Clinical Curriculum

Rotations (months)

  • Adult Cardiothoracic Anesthesia (6.5)
  • Echocardiography (1)
  • Intensive Care Unit (1)
  • Thoracic/Vascular Anesthesia (1)
  • Electrophysiology/Catheterization Lab (0.5)
  • Elective – Research, Thoracic, ICU, Echocardiography (2)

Adult Cardiothoracic Anesthesiology

This rotation, split over six and a half months, will form the backbone of the fellow’s clinical education over the course of the year. The fellow will routinely care for and manage patients with significant comorbidities.

The fellow will be involved with the management of:

  • Valve repair and replacement, both open and minimally invasive.
  • Coronary artery bypass grafting, both on-pump and off-pump.
  • Primary and re-do sternotomies.
  • Robotic revascularizations.
  • MAZE procedures.
  • Open aortic surgery, ascending and descending, with and without deep hypothermic circulatory arrest.
  • Epicardial lead placement.
  • Descending aortic procedures requiring left atrial-femoral bypass.
  • Extracorporeal membrane oxygenation.
  • Intra-aortic balloon pump management.

Transesophageal Echocardiography (TEE)

The fellow will spend one month in the echocardiography lab to focus on TEE. In the echocardiography lab, the fellow will perform and interpret exams under the supervision of cardiology faculty. This rotation will provide the fellow with a unique perspective on TEE exams that is very different from the OR environment. As time allows, the fellow will also have the opportunity to perform/review TEEs that are done in the operating room. The fellow will track and record all TEE exams reviewed and performed throughout the year. Additionally, a TEE lecture series will be given by anesthesiology faculty throughout the year. The fellow will have the option of spending a second month in the echocardiography lab as an elective.

Intensive Care Unit (ICU)

The ICU rotation is one month in duration. The fellow will have the option to use one elective month to spend another month on this rotation. The fellow will manage critically ill cardiothoracic patients on this rotation. The fellow will, as part of a multidisciplinary team, have the opportunity to manage postoperative hemodynamic issues, coagulopathy, postoperative bleeding, cardiac tamponade, cardiac arrhythmias, postoperative cardiac failure, infection, renal failure, stroke, and respiratory failure. The fellow will function on a team that includes residents, the ICU attending, the cardiac surgery attending, and the cardiac surgery advanced practice nurse. The fellow will work under the direct supervision of the ICU attending on service. The fellow will have the opportunity to supervise residents while on this rotation.

Thoracic/Vascular

The fellow will spend one month during the course of the year involved in the care of thoracic cases or major vascular cases. Cooper University Health Care boasts an increasing number of thoracic cases that include minimally invasive resections, open thoracotomies, lobectomies, pneumonectomies, and mediastinal mass resections. We also see a fairly consistent number of descending thoracic aortic aneurysm repairs involving left atrial-femoral artery bypass. The fellow will routinely be assigned to the cases that provide the greatest educational value.

Research (Elective)

The fellow may elect to spend up to two months on this rotation, if approved by the fellowship director. The purpose of this rotation will be to familiarize the fellow with scientific methodology and publication processes. The fellow will be actively mentored by Dr. Ludmil Mitrev, the Director of Clinical Research. The fellow will either initiate his/her own research project or will join a project already under way. The goal of this rotation will be to produce a piece of scientific work that can be presented at a major academic meeting.

Perfusion Services (Elective)

The fellow will have the option to rotate through Perfusion Services for up to two weeks. The fellow will work with the perfusionists to prepare the cardiopulmonary bypass machine prior to pump cases. The fellow will preoperatively assess the patient, and will be responsible for the perfusion of the patient during CPB under the supervision of the perfusionist.

Cardiology (Elective)

The fellow will have the option to rotate for two to four weeks under the supervision of cardiology faculty covering inpatient consults. During this rotation, the fellow will work with the cardiology team to provide inpatient consults on the general medical floors and intensive care units. The fellow will write notes and participate in the care of cardiology patients while on this rotation.