Department   of  AnesthesiologyVanderbilt  University  Medical  Center

Division  of  Cardiothoracic  Anesthesiology

Compassionate  |  Creative  |  Committed  |  Collaborative

INT

RO

DU

CT

ION The Vanderbilt Adult Cardiothoracic Anesthesia Fellowship Program is committed to providing

the highest quality t raining for future leaders, educators, and practitioners of cardiothoracicanesthesia. We offer a breadth of clinical experience including, but not limited to:

• On-pump coronary artery bypass surgery• Off-pump coronary artery bypass surgery (OPCAB)• Valve surgery• Minimally invasive surgery• Aortic surgery (including DHCA)• Thoracic surgery (VATS, open and interventional pulmonology)• Airway reconstruction• Heart and lung transplant• Ventricular assist device placement• Hybrid operating room procedures (Atricure, TAVR, Mitraclip, Lariat, Watchman)

Our ACGME-accredit ed program offers three one-year positions availabl e annually. We have made anapplication to expand the fellowship and expect to fill five positions starting in 2017. For our large clinicalvolume (1,500 cardi ac cases/year), the number of fellows in the program is rel atively small, allowing theopportunity for a personalized, tailored educational experi ence for each fellow. While the fellowship has aprimary focus of clinical training, fellows are required to complete at least one academic proj ect with a facultymentor during their fellowship year.

For fellowship candidates interest ed in a moreintensive research experi ence, we offer a research trackin Cardiothoracic Anesthesi a which requi res a 2-yearcommitment. The first year consists of researchconducted under the supervision of a faculty member atVanderbilt, and may be spent in any suitable laboratoryor research group. The second year is spent in the regularclinical fellowship, and successful completion of thisprogram will enable a competitive application to thedepartmental NIH T32 training program for academicperioperative physicians (75% protected non-clini caltime). During this advanced research program, fellowsmay simultaneously pursue a Master of Science inClinical Investigation (MSCI), a master’s programspeci fically designed to pai r young investigators withestablished mentors and provide coursework instatistical analysis and clinical trial design. Applicantswith an interest in this academic path may also applyafter their clinical fellowship year.

There are also clinical two-year fellowship options forfellows who wish to pursue additional subspecialtytraining and/or certifi cation in critical care, pain, orpediatric cardiac anesthesiology.

The clini cal program follows the course of study outlined by the ACGME Adult CardiothoracicAnesthesia Fellowship criteria.

Adult cardiothoracic rotation (7 months)

We are committed to providing the highest quality training for future leaders, educators, and practitioners ofcardiothoracic anesthesia. We offer a breadth of clinical experience in core cardi ac surgery procedures such asCABG, valve replacement surgery, aortic surgery and heart and lung transplant. In addition, fellows will getample exposure to caring for patients undergoing hybrid procedures (Atri cure, TAVR, Mitraclip, Lariat,Watchman), el ectrophysiology procedures (pacemaker/IC D placement), and int erventional cardiologyprocedures (t andem heart and ECMO placement, catheter based pulmonary thrombectomy, and device closureof sept al defects). As part of a program of graduated responsibility, teaching /supervision of residents in cardiaccases will be available in the second half of fellowship (January to June).

Cardiovascular intensive care unit rotation (1 month)

Fellows spend a month in the cardiovascular IC U under the supervision of cardiothoracic and criti cal careanesthesiologists. Fellows will be responsible for the comprehensive management of criti cally ill cardiovascularand thoracic patients.

Adult thoracic anesthesia rotation (1 month)

Fellows will get exposure to a wide variety of thoracicsurgery cases (600 cases/yr.) including VATS,thoracotomy, esophagectomy, lung volume reductionsurgery, lung transpl antation, airway reconst ruction andpectus repair. Fellows can also choose to spend time in thebronchoscopy suite where we have a robust interventionalpulmonary practice (1,800 cases/yr.).

Pediatric cardiothoracic anesthesia rotation (1 month)

Fellows are the primary anesthesia provider for pediat riccardiac surgery patients under the direct supervision of theattending. Pediat ric cardiac areas include operating rooms,a catheterization lab, and an electrophysiology lab.

