Adult Cardiothoracic Anesthesiology Fellowship

The Department of Anesthesiology at the University of Maryland School of Medicine has three ACGME-approved cardiothoracic anesthesia fellowship positions. Given our current surgical volume (over 1400 cases), CT anesthesia fellows receive ample opportunity to gain both personal and supervisory experience in managing the most interesting and challenging cases in anesthesia. Each cardiothoracic anesthesia fellow will participate in a total of six months in the cardiovascular operating rooms where he or she will both supervise and individually perform CT anesthesia cases (approximately 1/3 and 2/3). Fellows take approximately four weekday calls and one weekend of call coverage per month and have a guaranteed post call day free of clinical duties after every call period. In addition to the cardiac operating rooms fellows spend one month in the CSICU, have two months of elective time, two months of dedicated TEE time, and one month of thoracic anesthesia experience.

The CT anesthesia fellows are allotted ample time to pursue scholarly activities and the faculty are highly supportive of these endeavors. The fellows have a professional development/education fund that can be used to attend meetings or to purchase educational materials. The department pays for attendance of the SCA Perioperative TEE meeting in Atlanta, GA and fellows have the opportunity to attend other local and national meetings such as the Society for Cardiovascular Anesthesiologists Annual Meeting.

Fellows gain proficiency in and exposure to the perioperative evaluation and intraoperative management of cardiac surgical patients including:

• elective and emergency revascularization procedures
• complex valve repairs and replacements including a high volume of endocarditis cases
• pericardial procedures
• neoplastic procedures
• heart and lung transplants and combined procedures
• thoracic aortic surgery including ascending, transverse and descending aortic surgery with and without circulatory arrest
• thoracic endovascular aortic repair
• ventricular assist device implantation
• minimally invasive cardiac surgery including MitraClip, TAVR, and repair of congenital defects including: ASDs, anomalous pulmonary veins, etc.
• robotic CABGs
• pulmonary embolectomies and thromboendarterectomies

In addition, fellows will gain experience with thoracic surgery including:

• thoracoscopic and open lung resections
• bronchopulmonary lavage
• bronchoscopy and related procedures
• radical pleurectomy for mesothelioma
• esophageal surgery and resection
• robotic lung resection

Our fellows gain competence in TEE training with two months of dedicated echo time in both the cardiology echo lab as well as operating rooms. They receive training in TEE, TTE, epiaortic and 3D technologies.  We currently have five Phillips IE33 machines and Phillips Xcelera acrchiving, which allows for easy review of previous echoes outside of the operating room.  All IE33 machines have 3D capability.

Our fellows perform well over the required number of TEE examinations each year for the advanced PTE certification.  We offer and pay for our fellows to attend the echo week course offered by the Society of Cardiovascular Anesthesiologists in preparation for taking the Advanced PTE exam. The department has four echo technicians that are themselves skilled practitioners who support the technical aspects of the echo service, so that our fellows can concentrate on learning the techniques of echocardiography. 

‌Each fellow will have an assigned mentor who is usually a member of the Cardiothoracic Anesthesiology faculty. The cardiac anesthesia fellow will have a defined project and will be expected to submit findings for presentation at a national meeting, typically the SCA annual meeting. Areas of active investigation in the division include coagulation and hemostasis, outcomes research in cardiac surgery, ECMO related bleeding, disseminated intravascular coagulation, intracardiac thrombosis, and infectious complications of transfusion.  Members of the division have received recent grant funding from both industry and foundations including the SCA and APSF.

Abuelkasem, E., Hasan, S., Mazzeffi, M. A., Planinsic, R. M., Sakai, T., & Tanaka, K. A. (2017). Reduced Requirement for Prothrombin Complex Concentrate for the Restoration of Thrombin Generation in Plasma from Liver Transplant Recipients. Anesthesia and Analgesia, 125(2), 609–615. https://doi.org/10.1213/ANE.0000000000002106

Henderson, R. S., Jr., Deshpande, S., Williams, B., Taylor, B. S., & Tanaka, K. A. (2017). Idarucizumab for Dabigatran Reversal in Emergency Type-A Aortic Dissection. Journal of Cardiothoracic and Vascular Anesthesia, 31(6), e80–e81. https://doi.org/10.1053/j.jvca.2016.04.027

