Innovations in Review 2023

Cardiology and Heart Surgery

In 2023, our cardiologists and heart surgeons made important clinical and scientific advances. From innovative approaches to treating hypertension and pulmonary embolism to performing the first-ever domino partial heart transplant in an infant, the experts at Columbia and Weill Cornell Medicine are maximizing outcomes for patients with all levels of cardiac disease complexity. Our team-based collaborations lead to appropriate, personalized treatments for patients of all ages, elevating clinical outcomes and overall patient care.

Cardiology and Heart Surgery
Cardiology and Heart Surgery

Treating Hypertension with Ultrasound Renal Denervation

Hypertension in middle age is thought to be caused, in part, by overactive nerves in the kidneys. Dr. Ajay Kirtane and the team at NewYork-Presbyterian/Columbia demonstrated that ultrasound-based renal denervation therapy reduced blood pressure by an average of 8.5 points in middle-aged individuals who have not been able to control their hypertension with lifestyle modification or medication. Published in JAMA Cardiology, results of the pooled analysis of studies of the procedure (RADIANCEHTN SOLO, RADIANCE-HTN TRIO, and RADIANCE II) led to the approval of the device by the U.S. Food and Drug Administration in November 2023.

The Paradise Renal Denervation System administers ultrasound energy to the tissue surrounding the artery to decrease the signaling of overactive nerves leading to the kidney. The Hydrocooling System provides active cooling from circulating water to protect the artery (Image courtesy of Recor Medical)

Closing the Gender Gap in CABG Outcomes

There are over 370,000 coronary artery bypass graft (CABG) procedures performed in the United States each year. And while outcomes are improving overall, there is one stark reality: women continue to fare worse than men undergoing this procedure. NewYork‑Presbyterian/Weill Cornell Medicine is tackling this issue with the recent launch of ROMA: Women, a randomized trial which seeks to evaluate single vs. multiple arterial graft outcomes for females to understand the optimal surgical approach based on differences in biology and anatomy. The trial has received overwhelming encouragement to improve gender-based health care and patients have already begun enrolling as of March 2023.

Closing the Gender Gap in CABG Outcomes

The First-Ever Infant Domino Partial Heart Transplant

In May 2023, an integrated team of cardiologists and heart surgeons at NewYork-Presbyterian/Columbia performed the first-ever infant domino partial heart transplant in the world, and the first partial heart transplant in a pediatric patient in New York. Two infants born with different heart conditions benefited from this groundbreaking procedure—the first child received a heart transplant from a deceased donor and was also the living donor for the second child’s partial heart transplant. What made the procedure so novel was that while the domino donor’s heart was not strong enough to function normally, the heart valves were a perfect match for the other young patient who was in need of valve surgery. This allowed for the care team to perform what is called a living allogeneic heart valve transplant, demonstrating that a domino partial heart transplant can occur with a living heart donor.

Drs. Emile Bacha and David Kalfa (NewYork‑Presbyterian/Columbia) preparing the new valves for two month- old Brooklyn during the partial heart transplant

Treatment With the Potential to Transform PSVT

Affecting approximately two million Americans, paroxysmal supraventricular tachycardia (PSVT) is characterized by sporadic episodes of tachyarrhythmia. While it is treatable, the available treatments must be administered under medical supervision and intravenous access, usually in an emergency department or other acute-care setting. Recognizing the need for at-home interventions, NewYork-Presbyterian/Weill Cornell Medicine’s Dr. James Ip served as a primary investigator in a series of studies on etripamil: a rapid-acting, L-type calcium channel blocker that is administered as a nasal spray. The studies showed that etripamil has a significant treatment effect in terminating PSVT at earlier timepoints, and when taken in an optional repeat-dose combination, the termination rates improved even more. The studies’ findings support that etripamil could offer patients a meaningful intervention for their PSVT outside of the more costly and inconvenient acute-care setting.

ECG showing etripamil stopping an episode of PSVT

A Potentially Curative Procedure for CTEPH

In patients with chronic thromboembolic pulmonary hypertension (CTEPH), a pulmonary embolism forms chronic clots and scar tissue in the pulmonary arteries, resulting in severe shortness of breath and poor quality of life. In response, NewYork‑Presbyterian/Columbia cardiothoracic surgeons are performing pulmonary thromboendarterectomy (PTE), a potentially curative surgical procedure that entails putting the patient on cardiopulmonary bypass and cooling the body to remove the clot and scar tissue. NewYork‑Presbyterian has the only PTE program in New York and is one of just a few centers in the eastern U.S. that performs this procedure.

A surgical sample showing the clot and scar tissue removed from a patient with CTEPH during PTE