GOREDGONUTSYou may see a lot of women wearing red Friday, February 6th, to mark “Wear Red” Day. We support this – go ahead and wear read, even if it’s not your color! Because heart disease is the number 1 killer of women. That’s right – one in three women die of heart disease in our country, which is approximately one woman per minute. At least one or two women may have died since you began reading this blog.

We think it’s time to do something about this grim trend. So, after you’ve shown off the red dress for the day, how about taking it one step further?

Heart surgeons at Columbia University’s Department of Surgery, all of whom are recognized as top in their fields, shared their top nuggets of advice below. Lest you are tempted to run in the other direction at the hint of a scolding, rest assured these are small steps everyone can take – but which may just make a difference in how long – or how healthy – your life may be.

1)     Don’t be a stranger. To your doctor, that is. If you haven’t had a physical exam in more than a year, now would be a good time to break that trend. Michael Borger, MD, Director of the Aortic Surgery Program, wrote, “Women have a much higher prevalence of atypical symptoms, particularly for coronary artery disease, and therefore often present with more advanced disease. That is, their doctor often thinks they have gastrointestinal problems or ‘bad nerves’ before realizing (often too late) that it was angina (chest discomfort due to poor blood flow through the blood vessels in your heart). Therefore, my word of advice would be, ‘Make sure your doctor listens to you.’” Echoing this thought, the advice of Henry M. Spotnitz, MD, Director of the Cardiovascular Surgery Research Lab, “Find a doctor you enjoy visiting,” may sound deceptively simple — but his words underscore the importance of regularly seeing a doctor with whom you feel comfortable and who will genuinely listen. A good relationship with your doctor will make it more likely that you’ll discuss your risk factors for heart disease, and that he or she will take the time to help make sure you address risk factors such as high blood pressure or others that put your heart at risk.

2)     Go Nuts! Eat nuts, that is, and fruits and vegetables and other unadulterated, nutritious foods. As Sayed Tasnim Raza, MD, FACS, Director of the Cardiac Surgery Step-down Unit puts it, “Cook at home and go back to your grandmother’s cooking.” He warns us to avoid any food manufactured in a factory, which means NO processed foods, no canned foods, or boxed foods. A healthy diet that includes fruits and vegetables, grains, healthy protein, and healthy fats is one of the most important things you can do to protect your heart health.[1] [2] Even when you shop for groceries and cook at home, it is important to choose foods in their natural state (with nutrients and fiber intact) in lieu of processed products that contain artificial chemicals, added sugar, and high levels of salt and saturated fats.

3)     Go fly a kite. Join the neighborhood gym. Or catch up on the local gossip while speed-walking with your girlfriends around the neighborhood. However you enjoy being active, make sure you work your heart and body at least three hours per week, says Craig R. Smith, MD, Chairman of the Department of Surgery. Or, as Dr. Spotnitz put it, “Don’t consider your day complete without regular exercise.”

4)     Less is more — when it comes to waist size. “Maintain a normal waist size,” says Dr. Smith; indeed, research has linked higher waist circumference (above 35 inches for women, and 40 inches for men) with a higher risk of diabetes and heart disease.[3] Although obesity increases the risk of heart disease, waist size is a more accurate predictor than weight or body mass index (BMI) of death from heart disease because abdominal (visceral) fat is linked to insulin resistance, inflammation, and unhealthy cholesterol levels.[4]

5)     Stay sweet. In moderation. If you are among the third of adult women in the US who need to watch your weight or manage diabetes, there’s no better place to start taking care of your health than getting your diabetes and weight under control. Diabetes increases the risk of heart disease, and two out of three people with diabetes will die from heart disease or stroke. [5] You can significantly minimize this risk by carefully managing your diabetes through a heart-healthy diet, regular exercise, and medical therapy.