Mazzeffi, M. A., Lee, K., Taylor, B., & Tanaka, K. A. (2017). Perioperative management and monitoring of antiplatelet agents: A focused review on aspirin and P2Y12 inhibitors. Korean Journal of Anesthesiology, 70(4), 379–389. https://doi.org/10.4097/kjae.2017.70.4.379

Mazzeffi, M., Abuelkasem, E., Drucker, C. B., Kalsi, R., Toursavadkohi, S., Harris, D. G., … Crawford, R. (2018). Contemporary Single-Center Experience With Prophylactic Cerebrospinal Fluid Drainage for Thoracic Endovascular Aortic Repair in Patients at High Risk for Ischemic Spinal Cord Injury. Journal of Cardiothoracic and Vascular Anesthesia, 32(2), 883–889. https://doi.org/10.1053/j.jvca.2017.12.002

Mazzeffi, M., Tanaka, K., & Galvagno, S. (2017). Red Blood Cell Transfusion and Surgical Site Infection after Colon Resection Surgery: A Cohort Study. Anesthesia and Analgesia, 125(4), 1316–1321. https://doi.org/10.1213/ANE.0000000000002099

Odonkor, P., Srinivas, A., Strauss, E., Williams, B., Mazzeffi, M., & Tanaka, K. A. (2017). Perioperative Coagulation Management of a Hemophilia A Patient During Cardiac Surgery. Seminars in Cardiothoracic and Vascular Anesthesia, 21(4), 312–320. https://doi.org/10.1177/1089253217702747

Plurad, D. S., Chiu, W., Raja, A. S., Galvagno, S. M., Khan, U., Kim, D. Y., … Robinson, B. (2018). Monitoring modalities and assessment of fluid status: A practice management guideline from the Eastern Association for the Surgery of Trauma. The Journal of Trauma and Acute Care Surgery, 84(1), 37–49. https://doi.org/10.1097/TA.0000000000001719

Tanaka, K., Moser, K., Abraham, D., Sniecinski, R., & Mazzeffi, M. (2017). Off-Label Prothrombin Complex Concentrates: Buyer Be Careful! Journal of Cardiothoracic and Vascular Anesthesia, 31(6), e91–e92. https://doi.org/10.1053/j.jvca.2017.01.004

Williams, B., Wehman, B., Mazzeffi, M. A., Odonkor, P., Harris, R. L., Kon, Z., & Tanaka, K. A. (2017). Acute Intracardiac Thrombosis and Pulmonary Thromboembolism After Cardiopulmonary Bypass: A Systematic Review of Reported Cases. Anesthesia and Analgesia. https://doi.org/10.1213/ANE.0000000000002259

Wipfli, C., Fitzpatrick, M. V., Fitzpatrick, J. K., Taylor, B. S., & Tanaka, K. A. (2017). Assessment of Fibrin Polymerization During Bivalirudin Anticoagulation for Transcatheter Aortic Valve Replacement. Journal of Cardiothoracic and Vascular Anesthesia, 31(4), e65–e66. https://doi.org/10.1053/j.jvca.2017.02.178

Strauss ER, Li S, Henderson R, Carpenter R, Guo D, Thangaraju K, Katneni U, Buehler PW, Gobburu JV, Tanaka KA. A Pharmacokinetic and Plasmin-Generation Pharmacodynamic Assessment of a Tranexamic Acid Regimen Designed for Cardiac Surgery With Cardiopulmonary Bypass. J Cardiothorac Vasc Anesth. 36(8 Pt A), 2473-2482. PMID: 35094925. 2022

Everett L, Davis TA, Deshpande SP, Mondal S. Implementation of Bilateral Rectus Sheath Blocks in Conjunction With Transversus Thoracis Plane and Pectointercostal Fascial Blocks for Immediate Postoperative Analgesia After Cardiac Surgery. Cureus. 14(7), e26592. PMID: 35936156. 2022

Makkad B, Deshpande SP. Con: Interviews for Adult Cardiothoracic Anesthesiology Fellowship Program: In Favor of the In-Person Interview. J Cardiothorac Vasc Anesth. 36(4), 1209-1213. PMID: 34903455. 2022

Bergbower E, Park PS, Deshpande S. The Good, Bad, and Ugly of Inferior Vena Cava (IVC) Filters: Anesthetic Management for IVC Filter Retrieval in the Setting of Filter Thrombosis. Cureus. 2022 Feb 25;14(2):e22591. doi: 10.7759/cureus.22591. PMID: 35371650; PMCID: PMC8958871.

