Adult Cardiothoracic Anesthesiology
Vanessa Pantoja, GME Program Coordinator II
UT Southwestern Medical Center
Department of Anesthesiology
and Pain Management
5323 Harry Hines Blvd
Dallas, TX 75390-9068
Ravi Joshi, M.D., FASE
A comprehensive 12-month specialized training experience in the perioperative care of patients undergoing cardiac, thoracic, advanced vascular, and transplantation surgery. UTSW fellows will be taking care of high-risk and complex patient populations at a variety of clinical settings including the modern William P. Clements Jr. University Hospital, Baylor University Medical Center, Dallas Children’s Medical Center, and the North Dallas Veterans Affairs Hospital. As a major transplant center in North Texas, our fellows will have experience in the management of Heart/Lung Transplantation, implantation of extracorporeal devices (LVAD), and new minimally invasive procedures such as TAVR.
Goals and Objectives
Fellows in our Cardiothoracic Anesthesiology training program will:
Develop expertise in advanced cardiopulmonary physiology and pathophysiology
Understand the fundamentals of cardiopulmonary bypass and extracorporeal circulation
Learn the perioperative care of management of the cardiac surgical patient
Manage patients supported on extracorporeal mechanical devices (LVAD, ECMO, Impella)
Provide perioperative care of adult patients for heart and lung transplantation
Become familiarized with Transthoracic Echocardiography (TTE)
Train in minimally invasive cardiac and vascular procedures (TEVAR, TAVR)
Pursue academic or scholarly activity towards journal publication or national presentation
Supervise the training of CA-2 and CA-3 residents in cardiac anesthesia
Develop expertise in Transesophageal Echocardiography (TEE) with the intent to obtain Certification in Advanced Perioperative Transesophageal Echocardiography (PTEeXAM)
Participating Clinical Sites
UTSW William P. Clements, Jr. University Hospital
Baylor University Medical Center
Children’s Medical Center Dallas
Parkland Hospital System
Dallas VA Medical Center
William P. Clements, Jr. University Hospital (CUH) is the primary training site for our fellows, replete with 3 Cardiac operating rooms, 2 Thoracic operating rooms and 2 fully functional Hybrid suites. With a high-risk and complex patient population, fellows training at CUH will be exposed to adult cardiac surgery cases including CABG and valve replacement, aortic surgery with DHCA, heart/lung transplantation, and mechanical circulatory device implantation. Fellows will also experience cases involving minimally invasive cardiac surgery, TAVR, TEVARs, and robotic thoracic surgery. Fellows should expect to perform their own cases and supervise residents.
Baylor University Medical Center - Clinical training in adult cardiac surgery cases including valve and CABG procedures. Experience in heart transplantation is also possible. Fellows will perform their own cases.
Children’s Medical Center Dallas (Elective) - This site offers clinical experience in pediatric cardiac surgery. Fellows may work with the anesthesiology team in the perioperative care of patients with complex congenital lesions.
Parkland Hospital System - Spend elective time with cardiology in the echocardiography lab.
Dallas VA Medical Center - One of the nation’s largest VA Hospitals on an 85-acre campus acts as the secondary training site for our fellows. Clinical training involves the perioperative care of adult cardiac surgery in our veteran population. Elective time in the cardiology echocardiography lab is also possible.
90% of cardiac cases have TEE exams performed
Philips Healthcare Epic 3DTEE machines in all cardiac rooms
Epiaortic ultrasound performed routinely
Robotic Thoracic Surgery
Coronary Sinus Catheter and Pulmonary Vent Placement (Mini-thoracotomy)
Transvenous Pacing Catheter placement
Anesthesia for Transcutaneous Aortic Valvular Replacement (TAVR)
Strain Analysis and Myocardial Mechanic Capabilities
Cerebral oximetry (INVOS 5100)
FloTrac and Clear Site (continuous CO, systolic pressure variability)
Intrathecal pressure monitoring and CSF drainage (“spinal drains”)
ROTEM analysis for hemostasis
Mentored projects and funding for ALL poster presentations
Outcomes-based quality improvement and clinical research
Co-Participants in institutional/national STS database
Active projects include SCAF FOCUS/CSTS initiative
TRICS-III trial center for blood conservation research
RECESS trial center (Steiner, et al., NEJM 2015)
APART: Pilot Design for pre-operative anemia management
Enhanced Communication for Handovers from the OR (ECHO)
Weekly conferences (TEE didactics, Topics in CT anesthesiology, case conference, journal club)
Dallas - Ft. Worth
Located in North Texas, Dallas – Fort Worth (D/FW) offers a combination of big-city excitement and quiet suburban living. Being centrally located with access to one of the world’s busiest airports that can connect to any region of the continental United States within 4 hours, D/FW is a growing location with a “booming” economy. Together with a thriving community, D/FW offers a bustling nightlife mixed with family-friendly activities and all professional sports throughout the Metroplex.
Music and Entertainment
D/FW boasts some of the best music and entertainment anywhere, from Deep Ellum, a haven for alternative music and eclectic shops and galleries, to the Morton H. Meyerson Symphony Center and Winspear Opera House (Dallas) and Bass Performance Hall (Fort Worth). In addition, the American Airlines Center and Gexa Energy Pavilion in Dallas and AT&T Stadium in Arlington host many of the top concerts acts in the world.
Shopping and Dining
The Metroplex offers virtually unlimited shopping opportunities, from upscale malls such as the Galleria and NorthPark Center in Dallas to large outlet malls like Grapevine Mills, along with traditional malls, small boutiques, and specialty stores. Restaurants of all types abound in D/FW as well, ranging from world-renowned five-star establishments to the undiscovered hole-in-the-wall eateries. With more restaurants per person than New York, name the type of cuisine you are looking for and you will find it in D/FW.
Sports, from Professional to Amateur
D/FW is represented in all major professional leagues. Dallas Cowboys (NFL), Texas Rangers (MLB), Dallas Mavericks (NBA), Dallas Stars (NHL) and FC Dallas (MLS) represent the major sports leagues. Just north of Fort Worth, racing takes place at the Texas Motor Speedway. If smaller leagues are your interest, the major population of D/FW supports multiple amateurs and minor league sports of all types for all ages.
With a booming child population located in the D/FW area, many activities abound for families. Many museums are located throughout the Metroplex from Fort Worth to Dallas and surrounding areas. Two nationally acclaimed zoos are in the region, with the Fort Worth Zoo offering a newly renovated design. Water parks are virtually located in all major regions and a centrally located amusement park, Six Flags Over Texas, offers any adrenaline rush craving you need.
Fellowship Application Resources
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