6)     Look on the bright side. Negative thinking and emotions can adversely affect health. High levels of distress about family or work can damage the heart almost as much as smoking, according to a Canadian study from 2004. Numerous other studies have found that depression, cynicism, and chronic stress increase the risk of heart disease.[6] [7]  People who have an optimistic outlook have better cardiovascular health compared to people who are less optimistic. Not only are optimists more likely to have intermediate or ideal total heart health scores, but compared to less optimistic peers, they have better cholesterol and blood sugar levels, healthier body weight, and more rigorous physical activity levels.[8]

7)     Get with the 21st century. Cigarettes were cool in those old movies with John Wayne, but that’s so last century. We know better now.  By damaging the heart, blood vessels, and blood cells, it increases the risk of atherosclerosis and peripheral arterial disease, heart attack, and stroke.  Today smoking is directly responsible for one fifth of heart disease deaths in the U.S. and is the number one cause of preventable disease and death. So please, listen to Emile Bacha, MD, Director of Pediatric and Congenital Heart Surgery at Morgan Stanley Children’s Hospital of NewYork-Presbyterian. Don’t start smoking, and if you do smoke, stop.  Our colleague and Nobel laureate, Eric Kandel, MD has shown that eCigarettes aren’t the answer either.[9]

8)     Party hardly. Dr. Bacha advises women to limit alcohol to no more than one drink per day, with ‘a drink’ meaning one 12 oz. beer, 4 oz. of wine, 1.5 oz. of 80-proof spirits, or 1 oz. of 100-proof spirits. Drinking more than this can lead to high blood pressure, elevated ‘bad’ cholesterol, obesity, diabetes, and heart failure. Excessive and binge drinking can also cause stroke, arrhythmia, cardiomyopathy, and sudden cardiac death.

9)     Relax. Taking time out to meditate for even a short period of time each day can have dramatic benefits in preventing heart disease. Meditation reduces stress and reduces blood pressure, atherosclerosis, and heart rate. In some cases, the benefits of meditation are significant enough that patients can stop taking blood pressure medication, and studies have found it to reduce coronary heart disease and heart failure. [10]

10)  Turn it off. The TV, the computer, the X-box, all of it. Sitting for hours contributes to heart disease, increases the likelihood of disability after age 60, and shortens our lifespan. Research is now clear that even regular exercise cannot offset the effects of a sedentary lifestyle.[11] [12] [13]

The advice from individual surgeons in the Division of Cardiac, Thoracic, and Vascular Surgery was remarkably consistent. Their feedback was perhaps best summarized by Isaac George, MD, Surgical Director of Transcatheter Therapies at Columbia’s Heart Valve Center, who said the following: “Learn and understand your risk factors for heart disease. See your doctor and work to reduce this risk.”

We hope you will heed their advice, starting this month, to protect your hearts now and in the decades to come.  Follow us on Facebook and Twitter for continued information about your heath and visit for more information.





[4] Central obesity and survival in subjects with coronary artery disease: a systematic review of the literature and collaborative analysis with individual subject data. Coutinho T et al. Journal of the American College of Cardiology 2011 May 10;57(19):1877-86. doi: 10.1016/j.jacc.2010.11.058.



[7] Psychosocial Factors and Inflammation in the Multi-Ethnic Study of Atherosclerosis. Nalini Ranjit et al. Arch Intern Med. 2007;167(2):174-181. doi:10.1001/archinte.167.2.174.

[8] Multi-Ethnic Study of Atherosclerosis. Am. J. Epidemiol. (2002)156 (9): 871-881.doi: 10.1093/aje/kwf113




[11] Effects of Physical Activity and Sedentary Time on the Risk of Heart Failure. Deborah Rohm Young, PhD et al. Circulation: Heart Failure, 2014; 7: 21-27.