Choi S, Mazzeffi MA, Henderson R, Mondal S, Morita Y, Deshpande S, Tanaka KA. The FIBTEM paradox: Do coronary artery bypass grafting patients with high baseline FIBTEM clot firmness need more allogeneic blood transfusion? Transfusion. 2022 Oct;62(10):2020-2028. doi: 10.1111/trf.17065. Epub 2022 Aug 20. PMID: 36053950.

Fabbro M, Patel PA, Henderson RA, Bolliger D, Tanaka KA, Mazzeffi MA. Coagulation and Transfusion Updates From 2021. J Cardiothorac Vasc Anesth. 36(9), 3447-3458. PMID: 35750604. 2022

Strauss ER, Quinn RW, Pasrija C, Henderson R, Holmes SD, D'Ambra MN, Gammie JS. Intraoperative echocardiographic assessment of mitral valve translocation. Eur J Cardiothorac Surg. 62(2). 62(2):ezac133. PMID: 35277715. 2022

Mazzeffi M, Henderson R, Powell E, Strauss E, Williams B, Tanaka K, Yang S, Deatrick K, Madathil R. Thrombopoietin, Soluble CD40 Ligand, and Platelet Count During Veno-arterial Extracorporeal Membrane Oxygenation. ASAIO J. 68(5), e77-e79. PMID: 34081052. 2022

Mazzeffi M, Henderson R, Krause E, Rabin J, Madathil R, Chow J, Grazioli A, Meyer M, Wu Z, Tanaka K. In Vitro Comparison of Recombinant and Plasma-Derived von Willebrand Factor Concentrate for Treatment of Acquired von Willebrand Syndrome in Adult Extracorporeal Membrane Oxygenation Patients. Anesth Analg. 134(2), 312-321. PMID: 34903705. 2022

Tanaka KA, Henderson R, Thangaraju K, Morita Y, Mazzeffi MA, Strauss E, Katneni U, Buehler PW. In vitro effects of emicizumab on activated clotting time in blood samples from cardiac surgical patients. Haemophilia. 28(1), 183-190. PMID: 34735039. 2022

Denault A, Couture EJ, De Medicis É, Shim JK, Mazzeffi M, Henderson RA, Langevin S, Dhawan R, Michaud M, Guensch DP, Berger D, Erb JM, Gebhard CE, Royse C, Levy D, Lamarche Y, Dagenais F, Deschamps A, Desjardins G, Beaubien-Souligny W. Perioperative Doppler ultrasound assessment of portal vein flow pulsatility in high-risk cardiac surgery patients: a multicentre prospective cohort study. Br J Anaesth. 2022 Nov;129(5):659-669. doi: 10.1016/j.bja.2022.07.053. Epub 2022 Sep 30. PMID: 36184294.

Smeltz AM, Coleman PJ, Mondal S. Pro: Acute Normovolemic Hemodilution Should Be Used in Infective Endocarditis Patients Coming for Primary or Redo Cardiac Surgery. J Cardiothorac Vasc Anesth. 36(8 Pt A), 2811-2814. PMID: 35431117. 2022

Mondal S, Faraday N, Gao W, Singh S, Hebber S, Hollander KN, Metkus TS, Goeddel LA, Bauer M, Bush B, Cho B, Cha S, Ibekwe SO, Mladinov D, Rolleri NS, Lester L, Steppan J, Sheinberg R, Hensley NB, Kapoor A, Dodd-o JM. Selected Transesophageal Echocardiographic Parameters of Left Ventricular Diastolic Function Predict Length of Stay Following Coronary Artery Bypass Graft—A Prospective Observational Study. J Clin Med. 11(14), 3980. PMID: 35887745. 2022

Barrera L, Mondal S. Ethical and Clinical dilemma from an incidental cardiac lipoma in a young and healthy patient. Ann Card Anesth. 25(3)(Jul-Sep 2022), 353-355. PMID: 35799567. 2022

