Rotations

UMMC Thoracic & Foregut I

The dedicated non-cardiac thoracic surgery rotation includes instruction in all aspects of thoracic oncology, emphysema surgery, esophageal surgery, and thoracoscopy (VATS). The fellow is under the primary supervision of Dr. Rafael Andrade. The strength of the rotation is an introduction to advanced minimally invasive techniques. The fellow will be exposed to esophageal surgery, minimally invasive thoracic surgery, interventional airway and foregut endoscopy, endobronchial ultrasound, endoscopic ultrasound, diaphragm paralysis and treatment of hyperhidrosis.

VAMC I Cardiac/Thoracic

The first year fellow at VAMC directs the service under the supervision of Dr. Rosemary Kelly. Daily activities include ICU and ward rounds, thoracic and cardiac consults, and performing operations in one of the two dedicated cardiothoracic surgical operating rooms. First year fellows become the surgeon of record within the first two months of their instruction, performing distal and proximal anastomoses for coronary revascularization and straightforward valve replacements and repairs. The fellow performs most of the non-cardiac thoracic procedures as the operating surgeon. The first and third year fellows work in separate rooms and are responsible for their own cases. The Minneapolis VA has the busiest cardiac service for all of the VA centers in the United States.

UMMC Cardiac/Heart Transplant

This rotation provides the resident with an extensive experience in the medical and surgical therapies for heart failure as well as thoracic transplantation. This service provides a high measure of independence and our residents with master the procedures of VAD placement, extracorporeal support, and cardiac/pulmonary transplantation.

Abbott Northwestern Hospital (2nd year elective)

The concentrated cardiothoracic rotation in one of the most well-established private practice programs in the Twin Cities. This rotation is under the direction of Vibhu Kshettry, M.D. and includes a broad array of cardiac, aortic, and thoracic procedures. The fellows are involved with preoperative, operative, and postoperative care and hone their skills of intraoperative and postoperative management in a private practice setting. This rotation has a unique additional component of exposure to cardiac catheterization/intervention/endografts, and most recently, TAVR.

Fairview-Southdale Cardiac

This is a dedicated cardiac surgical rotation at a Fairview affiliate hospital. This is a high volume cardiac practice with a breadth of exposure to community surgery including approximately 300 open cases per year. As a fellow on the service, up to 4 months can be spent in a mentored relationship with one of the most experienced cardiothoracic surgeons in our community.

VA II Thoracic/Endovascular

Chief year rotation at the VA with exposure as a junior attending with dedicated responsibilities to general thoracic patients. The resident also has the opportunity to perform endovascular surgical procedures to satisfy newly required board experience for all graduates.

Donor Procurement

The donor procurement experience will begin in the 1st year and continue through the end of the 3rd year of training. The fellow is trained in the procurement of thoracic organs for transplantation. This is a great experience for the fellow as he travels to other institutions and hospitals operating independently and making decisions on the quality and suitability of organs for transplantation in recipients at UMMC. Fellows routinely reach UNOS requirements for procurement, as well as transplantation, by the completion of the fellowship.

Congenital

The congenital rotation occurs during the second year of fellowship. It is a concentrated experience in congenital heart disease with Dr. James St. Louis and Dr. Roosevelt Bryant. The cardiothoracic residents are exposed to a diverse population of infants and children with congenital heart disease. They fully participate in the preoperative, operative, and postoperative care of the patients. The strengths in this rotation include training the fellows in complex hemodynamic evaluations of cardiothoracic disease, involving them in hybrid procedures in the cath lab, and having them becoming accustomed to handling very delicate tissues.

Endovascular Surgery

The requirement set forth by the American Board of Thoracic Surgery is that the residents have an experience in endovascular stenting. During this rotation, it is our desire that the residents successfully complete the required volumes for cardiothoracic surgeons to qualify for future credentialing. Our goal is to see the resident successfully perform and participate in catheter interventions involving guide wire technology and steering catheters, participate in the successful placement of abdominal and thoracic aortic endovascular stent grafts or a combination thereof, gain experience with placement of large bore catheters into peripheral arteries, and gain experience with retroperitoneal exposure of the iliac and femoral arteries for endovascular procedures. During their second year of training, we will support the residents in completion an STS, AATS, or SBS sponsored endovascular training course. We are aware that the total volumes may not be achieved during their rotation but the goal is to perform as many of these procedures as is possible. The University also offers training in TAVR, both trans-apical and trans-femoral approaches.

Teaching staff include: Steven Santilli M.D., Kenneth Liao, M.D., and Ranjit John, M.D.

VA Chief

The VA chief cardiothoracic rotation provides the resident with advanced responsibilities for the cardiothoracic surgical patient. It is a transition rotation, leading the resident from supervised to independent activity. He/she will perform many complex cardiac procedures or crucial portions of procedures as the primary surgeon. He/she will also provide guidance and mentoring to a first year cardiothoracic resident. There is much exposure to thoracic aortic disease, mitral and aortic valve repair and replacement techniques. The chief rotation will give the resident the depth of knowledge and experience necessary to prepare for a future leadership role in cardiothoracic surgery. Residents will be fully prepared to independently offer safe and effective cardiothoracic care upon graduation.

UMMC Thoracic & Foregut II

As a chief on this rotation, the fellow will function as junior faculty and continue to build on his/her previous exposure to complex minimally invasive procedures. This exposure includes a breadth of operative experience in minimally invasive thoracic surgery as well as being trained in technically demanding cases such as VATS lobectomies and minimally invasive esophagectomies. The opportunity to train in this setting with the most complex minimally invasive surgical techniques is outstanding and the fellow is also encouraged to help in development of these novel approaches through research and clinical applications.