads product development and engineering. With previous positions at Boston Scientific, Abbott, and St. Jude Medical, he holds multiple patents in ablation systems and has contributed to the development of important cardiovascular devices, including several generations of the WATCHMAN system, force-sensing ablation catheters, and renal denervation systems.
In FastWave, you are reinventing how sonic pressure waves are generated and emitted. “From a technology perspective, we have fundamentally reimagined how sonic pressure waves are generated and delivered,” explains Iyer, “Artero uses independently powered emitters that deliver uniform, circumferential sonic pressure, eliminating the uneven power delivery and localized degradation issues that plague legacy IVL systems. Sola, our other platform, takes a completely different approach with a single translation laser emitter that delivers true 360° sonic pressure with every pulse.”
For Iyer, the input of doctors is essential to engineering itself. “We have spent considerable time listening to physicians describe times when existing IVL technology simply did not meet their clinical needs,” he says. “What became clear was that legacy systems had fundamental engineering limitations that created clinical limitations: clinicians faced limited energy pulses and unpredictability when treating eccentric or nodular calcified lesions.” That know-how led the team to question the underlying physics of how sonic pressure waves should be generated and delivered.
“We have spent considerable time listening to physicians describe times when existing IVL technology simply did not meet their clinical needs,” he says. “What became clear was that legacy systems had fundamental engineering limitations that created clinical limitations: clinicians faced limited energy pulses and unpredictability when treating eccentric or nodular calcified lesions.” That know-how led the team to question the underlying physics of how sonic pressure waves should be generated and delivered.
A model for medical technology
Despite advances in some areas of medical technology, leadership in cardiovascular technology remains predominantly male, particularly at the senior technical level. But there are other paths to follow. When companies create merit-based leadership teams and foster cultures that value diverse perspectives, technical excellence, and representation, the two don’t just coexist—they reinforce each other.
At FastWave, women are not only present in leadership meetings. Tieso and Iyer are shaping intellectual property, redesigning workflow and rethinking how procedures can be performed more efficiently and safely. As the team grew, other FastWave leaders such as Anindita Sengupta, Director of QA/RA, joined to build the regulatory and quality infrastructure necessary to bring the technology to market.
Most importantly, they are also leading with openness: actively engaging with cardiologists and vascular specialists from diverse backgrounds to refine and advance the company’s platforms. That willingness to integrate broad real-world feedback ensures that the technology reflects not only engineering expertise but also the lived experience of those who use it in practice.
The result is instructive: When diverse, merit-based leadership combines technical depth with responsiveness to user needs, technology becomes more aligned with both clinicians’ workflow and patients’ realities. In cardiovascular care, where life or death is at stake, that alignment is important. Tieso and Iyer offer evidence that representation, technical rigor, and openness to diverse voices can intersect to advance medical technology in meaningful ways.