[12] Sedentary Time in U.S. Older Adults Associated With Disability in Activities of Daily Living Independent of Physical Activity. Dorothy Dunlop et al. Journal of Physical Activity and Health, Nov. 12, 2013

[13] Duck-chul Lee, Russell R. Pate, Carl J. Lavie, Xuemei Sui, Timothy S. Church, Steven N. Blair.Leisure-Time Running Reduces All-Cause and Cardiovascular Mortality RiskJournal of the American College of Cardiology, 2014; 64 (5): 472 DOI: 10.1016/j.jacc.2014.04.058


2014: A Year in Review

by Columbia Surgery on December 26, 2014


Using 3D printing technology to repair a baby’s heart, discovering new ways to preserve livers for transplantation, helping chemotherapy drugs find their way to treat pancreatic cancer, and performing surgery with robots through pinhole incisions are just some of the breakthroughs that stood out during 2014 at Columbia University Department of Surgery. Some of these innovations are already saving and improving lives, while others under investigation have demonstrated significant success in advancing our understanding of the science behind the medicine. All will have far-reaching impact for years to come

Read more about this year’s highlights:

Three-Dimensional Printed Heart Helps to Save Baby’s Life

Even the most ardent advocates for 3-D printing may have may have been stunned in late 2014 when Dr. Emile Bacha, Chief of the Congenital and Pediatric Heart Surgery, used the technology to save the life of a two-week old baby.

The baby was born with complex heart defects including many holes and malformations. Dr. Bacha’s surgical team printed a 3-D model of the heart based on a CT scan, which they were able to study before operating. This process enabled them to plan exactly how they would approach the procedure, including the order of steps and where they would put patches and sutures.

According to Dr. Bacha, “the baby went from having a limited life expectancy to normal life expectancy. And instead of needing three or four surgeries to repair the multiple defects, we were able to correct all the defects in a single surgery.”

See CNBC’s coverage of the story:

Tackling Pancreatic Cancer: New Strategy to Help Chemotherapy Drugs Reach their Target

Pancreatic cancers are notoriously resistant to chemotherapy drugs because their dense tissue blocks penetration of systemic drugs. Thanks to the persistence of determined researchers and significant funding from the National Institutes of Health, that barrier may soon be overcome. A study led by Dr. Kazuki Sugahara, who joined Columbia University College of Physicians and Surgeons as a research scientist and surgical resident in 2014, aims to create a new type of chemotherapy delivery system that will be far more effective than what has been available to date.

Building on his earlier discovery that found that small pieces of proteins called peptides are able to penetrate deeply into pancreatic cancers and other fibrotic tissue, Dr. Sugahara and his colleagues are now working to test the safety of using the peptides as carriers for cancer drugs.

According to Dr. Sugahara, a delivery system that gets through the tissue barrier and directly infiltrates the tumor cells could have tremendous therapeutic impact.  The work in the Sugahara laboratory is part of the Department of Surgery’s broad mission to tackle pancreatic cancer from every angle, which includes initiatives in early detection, prevention and genetic testing, and the full range of medical and surgical options.

Learn more about our efforts to fight pancreatic cancer at

First Robotic Whipple Procedure for Pancreatic Cancer

Use of the surgical robot gained a significant foothold during 2014 when Drs. Yanghee Woo, Director of the Global Center of Excellence in Gastric Cancer Care and John Chabot, Chief of the Division of GI/Endocrine Surgery and Executive Director of the Pancreas Center, performed the first robotic Whipple procedures at the NewYork-Presbyterian/Columbia University Medical Center.

The Whipple procedure, a common surgical procedure to remove pancreatic tumors, was first developed in 1935 by Dr. Allen Whipple, a professor of surgery at Columbia University.  It involves removal of the head of the pancreas, the first part of small intestine (duodenum), the gallbladder, the end of the common bile duct, and sometimes a portion of the stomach.

The robotic surgical approach was initially used it to treat benign conditions and less advanced cancers before reaching patients with pancreatic cancer. While this process revealed it to be less useful in some operations, it has great benefit for a number of colorectal, liver, and gastric operations where it reduced surgical trauma, shorter hospital stays, and shorter recovery times. Because of the surgical robot’s freedom of movement, precision, and magnified 3-D imaging capability, Dr. Woo is confident that she is able to do complex gastric operations better with the robot than without, and that robots will become an integral part of the OR in the coming decades.

Read the full story on our previous blog post.

Preventing and Reversing Lymphedema after Breast Surgery

The treatment of lymphedema, a disfiguring, painful swelling of the arms and hands that can occur after removal of the lymph nodes during breast cancer surgery, saw much innovation with the Clinical Breast Cancer Program in 2014.

