Adult Cardiothoracic Anesthesia Fellowship

The Adult Cardiothoracic Anesthesia Fellowship is an Accreditation Council for Graduate Medical Education (ACGME) accredited 1-year fellowship. The goal of the fellowship is to provide an academic environment and enough clinical substrate to ensure that the fellow achieves a level of autonomy in delivering anesthetic care for complex cardiac surgery. 

Curriculum / Clinical Training

Echocardiology

Extensive clinical and formal didactic training in transesophageal echocardiography is provided via lectures and clinical training. In addition to performing TEE on all his/her cardiac cases throughout the year the fellow will have a dedicated rotation in echocardiography. This will involve intraoperative examinations and interpretation as well as examinations under the teaching of our cardiology service. Here the fellow will have the opportunity to learn transthoracic echocardiography as well as transesophageal echocardiography. The program is structured so that the fellow will have performed and interpreted the required number of exams to sit for the advanced PTEeXAM given by the National Board of Echocardiography. To date all of our fellows who have taken the exam have passed on the first attempt.

Perfusion

A two-week rotation with the Perfusion Service is offered during which the fellow will have the opportunity to learn basic perfusion techniques and physiology. The fellow will assemble the perfusion circuit and assist the perfusionist in maintaining the patient on cardiopulmonary bypass. This allows the fellow to gain the perspective necessary to collaborate with the perfusionist to plan for today’s increasingly complex cardiac surgeries. One day a week during this rotation the fellow will scrub with the surgeon for a case for some closer hands-on experience.

Cardiac Surgical Intensive Care

The fellow will have a one-month rotation in the cardiac surgical intensive care unit. Here the fellow will participate in the care of the postoperative cardiac surgical patients. This allows the fellow to gain an understanding of potential complications and how our operating room management impacts the patient’s recovery. During this rotation they will also be given the opportunity to join one of our surgeons in his office and see patients coming for preoperative consultation and postoperative follow up.

Thoracic Anesthesia

A one-month rotation on the thoracic anesthesia service is also provided where the fellow will provide anesthesia for complex thoracic patients. The fellow will have ample exposure to double lumen tube placement utilizing fiberoptic bronchoscopy. They will manage one-lung ventilation and have the opportunity to place thoracic epidurals. During this rotation they will also be given the opportunity to join one of our surgeons in his office and see patients in that area.

Throughout the year the fellow is given the opportunity to provide anesthesia for major vascular cases such as open thoracoabdominal aneurysm repair and thoracic endovascular aneurysm repair.

Cardiology 

The fellow will have a two-week rotation with the cardiology service. During this time the fellow will round with the cardiology fellows and the attending cardiologist on the acute inpatient cardiology service. The fellow will have exposure to the management of various cardiac diagnoses including acute MI and post interventional catheterization patients. The fellow is encouraged to observe cardiac catheterization procedures during this time as well.

Electrophysiology/Cardiac Catheterization

A total of 4 weeks in the electrophysiology/Cardiac Catheterization suite is also offered. Here the fellow will gain an appreciation for the increasingly complex nature of the procedures performed in this arena. The fellow will spend two weeks providing anesthesia for these procedures and two weeks with the Electrophysiologist.

The fellow will have the opportunity to mentor a resident for his/her case conference presentation at least once per year. The fellow will also take part in Journal Club once a year. The fellow will have the opportunity to participate in ongoing clinical research projects conducted within the department.