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.
Dmitriy Yukhvid, MD
Associate Professor of Anesthesiology
Program Director, Adult Cardiothoracic Anesthesiology Fellowship
Upon joining the attending staff in 1976, Dr. Farhan Sheikh took a particular interest in utilizing anesthesia for cardiac surgery and, together with several other anesthesiologists, trained many residents who then became anesthesiologists with an interest in cardiac anesthesia. Dr. Sheikh later founded Albany Medical College’s cardiac anesthesia fellowship training program, with some of those graduates currently working in the division now.
In the late 1970s, Dr. Eric Foster joined the group of cardiac surgeons, and brought to the division expertise in cardiac surgery for children. A heart transplant program existed between 2000 and 2008. An LVAD program existed from 2013-2016. A TAVR program began in 2011 and has continued to grow by leaps and bounds. An ECMO program was started several years ago.
The program gained accreditation for its Adult Cardiothoracic Anesthesiology Fellowship in 2016 with one fellow per year. Currently there are six full-time, board-certified and echo boarded cardiac anesthesiologists trained at multiple institutions. More than 450 open heart cases are performed annually using cardiopulmonary bypass. We also support a busy structural heart program (TAVRs, MitraClips and Watchmans).
Over a period of fifty years, we have seen the advent of PA catheters, TEE, minimally invasive surgeries, off-pump CABG, ventricular assist devices, ECMO and an ERAS program for cardiac surgery. Since its inception, the division of cardiac anesthesiology has consistently risen to new challenges and technologies.
About the Program
Anesthesia care is provided by seven full-time cardiac anesthesiologists trained in transesophageal echocardiography. Currently, we work with five adult cardiac surgeons, one pediatric cardiac surgeon and three 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 Columbia Presbyterian Hospital in NYC 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.
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.
Rescue management of a coronary artery occlusion during transcatheter aortic valve replacement. Divya Yadlapalli, Sridhar Reddy Musuku, Saroj Pani, Anthony G Nappi. J Cardiothorac Vasc Anesth. 2020 Jul 30;S1053-0770(20)30739-4. PMID: 32868153.
Use of Transesophageal Echocardiogram and an Interdisciplinary approach to Intraoperative management of renal cell carcinoma with inferior vena cava invasion. Saroj Pani, Rhiannon Kelsh-Lasher, Joanne Barlin, Clement Darling, Ronald P Kaufman, Jr., Journal of Cardiothoracic and Vascular Anesthesia 34 (2020) 995-1001. PMID: 31780356.
Conservatively treated bacterial Tricuspid valve endocarditis complicated with fungal reinfection, tricuspid valve destruction and septic emboli necessitating surgical intervention. Saroj Pani, Joanne Barlin, Mikhail Torosoff, Sridhar Musuku, Adanna Akujuo Annals of Clinical Anesthesia Research 2019, Vol 3 Issue 1 Article 1019.
Musuku SR, Cherukupalli D, Di Capua C, et al. Point-of-Care Ultrasound Before and After Transfemoral Transcatheter Aortic Valve Implantation. Turk J Anaesthesiol Reanim. 2020;48(6):491-496.
Musuku SR, Doshi I, Yukhvid D, Di Capua CA, Shapeton AD. Supraglottic airway versus endotracheal tube for transesophageal echocardiography guided watchman procedures. Ann Card Anaesth. 2021 Jul-Sep;24(3):345-352.