The Department of Surgery is the first in the U.S. to perform LYMPHA, a procedure at the time of lymph node removal that could potentially prevent the development of lymphedema. This surgical procedure creates a bypass to restore lymphatic flow by connecting lymph vessels to a branch of the axillary vein, significantly reducing the risk of developing the condition.

In addition, following the success of a similar study among English-speaking patients, a new study by the Clinical Breast Cancer Program aims to reduce the incidence and severity of lymphedema in the Chinese community through implementation of a Chinese language educational intervention. The program emphasizes specific breathing techniques, arm exercises, proper skin care and protection, and behavioral interventions to promote lymph flow, prevent inflammation and infection, and maintain optimal body weight.

Check out ABC 12 KSAT’s coverage of this story.

Hypothermic Liver Perfusion: Closing the Gap between Supply and Demand for Donor Livers

To increase the number of healthy donor livers available for transplant, experts at the Center for Liver Disease and Transplantation and the Molecular Therapies and Organ Preservation Laboratory of the Department of Surgery have been working to find ways to better preserve and protect donated livers, rendering them eligible for transplantation. Dr. James Guarrera, Surgical Director of Adult Liver Transplantation, and his team became the first anywhere to successfully use hypothermic machine perfusion (HMP) in the liver.

Whereas traditional cold perfusion involves preserving the donor organ at cold temperature, hypothermic machine perfusion (HMP) entails infusing the donor organ with oxygen and nutrients to simulate aliveness and reduce injury to the organ. The continuous flow of nutrients not only preserves the organ, which has shown better outcomes, shorter hospital stays, and fewer long-term complications, but it can also improve the function of an imperfect liver.

These were considered “orphan” livers that were initially deemed too compromised for transplant and likely would have been among the 600 donor livers discarded each year, but with these advances,  “we should be able to expand the liver donor pool, making transplant available to many more patients,” says Dr. Guarrera.

Learn more about HMP here.

TAVR offers Lifesaving Option for Patients Unable to withstand Open-heart Surgery

The Columbia Heart Valve Center at the Department of Surgery marked a milestone in cardiac care upon completing its 1,000th transcatheter aortic valve replacement (TAVR) in March, 2014.

TAVR is a catheter-based procedure for patients with aortic stenosis who need a new heart valve but are too sick to undergo open-heart surgery.  During TAVR, a replacement valve is inserted through the groin and advanced to the heart using a specially designed delivery catheter. With this technique, the aortic valve can be replaced without incisions and without stopping the heart.

“Before we had TAVR, many of our patients had no clinical options to treat their aortic stenosis, a potentially fatal condition,” says Dr. Susheel Kodali, Director of the Columbia Heart Valve Center. “As of today, we have been able to treat more than 1,200 patients with exceptional outcomes, thanks to this lifesaving procedure.”  With this milestone, he Columbia Heart Valve Center remains the highest volume center in the US and plays an integral role in the development of the technique.

See CBS’s coverage of the story:

Unprecedented Studies in Human Immunology

Because of the near-impossibility in obtaining human immune cells from healthy lymphoid tissues, research has generally been done on peripheral blood and mouse models, leaving 98% of the immune function (the lymphatic system) almost entirely unstudied and very poorly understood. A new multicenter study led by Columbia Center for Translational Immunology (CCTI) is now exploring this frontier with unprecedented access to human lymph tissues (the spleen and lymph nodes, lungs and intestines, and skin and liver) from deceased organ donors, provided through the first-ever collaboration with the New York Organ Donor Network.

The first part of the 4-part study, directed by Dr. Donna Farber of CCTI has already led to new discoveries about T cells that have the potential to yield paradigm changes in the effectiveness of vaccines and immunotherapies.  Other segments of the study investigate how to effectively target B cells in vaccines and immunotherapies and to develop new tissue repair strategies. A fourth segment, which includes collaboration with Dr. Megan Sykes, Director of CCTI, and Dr. Tomoaki Kato, Surgical Director of Liver and Intestinal Transplantation at the Department of Surgery, may yield new methods of achieving immune tolerance after organ transplantation.

