Advances in Care

On this episode of Advances in Care, host Erin Welsh talks to Dr. Andrew Goldstone and Dr. David Kalfa, pediatric cardiac surgeons at NewYork-Presbyterian and Columbia, about their groundbreaking heart transplant that saved the lives of three separate children. It was the first time doctors at NewYork-Presbyterian Morgan Stanley Children’s Hospital performed a split-root domino partial heart transplant. In this procedure, one child was transplanted with a new heart and their original heart was used to donate living pulmonary and aortic valves to two separate recipients in need.

Dr. Goldstone, Dr. Kalfa and the rest of the team at NewYork-Presbyterian and Columbia had previous experience with a handful of domino partial heart transplants where one patient is transplanted with a new heart and another receives a valve from the explanted heart. Those experiences helped prepare for the split-root domino, which took nearly 24 hours of extremely coordinated care. In addition to their efforts to increase the number of domino heart transplants being done, physician-researchers at the institution are leading new studies that are  also helping improve living valve procurement and storage, allowing more children to receive heart valves that will grow with them and require less surgeries.

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Dr. Andrew Goldstone is the Surgical Director of Heart Transplant and Mechanical Circulatory Support and Director of the Valve Transplant Program at Columbia and NewYork-Presbyterian. He has been recognized nationally and internationally for his clinical and basic science research.  In the lab, he focuses on mechanisms underlying collateral artery formation and cardiac regeneration. His long-term goal is to continue adding high-level evidence to better inform the surgical treatment of pediatric and adult cardiovascular disease.

Dr. David Kalfa is a Board-certified cardiothoracic surgeon with a subspecialization in pediatric cardiac surgery. He is also a researcher focusing in the field of growing heart valves and growth accommodating heart valves.

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On this episode of Advances in Care, host Erin Welsh and Dr. Moeun Son, OB/GYN and Maternal-Fetal Medicine Specialist at NewYork-Presbyterian and Weill Cornell Medicine, discuss Dr. Son’s perspective on treating patients who face a high-risk pregnancy and might need a caesarian delivery.

Dr. Son explains that even though c-sections are a highly common and safe delivery option for many women, they’re not often not the top option in a woman’s birth plan, and don’t carry the same benefits as natural labor. She outlines the standard methods for labor induction to prevent the necessity of a c-section, which includes the administration of a synthetic form of the hormone oxytocin.

Beyond her work with patients, Dr. Son is also passionate about researching alternative methods for labor induction and preventing unnecessary c-sections. She and her colleagues designed a study to promote natural oxytocin release through nipple stimulation – mimicking breastfeeding through the use of a hospital grade breast pump. The success of that treatment eventually led to the The Stimulation To Induce Mothers Study – or STIM Study. Today, it’s an ongoing trial that aims to compare the effectiveness of natural oxytocin versus synthetic oxytocin in helping women give birth vaginally.

Dr. Son hopes that this research will broaden birthing options for women experiencing a high-risk pregnancy, and add more safe and effective treatment methods to the field of women’s health.

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Dr. Moeun Son is board-certified in Obstetrics and Gynecology and Maternal-Fetal Medicine. In her practice, she focuses on women with high-risk pregnancies, from pre-existing maternal conditions to babies with health anomalies. She is the principal investigator on many clinical research projects, including various randomized clinical trials. Dr. Son also serves as the Program Director of the MFM Fellowship Program at Weill Cornell

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On this episode of Advances in Care, host Erin Welsh and Dr. Karan Dua, an orthopedic surgeon at NewYork-Presbyterian and Columbia, discuss novel approaches to shoulder surgery, including transferring donor tendons to the upper extremity with arthroscopic tools. Dr. Dua shares his passion developing personalized treatments that get to the root cause of a wide range of shoulder issues.

Dr. Dua explains the importance of the scapula and what happens when its range of motion is abnormal, or out of alignment. He talks about his process for balancing the scapula to relieve pain in his patients, who are often young and suffering from pain due to injuries from work or sports.

He also discusses the difference between shoulder replacement – a common treatment for patients with arthritis – and shoulder reanimation. Dr. Dua is skilled in shoulder reanimation, and describes how he performs tendon transfers to preserve a patient’s joints and allow them to restore movement of their shoulder. Using arthroscopic instruments, Dr. Dua collects a donor tendon either from another part of the patient’s body or from a cadaver, and replaces the injured tendon with a healthy one.

Dr. Dua hopes to develop a robust scapula program at NewYork-Presbyterian and Columbia that offers targeted treatment for patients suffering from a range of upper extremity issues.

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Dr. Karan Dua is an orthopedic surgeon specializing in the treatment of structures affecting the form and function of the entire arm. He is dual trained in hand, upper extremity, and microvascular surgery, and in shoulder and elbow surgery. He has an avid interest in open and arthroscopic tendon transfers of the shoulder, complex reconstructions after failed surgery, arthroscopic and minimally invasive techniques for nerve decompression including the brachial plexus and around the shoulder blade, and tendon transfers for scapular winging.

