Progress ReportReports of the Clinical Vice Chairmen

Cardiac
Mehmet C. Oz, MD

Mehmet C. Oz, MD Director, Cardiovascular Institute; Vice Chairman, Cardiovascular Services

The Department of Surgery has made major advances in the treatment of heart failure, atrial fibrillation, and minimally invasive heart surgery. Under the leadership of Craig R. Smith, MD, the Division of Cardiothoracic Surgery has partnered with the biotech industry to create new surgical devices and minimal access techniques. We have also conducted major trials on the safety, cost effectiveness, and life-extending benefits associated with these new procedures.

Columbia surgeons pioneered the implantation of the LVAD (Left Ventricular Assist Device), an implantable heart pump that may keep heart failure patients alive for up to four years while they are awaiting transplant. We have begun using the LVAD in high-risk patients and in the last decade, we have administered over 100 training programs in surgical centers throughout the world. The department is now working closely with the bioengineering industry to test a second and third generation pump under the leadership of Yoshifuma Naka, MD.

With our industry partner, Thoratec, we sponsor a program called HeartHope. Our goal is to educate physicians and patients about the appropriate use of LVADs and other heart failure therapies, and also work with insurance companies to ensure patient reimbursement.

Our new approach to mitral valve repair is perhaps the most important advance in the arena of minimal access surgery. After advancing the "bow-tie procedure" that allows us to repair more complex leaky valves with addition of a single stitch, we invented and helped develop a device that accomplishes the same results. The Evalve® is a percutaneous method of edge-to-edge mitral valve repair that allows us to perform this surgery without cardiopulmonary bypass.

Some of our most dramatic successes involve new approaches to Atrial Fibrillation (AF). Columbia is now one of the main training centers in the nation for AF surgery. Led by Michael Argenziano, MD, our physicians helped pioneer a new approach to AF called pulmonary vein isolation, and performed the world's first totally endoscopic beating-heart AF ablation, using a microwave probe and the da Vinci™ surgical robot.

In collaboration with bioengineering firms, our Surgical Arrhythmia Program has begun to test other energy sources for ablation, including laser, high-intensity ultrasound, and chemical injections.

Columbia faculty also host an annual conference called New Era, a forum for medical device and pharmaceutical firms to dialogue with cardiovascular specialists to discuss and refine the latest innovations.

Our researchers have shown that robotically assisted and minimal access techniques can improve the patient experience with acceptable costs.