According to Dr. Farber, “We now have the technological tools for high-throughput analysis and for probing molecules and proteins. With these tissue samples, we can go far beyond what we were ever able to do in studying human physiology.”

Reducing the Toll of Liver Disease: Education Matters

Treatment of liver disease is only the first step; the next most important task may be educating the public about it. In a host of speaking engagement, television appearances, and publications, Dr. Robert Brown, Jr., Medical Director of the Transplantation Initiative at the Department of Surgery, has contributed powerfully to public awareness of trends in hepatitis C and fatty liver disease during 2014.

October 2014 marked the arrival of a single tablet regimen (Sofosbuvir/Ledipasvir) for Hepatitis C that cures 95% of patients in 8 weeks, with extremely low side effects. This regimen marks a radical departure from painful injections of interferon and oral medications, which cure less than half of patients while causing side effects so serious that many patients refuse therapy. Dr. Brown asserts that the new, highly effective regimen “should herald a long-awaited milestone in medicine: the beginning of the end of hepatitis C, the most common and deadly chronic liver disease plaguing millions of Americans.” Unfortunately, the high cost of the therapy currently presents a deterrent to insurers, physicians, and patients. Dr. Brown presents critical insight on what appears to be a conflict between curing millions of patients and managing health care costs – and calls on the medical community to consider long-term costs, quality of care, and ethics in their equation.

Dr. Brown also addressed another common liver disease, non-alcoholic fatty liver disease (also called NASH), which affects approximately 80 million Americans. Speaking on the New England Cable Network in the fall of 2014, he informs listeners about the silent but growing epidemic and its relationship to obesity and diabetes.

Read the Dr. Brown’s article in Pacific-Standard Magazine.

See the NECN coverage on fatty liver disease:

Perfecting the Mechanical Heart: 25 Years of Innovation

Initiation of a study of the HeartMate III Left Ventricular Assist System (also called a left ventricular assist device, or LVAD) in 2014 marks 25 years of pioneering work in the field of ventricular support and heart failure management for the Department of Surgery.

Implantable LVADs take over the pumping action of the left ventricle in patients whose hearts are too weak to sustain themselves. Candidates for the HeartMate III trial include patients with advanced heart failure who need a device either as a bridge to heart transplantation, or who are ineligible for transplant and who will use the device indefinitely (called ‘destination therapy’).

The Mechanical Circulatory Support Program at the Department of Surgery is the only New York area surgical group to participate in the HeartMate III study. Having been one of the first surgical centers to pioneer heart transplantation (beginning in 1971), The Department of Surgery has played an integral role in the development of many groundbreaking devices and procedures, including the FDA approval of the HeartMate® II LVAS, the predecessor to the HeartMate III.

Learn more about the history of the artificial heart in the TIME Magazine feature.

Find out more about the current Heartmate III trial here.

Preventing Diabetes after Surgery for Pancreatitis

Beginning in 2014, the Pancreas Center at the Department of Surgery became the first New York surgical center to offer autologous pancreatic islet cell transplantation providing many patients an option to prevent diabetes after undergoing pancreatic surgery.

Every year, roughly 87,000 people in the United States receive surgical treatment for pancreatitis, a debilitating condition that causes intense abdominal pain and, potentially, diabetes. Pancreatitis can be so painful that in some cases, patients must have the entire pancreas removed. While surgery to remove the pancreas (pancreatectomy) relieves pain in 90% of cases, patients are left without the ability to produce insulin, causing a difficult-to-treat form of Type 1 diabetes known as “brittle diabetes.”

In auto islet transplantation, the patient’s islet cells, which produce hormones that regulate the endocrine system, are extracted from the pancreas after it is removed. The cells are then processed and re-infused into the patient’s liver, where they may eventually produce insulin to regulate blood sugar.

According to Dr. Beth Schrope, who spearheaded the auto islet transplant protocol at the Department of Surgery, about one third of patients require no insulin therapy after autologous islet transplantation, another third require some insulin therapy after the procedure, and the procedure is still unsuccessful in preventing diabetes in the remaining third. For two thirds of patients, the reduction of prevention of diabetes represents a tremendous advantage

Learn more in our previous blog posting and Healthpoints newsletter.

