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Few health threats loom larger in the U.S. than heart disease. It remains the nation’s leading cause of death, killing over 900,000 people in 2023, according to the CDC. Yet despite the universal stakes, the cardiovascular technology sector responsible for developing treatments and devices continues to be led overwhelmingly by men. This imbalance matters: when leadership and R&D teams do not reflect the diversity of the patient population, blind spots in design and decision-making can emerge.

One exception is FastWave Medical, where women hold pivotal 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 one that’s influencing how the technology itself is being designed.

Why Representation Matters in Cardiovascular Innovation

How did that composition come about? It wasn’t the result of deliberate targets, 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,” he says. That framing — merit first, diversity as outcome — reflects a hiring philosophy that prioritizes environment over intention. “Our philosophy is straightforward: create a great place to work, and you’ll attract top talent. That’s exactly how we’ve ended up with such a strong team.”

The benefit extends beyond hiring philosophy. When team members bring different perspectives to the table, they surface questions that more homogeneous teams may not think to ask. In cardiovascular innovation — where patient needs vary widely across gender, age, and anatomy — that breadth of insight 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 engineered to address limitations of first-generation systems: Sola, its coronary laser IVL platform, and Artero, its electric IVL platform for peripheral artery disease. But the technology isn’t being shaped just by leadership on paper — it’s being built day-to-day by women with decades of device development experience.

Tristan Tieso, FastWave’s Chief Operating Officer, brings more than 20 years of experience in cardiovascular and neurovascular devices to her role — including leadership positions at Vention Medical, where she managed over 50 professionals, and at Worrell, a global healthcare design and strategy firm.

At FastWave, she oversees engineering, quality, regulatory, and preclinical operations, and her leadership has been instrumental in building the company’s intellectual property portfolio. “When you consider that FastWave is only four years old, securing nine U.S. patents is really quite remarkable — it speaks to our team’s innovative capabilities and how seriously we’ve approached building our intellectual property portfolio from day one,” Tieso says. “This isn’t just about collecting patents for the sake of it. We’re 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 built around spending extensive time with interventional cardiologists, vascular surgeons, and interventional radiologists to understand their daily frustrations with existing IVL technology, then engineering backward from those pain points,” she explains. One clear example: doctors were consistently reporting hassles with reusable dongles and time lost to generator charging. “That direct input led us to make some compelling improvements to the user experience,” Tieso says — resulting in a plug-and-play, AC-powered system with one-click activation that does away with reusable dongles, generator charging, and the need to hold down buttons during procedures.

Sukanya Iyer, Head of Technology, leads product development and engineering. With prior roles at Boston Scientific, Abbott, and St. Jude Medical, she holds multiple patents in ablation systems and has contributed to the development of major cardiovascular devices, including multiple generations of the WATCHMAN system, force-sensing ablation catheters, and renal denervation systems.

At FastWave, she is reimagining how sonic pressure waves are generated and delivered. “From a technology perspective, we’ve fundamentally reimagined how sonic pressure waves are generated and delivered,” Iyer explains, “Artero utilizes independently powered emitters that deliver uniform, circumferential sonic pressure, eliminating the uneven energy delivery and localized degradation issues that plague legacy IVL systems. Sola, our other platform, takes an entirely different approach with a single, translating laser emitter that delivers true 360° sonic pressure with every pulse.”

For Iyer, physician input is essential to the engineering itself. “We’ve spent considerable time listening to physicians describe moments when existing IVL technology simply didn’t meet their clinical needs,” she says. “What became clear was that legacy systems had fundamental engineering limitations that created clinical constraints — physicians were dealing with limited energy pulses and unpredictability when treating eccentric or nodular calcific lesions.” Those technical insights drove the team to question the underlying physics of how sonic pressure waves should be generated and delivered.

“We’ve spent considerable time listening to physicians describe moments when existing IVL technology simply didn’t meet their clinical needs,” she says. “What became clear was that legacy systems had fundamental engineering limitations creating clinical constraints — physicians were dealing with limited energy pulses and unpredictability when treating eccentric or nodular calcific lesions.” Those technical insights drove the team to question the underlying physics of how sonic pressure waves should be generated and delivered.

A Model for Medtech

Despite progress in some areas of medtech, cardiovascular technology leadership remains predominantly male, particularly at the senior technical level. But there are other paths forward. When companies build leadership teams on merit and foster cultures that value diverse perspectives, technical excellence, and representation, the two don’t just coexist — they reinforce each other.

At FastWave, women aren’t just 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 has grown, other FastWave leaders like Anindita Sengupta, Head of QA/RA, have joined to build out the regulatory and quality infrastructure needed to bring the technology to market.

Crucially, they are also leading with openness — actively engaging with cardiologists and vascular specialists from a variety of backgrounds to refine and advance the company’s platforms. That willingness to integrate broad, real-world feedback ensures the technology reflects not just engineering expertise but the lived experience of those using it in practice.

The outcome is instructive: when diverse, merit-based leadership combines technical depth with responsiveness to user needs, the technology becomes more aligned with both physician workflow and patient realities. In cardiovascular care, where the stakes are life and death, that alignment matters. Tieso and Iyer offer evidence that representation, technical rigor, and an openness to diverse voices can intersect to advance medical technology in meaningful ways.