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On this episode of Advances in Care, host Erin Welsh first hears from Dr. Richard Friedman, a clinical psychiatrist at NewYork-Presbyterian and Director of the Psychopharmacology Clinic at Weill Cornell Medicine. Using his background in psychopharmacology, Dr. Friedman distinguishes between psychedelics and standard antidepressants like SSRIs and SNRIs, explaining the various mechanisms in the brain that respond uniquely to psychedelic compounds. While both methods of treatment involve serotonin stimulation, psychedelics are the only known drug to shut off the brain’s Default Mode Network, which is the group of brain regions that are active when a person is not thinking about external stimuli. Dr. Friedman also identifies that the challenge of proving efficacy of psychedelic therapy lies in the question of how to design a clinical trial that gives patients a convincing placebo.

To learn more about the challenges of trial design, Erin also speaks to Dr. David Hellerstein, a research psychiatrist at NewYork-Presbyterian and Columbia. Dr. Hellerstein contributed to a 2022 trial of synthetic psilocybin in patients with treatment resistant depression. He and his colleagues took a unique approach to dosing patients so that they could better understand the response rates of patients who use psychedelic therapy. The results of that trial underscore an emerging pattern in the field of psychiatry – that while psychedelic therapy has its risks, it’s also a promising alternative treatment for countless psychiatric disorders. Dr. Hellerstein also shares more about the future of clinical research on psychedelic therapies to potentially treat a range of mental health disorders.

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Dr. Richard Friedman is a professor of clinical psychiatry and is actively involved in clinical research of mood disorders. In particular, he is involved in several ongoing randomized clinical trials of both approved and investigational drugs for the treatment of major depression, chronic depression, and dysthymia.

Dr. David J. Hellerstein directs the Depression Evaluation Service at Columbia University Department of Psychiatry, which conducts studies on the medication and psychotherapy treatment of conditions including major depression, chronic depression, and bipolar disorder.

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On this episode of Advances in Care, host Erin Welsh and Dr. Serge Przedborski, Chief of the Division of Movement Disorders at NewYork-Presbyterian and Columbia, discuss what happens in the brains of patients with Parkinson’s disease. Dr. Przedborski came to Columbia thirty two years ago and has spent that time researching why some neurons in the brain die while others live in people who suffer from the condition – and he’s learned a lot. With the help of the New York Brain Bank at Columbia, his lab has been able to map out what the neuronal patterns of death look like with the goal of using these brain maps to develop novel treatments that seek to address the progression of Parkinson’s rather than just treating the symptoms, which is how all current treatments work.

Dr. Przedborksi also shares updates on new gene therapies that are being investigated across the institution to replace Deep Brain Stimulation – a common treatment for Parkinson’s where a wire is placed in the brain. While these gene therapy treatments are still invasive, the technology behind them is constantly improving and will likely lead to significant benefits to patients

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Dr. Przedborski’s ongoing research aims at understanding the contributions of cell-autonomous and non cell-autonomous mechanisms to neurodegeneration using both toxic and genetic experimental models of Parkinson’s Disease and ALS. In keeping with this goal, how alterations in mitochondrial biology, especially of mitochondrial dynamics and mitophagy, provoke degeneration of specific subpopulations of neurons is one of the main areas of research in the Przedborski laboratory. To what extent and by which mechanisms do non-neuronal cells, like microglia and astrocytes, participate in the demise of neurons in neurodegenerative disorders, such as Parkinson’s and ALS, represent a second main line of research in this laboratory. These research efforts are supported by federal grants from both NIH and the DoD as well as by several private agencies such as the Parkinson's Disease Foundation and the Thomas Hartman Foundation.

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On this episode of Advances in Care, host Erin Welsh explores the story behind the GUARDIAN study, where thousands of newborn babies have been screened against rare disease by sequencing their genes, and looking  for more conditions than any of the current standard screening panels. First, she hears from Dr. Jordan Orange, Physician-in-Chief at Morgan Stanley Children’s Hospital at NewYork-Presbyterian and Columbia, about why genetic testing is a promising way of not only catching treatable rare diseases in infants, but also expanding health equity and medical resources to marginalized populations.

Erin also hears from Dr. Josh Milner, a pediatric immunologist who treated a patient with a rare form of SCID, or severe combined immune deficiency, also known as bubble boy disease that was detected in the GUARDIAN screening panel. SCID is a disease that typically occurs in 1 of 50,000 babies. But GUARDIAN caught two cases within the first 10,000 babies involved in the program, indicating that the rate of the disease might be higher than expected, and that the most accurate way to detect is through genetic screening.

