Adult Cardiothoracic Anesthesiology Fellowship
Welcome to our fellowship program, part of a friendly, collegial department in beautiful upstate New York. We are accredited by the ACGME and are currently accepting one fellow per academic year.
As the region’s only academic medical center with a 25-county service area, you will find that Albany Medical Center’s clinical case load is diverse and has a high degree of acuity. We perform more than 1,400 procedures per year, 500 of those utilizing cardiopulmonary bypass. We have a growing ECMO service providing both VA and VV ECMO for critically ill patients. Additionally, our structural heart practice is very busy with over 600 procedures performed annually. This includes TAVRs, MitraClip and Watchman procedures for which we perform all transesophageal echocardiography (TEE) guidance.
We use a multidisciplinary approach to manage cardiovascular problems. This collaboration between cardiologists, cardiothoracic surgeons, perfusionists, intensivists and nurses is the key to patient safety, and ultimately the success of our program.
I invite you to learn more about our program.
Tanya Richvalsky, DO
Associate Professor of Anesthesiology
Program Director, Adult Cardiothoracic Anesthesiology Fellowship
Our History
Dr. Farhan Sheikh joined the attending staff in 1976 and quickly developed a strong interest in the use of anesthesia for cardiac surgery. Alongside a group of like-minded anesthesiologists, he played a key role in training residents who went on to pursue careers in cardiac anesthesia. Dr. Sheikh later founded Albany Medical College’s Cardiac Anesthesiology Fellowship Program—several of its graduates now serve as faculty within the division.
In the late 1970s, Dr. Eric Foster joined the cardiac surgery team and introduced specialized expertise in pediatric cardiac surgery. Over the years, the program has expanded its scope to include various advanced services: a heart transplant program (2000–2008), a Left Ventricular Assist Device (LVAD) program (2013–2016), and an ever-growing Transcatheter Aortic Valve Replacement (TAVR) program launched in 2011. An ECMO program was also established in recent years.
The Adult Cardiothoracic Anesthesiology Fellowship received ACGME accreditation in 2016 and continues to train one fellow per year. The division now includes eight ABA board-certified and NBE advanced perioperative TEE certified cardiac anesthesiologists who trained at institutions across the country. We support over 450 open-heart cases annually involving cardiopulmonary bypass, in addition to a high-volume structural heart program that includes TAVR, MitraClip, Watchman, and PFO Closure procedures.
Over the past five decades, the division has witnessed and embraced major advancements in cardiac care—from PA catheters and TEE to minimally invasive techniques, off-pump CABG, ventricular assist devices, ECMO, and the implementation of an Enhanced Recovery After Surgery (ERAS) protocol for cardiac surgery. From its inception, the division of cardiac anesthesiology has continuously evolved, meeting new challenges and adopting emerging technologies to provide leading-edge care.
About the Program
Anesthesia care is provided by eight full-time cardiac anesthesiologists trained in transesophageal echocardiography. Currently, we work with five adult cardiac surgeons, one pediatric cardiac surgeon and four thoracic surgeons. We also provide service to a busy vascular surgery practice.
Our state-of-the-art facility includes a dedicated hybrid OR, cath lab and EP suites. We have three cardiac ORs and one OR dedicated to pediatric heart surgery. We are equipped with the latest TEE machines with advanced 2D and 3D capabilities (Philips EPIQ).
Our training is individualized. The fellow will provide anesthesia care for patients undergoing cardiac, thoracic and major vascular surgery at Albany Medical Center. We are fortunate to have a very active thoracic surgical group that performs close to 1,000 procedures a year. At least 600 of these include pneumonectomies, lobectomies, and wedge resections. Our thoracic surgeons also perform thymectomies, esophagectomies and numerous diagnostic procedures for mediastinal and pulmonary masses.
Fellows take call from home for cardiac emergencies such as repair for Type A dissections during the year. This offers an extraordinary variety of cases for our cardiothoracic fellow to be involved with.
The fellowship includes a one-month experience managing adult cardiothoracic surgical patients in a critical care setting as well as a month learning about the intricacies of cardiopulmonary bypass/perfusion. Additionally, there is a required rotation in cardiology and an elective month at New York University Langone Health in New York City for VADs and transplants. During the cardiology rotation the fellow works directly with cardiologists to improve their diagnostic and interpretive skills in echocardiography.
In addition to perioperative teaching, there is a dedicated weekly lecture series. The fellow actively participates in the monthly mortality and morbidity conference, echo rounds and journal clubs and also receives multidisciplinary instruction in both TEE and TTE. The fellow acts as a mentor to residents and has an opportunity to supervise them later in their training. The goal is to provide high quality patient care and to train competent anesthesiologists who will become future leaders in our specialty. By the completion of fellowship, the fellow will be well prepared to take the Advanced PTE Exam.
Research Initiatives
The fellow is required to participate in research with the goal of presenting at the Annual Society of Cardiovascular Anesthesiologists conference. Currently, there are multiple ongoing research projects within the department in which the fellow can participate, many focusing on outcomes research for structural heart procedures.
- Implementation of an ERAS pathway for cardiac surgery
- Supraglottic airway use in Watchman procedures
- Comparison of TAVR outcomes with MAC vs General Anesthesia
- Protocol based use of Swan Ganz catheters in low risk cardiac surgical patients
- Transthoracic echocardiography use for structural heart procedures
Financial support is given to attend conferences. There is full access to departmental resources in preparation for the ABA APPLIED examination.