Welcome Letter from Program Chief

Yoshifumi Naka, MD, PhD Director, Cardiac Transplantation and Mechanical Circulatory Support Programs

Each year approximately 500,000 Americans are diagnosed with heart failure—their hearts have become too weak to effectively pump blood to the rest of the body. Heart failure usually develops slowly over time and some loss in pumping capacity is natural as people age. With end stage heart failure, however, that loss becomes life threatening and is no longer manageable through medical therapies.

Previously, heart transplantation was the only hope for patients with end stage heart failure. Founded over a quarter of a century ago, the heart transplant program at NewYork-Presbyterian Hospital/Columbia University Medical Center (NewYork-Presbyterian/Columbia) is the top cardiac transplant program in the United States by volume. In an effort to overcome some of the limitations of transplantation (in particular, the long waiting lists for donor organs), our surgeons have helped to spearhead the international effort to develop and implement cardiac assist devices, which provide mechanical support to failing hearts.

The Mechanical Circulatory Support Program, led by Yoshifumi Naka, MD, PhD, was founded at NewYork-Presbyterian/Columbia in 1990. Initially, the goal of the program was to provide a bridge-to-transplantation for patients requiring heart transplants—supporting their lives until a suitable donor heart became available. Today, we also offer assist devices as a destination therapy for patients with end stage heart failure who are not eligible for a transplant.

Currently, the most common type of cardiac assist device is a left ventricular assist device (LVAD). In 2003, we implanted around 40 LVADs, of which 30 were intended as a bridge-to-transplantation and 10 as a destination therapy. We have trained surgeons at over 100 medical centers worldwide in how to implant LVADs. We are also paving the way in the research and innovation of new approaches to mechanical circulatory assistance. In particular, we are investigating a range of new devices in an effort to provide patients with devices that are smaller, quieter, and more portable, fully implantable, or capable of providing biventricular support.

Through all of these efforts, our mission remains to both extend life and the quality of life for end stage heart failure patients.