Strauss ER, Odonkor PN, Williams B. Porcine Orthotopic Cardiac Xenotransplantation: The Role and Perspective of Anesthesiologists. J Cardiothorac Vasc Anesth. 36(8), 2847-2850. PMID: 35537973. 2022

Smith Bergbower EA, Odonkor PN. Con: Acute Normovolemic Hemodilution Should not be used in Infective Endocarditis. J Cardiothorac Vasc Anesth. 36(8), 2815-2818. PMID: 35501262. 2022

Odonkor P, Strauss E, Williams B. Ethical considerations during a pioneering surgical procedure: porcine cardiac xenotransplantation. Br J Hosp Med. 83(6), 1-7. PMID: 35787171. 2022

Mohiuddin MM, Goerlich CE, Singh AK, ...,Strauss E, Odonkor P, ..., Griffiths BP. Progressive Genetic Modifications of Porcine Cardiac Xenografts Extend Survival to 9 Months. Xenotransplantation. 29(3), e12744. doi: 10.1111/xen.12744. PMID: 35357044. 2022

Shah A, Goerlich CE, Pasrijah C, Hirsch J, Fisher S, Odonkor P, Strauss E, Ayares D, Mohiuddin M, Griffith BP. Anatomical Differences Between Human and Pig Hearts and Their Relevance for Cardiac Xenotransplantation Surgical Technique. JACC Case Rep. 4(16), 1049-1052. PMID: 36062051. 2022

Pasrija C, Quinn R, Strauss E, Wang L, Tran D, D'Ambra MN, Gammie JS. Translocation of the Mitral Valve in an Acute Large Animal Model. J Cardiovasc Transl Res. DOI: 10.1007/s12265-022-10215-2. PMID: 35175554. 2022

Strauss ER, VanDyck K, Mazzeffi MA. Tranexamic acid for cesarean delivery: induction of a regimen for postpartum hemorrhage?. Am J Obstet Gynecol. PMID: 35998746. 2022

Strauss E, Dahmane E, Judd M, Guo D, Williams B, Meyer M, Gammie JS, Taylor B, Mazzeffi MA, Gobburu JV, Tanaka KA. A Pharmacokinetic and Pharmacodynamic Investigation of an ε-Aminocaproic acid regimen designed for the context of cardiac surgery with cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 35(2), 406-417. PMID: 32811752. 2022

Book Chapter:

Odonkor, P.N., Mondal, S. (2022). Anesthesia Considerations in Global Cardiac Surgery Capacity Development in Emerging Countries. In: Kpodonu, J. (eds) Global Cardiac Surgery Capacity Development in Low an-+d Middle Income Countries. Sustainable Development Goals Series. Springer, Cham. https://doi.org/10.1007/978-3-030-83864-5_22

Lopez K, Suen A, Yang Y, Wang S, Williams B, Zhu J, Hu J, Fiskum G, Cross A, Kozar R, Miller C, Zou L, Chao W. Hypobaria Exposure Worsens Cardiac Function and Endothelial Injury in an Animal Model of Polytrauma: Implications for Aeromedical Evacuation. Shock. Published Ahead of Print. PMID: 33394971. 2021

Chen F, Zou L, Williams B, Chao W. Targeting Toll-Like Receptors in Sepsis - From Bench to Clinical Trials. Antioxid Redox Signal. DOI: 10.1089/ars.2021.0005. PMID: 33588628. 2021

Chow JH, Khanna AK, Kethireddy S, Yamane D, Levine A, Jackson AM, McCurdy MT, Tabatabai A, Kumar G, Park P, Benjenk I, Menaker J, Ahmed N, Glidewell E, Presutto E, Cain S, Haridasa N, Field W, Fowler JG, Trinh D, Johnson KN, Kaur A, Lee A, Sebastian K, Ulrich A, Peña S, Carpenter R, Sudhakar S, Uppal P, Fedeles BT, Sachs A, Dahbour L, Teeter W, Tanaka K, Galvagno SM, Herr DL, Scalea TM, Mazzeffi MA. Aspirin Use Is Associated With Decreased Mechanical Ventilation, Intensive Care Unit Admission, and In-Hospital Mortality in Hospitalized Patients With Coronavirus Disease 2019. Anesth Analg. 132(4), 930-941. PMID: 33093359. 2021