Dr. Steven Lobritto, a pediatric gastroenterologist, also weighs in on how genetic screening can help identify Wilson’s disease, a copper storage disorder that causes liver damage when left unchecked. And Dr. Eric Silver, a pediatric electrophysiologist, discusses how the program detected a heart rhythm disorder called Long QT Syndrome for both a newborn baby and their father.

Finally, Erin gets the big-picture takeaways from Dr. Orange, who reflects on what the results of GUARDIAN could mean for the future of newborn screening and health policy, and how he hopes to see genetic testing expand research and treatment of rare diseases.

Since recording this episode, Dr. Orange has taken on the role of pediatrician-in-chief of the Children’s Hospital of Philadelphia. Under his leadership, the department of pediatrics received consistent funding for research projects, reaching its highest level in 2024. This podcast conversation is a direct reflection of his team’s commitment to advancing children’s health at NewYork-Presbyterian and Columbia.

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On this episode of Advances in Care, host Erin Welsh and Dr. Markus Mapara, Director of the Blood and Marrow Transplantation and Cell Therapy Program at NewYork-Presbyterian and Columbia, discuss the current challenges in treating sickle cell disease and how newly FDA approved gene editing treatments are leading to new treatment pathways. Dr. Mapara covers two new gene editing approaches, explaining that both involve editing stem cells and reintroducing them to patients’ bodies to curb the sickling of red blood cells. He also helps listeners to understand the difference between the two: one gene therapy uses CRISPR technology to help the body create fetal hemoglobin which mitigates cell sickling while the other uses a lentiviral vector to edit stem cells to produce anti-sickling hemoglobin that’s similar to fetal hemoglobin once reintroduced to the body. 

Dr. Mapara also goes into the innovative work that the Blood and Marrow Transplantation and Cell Therapy Program is doing with CAR-T cell therapies. And he shares how these advancements in treating sickle cell disease will have a significant impact on how physicians approach treating patients.

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Dr. Mapara is a Professor of Medicine at Columbia University Medical Center and the Director of the Blood and Marrow Transplantation (BMT)/Cell Therapy Program at New York Presbyterian Hospital/Columbia University Medical Center. He specializes in the care of patients with sickle cell disease and certain blood cancers (Multiple Myeloma, Amyloidosis) undergoing bone marrow transplantation and gene therapy.  His research is focused on developing novel approaches to make bone marrow transplantation and cell therapy safer for patients.. 

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On this episode of Advances in Care, host Erin Welsh and Dr. Craig Smith, Chair of the Department of Surgery and Surgeon-in-Chief at NewYork-Presbyterian and Columbia discuss the highlights of Dr. Smith’s 40+ year career as a cardiac surgeon and how the culture of Columbia has been a catalyst for innovation in cardiac care. Dr. Smith describes the excitement of helping to pioneer the institution’s heart transplant program in the 1980s, when it was just one of only three hospitals in the country practicing heart transplantation.

Dr. Smith also explains how a unique collaboration with Columbia’s cardiology team led to the first of several groundbreaking trials, called PARTNER (Placement of AoRTic TraNscatheteR Valve), which paved the way for a monumental treatment for aortic stenosis — the most common heart valve disease that is lethal if left untreated. During the trial, Dr. Smith worked closely with Dr. Martin B. Leon, Professor of Medicine at Columbia University Irving Medical Center and Chief Innovation Officer and the Director of the Cardiovascular Data Science Center for the Division of Cardiology. Their findings elevated TAVR, or transcatheter aortic valve replacement, to eventually become the gold-standard for aortic stenosis patients at all levels of illness severity and surgical risk. Today, an experienced team of specialists at Columbia treat TAVR patients with a combination of advancements including advanced replacement valve materials, three-dimensional and ECG imaging, and a personalized approach to cardiac care.

Finally, Dr. Smith shares his thoughts on new frontiers of cardiac surgery, like the challenge of repairing the mitral and tricuspid valves, and the promising application of robotic surgery for complex, high-risk operations. He reflects on life after he retires from operating, and shares his observations of how NewYork-Presbyterian and Columbia have evolved in the decades since he began his residency.

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Join host Erin Welsh as she talks with NewYork-Presbyterian physicians from Columbia & Weill Cornell Medicine about how they are solving some of the most challenging and complex cases in medicine. Together, they discuss groundbreaking discoveries, novel treatments, and the dedication to providing compassionate patient care. This is a show for medical professionals interested in how cutting-edge research and innovations are transforming the future of health care.

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On this episode of Health Matters, Faith Salie talks with Dr. Benjamin Lebwohl, a gastroenterologist at NewYork-Presbyterian and Columbia. He’s also the Director of Clinical Research at Columbia’s Celiac Disease Center, and an expert on the connections between gastrointestinal health and the other systems in our body that rely on good digestion for their function. He describes how GI diseases like Celiac have implications for mental health, and what anyone can do to support their digestive health.