Cardiology elective (1 month)

Four weeks are spent in the subspecialty ofechocardiography under the supervision of adultechocardiography cardiologists. During the rotation,fellows continue to develop skills in performance andinterpret ation of transthoraci c echocardiography. They arerequi red to attend all cardiology conferences during thatmonth.

Elective rotation (1 month)

Typically, one of the two elective months is a cardiologyrotation, but other clinical or research el ectives pert ainingto cardiothoraci c anesthesi a may be substituted withpermission of the Program Director.

CLI

NIC

AL

PR

OG

RA

M

The fellowship has several components that contributes to the academic enrichment of fellows:

Weekly Cardiothoracic Division Conference (CME)

Our CME accredited weekly conference covers a wide spectrum of topics pertinent to the management of thecardiothoracic pati ent. Lectures are given by cardiothoracic surgeons, interventional and heart failurecardiologists, electrophysiology speci alists, thoracic surgeons, interventional pulmonologist, as well as ourcardiothoracic anesthesiology faculty. Every quarter a guest lecturer from an outside institution is invited togive a talk in their area of expertise. In addition challenging case presentations and journal club are also heldduring this conference. This conference has been highly regarded by past fellows as an integral part of thei rtraining.

Weekly Echo Conference (CME)

Led by Dr. Robert Deegan, director of perioperativeechocardiography who has 20 years of echocardiographyexperience, fellows will get exposure to evaluation andinterpret ation of both common and rare cardiac pathology.Approximately 150 cases are reviewed annually duringthis conference.

TEE Simulation

Cardiothoraci c fellows will receive image acquisitiontraining on our high fidelity Heartworks TEE simulators inCELA and our division office suite. The simulatorsdemonstrat e cardiac anatomy and the complex spatialrelationships involved in TEE imaging with impressiveclarity. Experi ence with the TEE simulator allows fellowsto rapidly mast er basi c imaging anatomy in order toprogress to more advanced aspects of the TEE exam.

Scholarly Activities

Fellows are encouraged to attend and submit presentationsto local, regional, and national cardiothoracic meetings.They are given a Continuing Medical Education (CME)budget to help defray the expenses of a conference. Allfellows will be expected to attend the Society ofCardiovascular Anesthesiologists Annual meeting topresent their work.

Oral Board Preparation

Several members of the department are oral boardexaminers. Fellows will be eligible to parti cipat e in thedepartmental oral board preparation program, whichincludes several mock oral examinations.

AC

AD

EM

IC E

NR

ICH

ME

NT

KE

Y F

AC

ULT

Y

Warren Sandberg, MD, PhDProfessor and Chair

Andrew Shaw MB, FRCA, FFICM, FCCMProfessor of AnesthesiologyVice-Chair of Clinical Affairs

Executive Medical Director for Perioperative Services

Mias Pretorius, MBChB, MSCIAssociate Professor of Anesthesiology and Clinical Pharmacology

Interim Chief, Cardiothoracic AnesthesiologyProgram Director, Cardiothoracic Anesthesia Fellowship

Bantayehu Sileshi, MDAssistant Professor of Anesthesiology

Associate Program Director, Cardiothoracic Anesthesia Fellowship

Robert Deegan, MB, ChB, BAO, PhD, FFARCSIAssociate Professor of Anesthesiology and Clinical Pharmacology

Director, Intraoperative EchocardiographyMedical Director II, OR Cardiac Services

Susan Eagle, MDAssociate Professor of Anesthesiology

Director, Thoracic Anesthesiology

KE

Y F

AC

ULT

Y

Jeremy Bennett, MDAssistant Professor of Anesthesiology

Director, Non OR Cardiac Anesthesiology

Josh Billings, MD, MSCIAssistant Professor of Anesthesiology

Division of Critical Care Anesthesiology

Yafen Liang, MDAssistant Professor of Anesthesiology

Jason Kennedy, MDAssistant Professor of Anesthesiology

Medical Director, Perfusion Services and ECMO

Antonio Hernandez, MDAssociate Professor of Anesthesiology

Medical Director, CVICU

Julian Bick, MDAssistant Professor of Anesthesiology

Jane Brock, DOAssociate Professor of Anesthesiology

Amr Waly, MDAssistant Professor of Anesthesiology