Sankova S, Deshpande S, Miller SP, Tanaka K. Anesthesia in the Postgenomic Era: Commercial Polymorphism Screening in a Cardiac Surgery Patient. Anesth Analg. 132(6):1781-1785. PMID: 33780384. 2021

Deshpande SP, Makkad B. Pro: Length of Adult Cardiothoracic Anesthesiology Fellowship Training Should Be Extended Beyond One Year. J Cardiothor Vasc Anesth. DOI: 10.1053/j.jvca.2021.02.002. PMID: 33653577. 2021

Grewal A, Odonkor P, Ghoreishi M, Deshpande SP. Anesthetic Considerations in Endovascular Repair of the Ascending Aorta. J Cardiothorac Vasc Anesth. S1053-0770(21), S1053-0770. PMID: 34059437. 2021

Mazzeffi M, Judd M, Rabin J, Tabatabai A, Menaker J, Menne A, Chow J, Shah A, Henderson R, Herr D, Tanaka K. Tissue Factor Pathway Inhibitor Levels During Veno-Arterial Extracorporeal Membrane Oxygenation in Adults. ASAIO J. PMID: 33606392. 2021

Pasrija C, Quinn RW, Bernstein D, Tran D, Alkhatib H, Rice M, Morales D, Shah A, Ghoreishi M, Strauss ER, Henderson R, D'Ambra MN, Gammie JS. Mitral Valve Translocation: A Novel Operation for the Treatment of Secondary Mitral Regurgitation. Ann Thorac Surg. 112(6), 1954-1961. PMID: 34419436. 2021

Patel PA, Henderson RA, Bolliger D, Erdoes G, Mazzeffi MA. The Year in Coagulation: Selected Highlights from 2020. J Cardiothorac Vasc Anesth. 35(8), 2260-2272. PMID: 33781668. 2021

Henderson RA, Judd M, Strauss ER, Gammie JS, Mazzeffi MA, Taylor BS, Tanaka KA. Hematologic evaluation of intraoperative autologous blood collection and allogeneic transfusion in cardiac surgery. Transfusion. 61(3), 788-798. PMID: 33423288. 2021

Jain V, Ghosh RK, Bandyopadhyay D, Kondapaneni M, Mondal S, Hajra A, Aronow WS, Lavie CJ. Serum Bilirubin and Coronary Artery Disease: Intricate Relationship, Pathophysiology, and Recent Evidence. Curr Probl Cardiol. 46(3), 100431. PMID: 31350011. 2021

Goerlich CE, Griffith B, Singh AK, Abdullah M, Singireddy S, Kolesnik I, Lewis B, Sentz F, Tatarov I, Hershfeld A, Zhang T, Strauss E, Odonkor P, Williams B, Tabatabai A, Bhutta A, Ayares D, Kaczorowski DJ, Mohiuddin MM. Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation. Front Immunol. 12, 667093. PMID: 34177906. 2021

Mondal S, Sankova S, Lee K, Sorenson E, Kaczorowski D, Mazzeffi M. Intraoperative and Early Postoperative Management of Patients Undergoing Minimally Invasive Left Ventricular Assist Device Implantation. J Cardiothorac Vasc Anesth. 35(2), 616-630. PMID: 32505605. 2021

Gammie JS, Quinn RW, Strauss ER, Wang L, D'Ambra MN, Hung J, Bernstein DA, Tran D, Rice MK, Holmes SD, Pasrija C. Initial Clinical Experience with Mitral Valve Translocation for Secondary Mitral Regurgitation. Ann Thorac Surg. S0003-4975(21), 00051-5. PMID: 33440174. 2021

Chow JH, Strauss E, Mazzeffi MA. Angiotensin II and Vasoplegia in Cardiac Surgery: Paradigm Changer or Costly Contender?. J Cardiothorac Vasc Anesth. 35(1), 59-60. PMID: 32950345. 2021

Henderson RA. Vascular Anesthesia Procedures. Alan Kaye, eds. Hemostasis, Thrombosis, Transfusion, and Blood Conservation. Oxford University Press: Chapter 3 23p-40p. 2021