We’re looking for to 2015 as a year of continued scientific progress, clinical innovation, and care for our patients!  Keep informed by following us on Facebook and Twitter!



Emile Bacha, MD is Featured on ABC’s The View with Barbara Walters

February 27, 2014

TweetIn honor of February being “heart month,” the February 21, 2014 episode of ABC’s The View, entitled “Barbara’s Heart to Heart,” featured Emile Bacha, MD, Director, Congenital and Pediatric Cardiac Surgery at Morgan Stanley Children’s Hospital at NewYork-Presbyterian. In this episode, Dr. Bacha escorts Barbara Walters through the hospital where she underwent heart surgery four […]

Read the full article →

Transplant Patient Reunites with Care Team

January 30, 2014

TweetTwenty years after receiving a heart and double-lung transplant at NewYork-Presbyterian/Columbia University Medical Center, grateful patient Sean Kunzli and his family came to New York City for a celebratory reunion with his surgeon, Craig R. Smith, MD, and the team that performed this lifesaving surgery. Born with congenital heart disease, Mr. Kunzli underwent the risky […]

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Surgery for Aortic Stenosis: PARTNER Trial Update

January 25, 2014

TweetResults from PARTNER trial Cohort B show that patients with severe aortic stenosis who are unable to undergo traditional surgery for technical reasons fared better with transcatheter aortic valve replacement (TAVR) than patients who were just too sick to undergo valve surgery. Approximately 300,000 Americans have aortic stenosis, or narrowing of the aortic valve in […]

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Paul Kurlansky returns to Columbia for HeartSource and CIOR roles

January 17, 2014

TweetAssistant Professor of Clinical Surgery, NewYork-Presbyterian/Columbia University Medical Center Director of Research, Recruitment and Continuous Quality Improvement, HeartSource Paul Kurlansky, MD, returns to the home of his post-graduate training for a dual role at Columbia HeartSource and the Center for Innovations and Outcomes Research (CIOR). Dr. Kurlansky received his baccalaureate degree from Harvard University and […]

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Concurrent Coronary Artery and Valvular Heart Disease: Hybrid Treatment Strategies in 2013

December 16, 2013

TweetA review published by Columbia University Heart Valve Center’s doctors: Kendra J Grubb, MD*; Tamim Nazif, MD; Mathew R. Williams, MD; and Isaac George, MD Having both heart valve disease and Coronary Artery Disease (CAD) is a common health problem in our aging population. Statistics show patients who have aortic stenosis frequently experience CAD symptoms […]

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TCT Conference Recap

December 9, 2013

TweetThis year marked the twenty-fifth annual Transcatheter Cardiovascular Therapeutics Conference (TCT). TCT is a yearly event where interventional cardiologists, cardiac and vascular surgeons, nurse practitioners, and other health care professionals meet to discuss the latest breakthroughs and developments in the field of interventional cardiology. This year’s conference in San Francisco had over 12,000 attendees, and […]

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Hybrid Cardiac Surgery Twitter Chat: Questions and Answers

November 14, 2013

Tweet On November 8th, 2013, @ColumbiaSurgery and @HeartValveCntr encouraged followers to ask NYP/Columbia Heart Valve Center’s doctors, Isaac George, MD, Attending Cardiac Surgeon, and Tamim M. Nazif, MD, Attending Interventional Cardiologist, about their questions and concerns during a Twitter chat, “Hybrid Cardiac Surgery: A Minimally Invasive Approach to Coronary and Valve Disease.” As promised here […]

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Hybrid Cardiac Surgery: A Minimally Invasive Approach to Coronary and Valve Disease

November 11, 2013

TweetIt is estimated that nearly 1 in 8 people over the age of seventy-five have heart valve disease. Thanks to new technology, many of the patients who were not good candidates for conventional surgery in the past, can now be treated with hybrid surgical approaches. Hybrid cardiac surgery uses both interventional and conventional cardiac procedures […]

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