Adult Cardiothoracic Anesthesiology Fellowship
Message from the Program Director
The goal of the Adult Cardiothoracic Anesthesiology Fellowship at the University of Maryland is to train leaders in perioperative cardiovascular care. Our cardiac surgery program is currently the largest in the state of Maryland and offers a complex case mix that allows fellows to grow tremendously in their skills and confidence. Fellows in our program are exposed to the full gamut of contemporary cardiothoracic surgery procedures including: complex mitral valve repairs, major aortic surgery, coronary revascularizations (both robotic and on-pump), pulmonary embolectomies and thromboendarterectomies, transcatheter aortic valve replacements, heart and lung transplantations, and LVAD implantations.
Our center also has one of the largest adult ECMO programs in the country and many cardiac surgery patients are bridged to operations or recovery with ECMO. In addition to training outstanding clinicians, we are committed to our fellows’ professional growth and achieving the highest possible levels in all ACGME competencies including communication, teamwork, professionalism, and systems based practice. Our diverse faculty provides fellows with the opportunity to learn from a variety of past experiences and recent graduates have had great success in both academic medicine and private practice. Our division offers unique research opportunities with nationally recognized faculty in areas that include bleeding/coagulation, epidemiology, and outcomes research for cardiac surgery patients.
We welcome your interest in our training program and look forward to meeting you.
Seema Deshpande, MBBS
Assistant Professor and Fellowship Program Director
Learn More about the Adult Cardiothoracic Fellowship Program
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
- Guinn N, Tanaka K, Erdoes G, Kwak J, Henderson R, Mazzeffi M, Fabbro M, Raphael J. The Year in Coagulation and Transfusion: Selected Highlights from 2022. J Cardiothor Vasc Anesth. 2023;https://doi.org/10.1053/ j.jvca.2023.08.132.
- Mondal S. Intrathecal Morphine for Analgesia in Robotic Totally Endoscopic Coronary Artery Bypass and Myocardial Bridge Unroofing. J Cardiothorac Vasc Anesth. 2023;37(2):322-323. PMID: 36396572.
- Mondal S, Deshpande SP. Reverse Takotsubo Stress Cardiomyopathy During Liver Transplantation. J Cardiothorac Vasc Anesth. 2023;37(4);654-656. PMID: 36682918.
- Ibekwe SO, Mondal S, Faloye AO. Pulmonary prehabilitation and smoking cessation. Curr Opin Anaesthesiol. 2023;36(1):96-102. PMID: 36550610.
- Strauss ER, Odonkor PN, Williams B, Choi S, Mueller J, Taylor B, Shah A, Goerlich CE, Mohiuddin MM, Griffith BP. Intraoperative Management of an Orthotopic Porcine-to-Human Cardiac Xenotransplant. Ann Thorac Surg. 2023;115(3):784-786. PMID: 36621667.
- Strauss ER, VanDyck K, Mazzeffi MA. Tranexamic acid for cesarean delivery: induction of a regimen for postpartum hemorrhage? Am J Obstet Gynecol. 2023;228(1):110-111. PMID: 35998746.
- Kahntroff S, Hollander K, Stewart K, Tanaka KA. Role of Intrinsic Pathway in Coagulation After Use of Activated Prothrombin Complex Concentrate in Neonatal Cardiac Surgery. Anesth Analg. 2023;136(6):e39-e40. PMID: 37205822.
- Barrera L, Mondal S. Ethical and Clinical dilemma from an incidental cardiac lipoma in a young and healthy patient. Ann Card Anesth. 2022;25(3):353-355. PMID: 35799567.
- Everette 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. 2022;14(7):e26592.
- 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. 2022;134(2):312-321. PMID: 34903705.
- 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. 2022;28(1):183-190. PMID: 34735039.
- 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. 2022;62(2):ezac133. PMID: 35277715.
- Strauss ER, Odonkor PN, Williams B. Porcine Orthotopic Cardiac Xenotransplantation: The Role and Perspective of Anesthesiologists. J Cardiothorac Vasc Anesth. 2022;36(8 Pt B):2847-2850. PMID: 35537973.
- Fontaine MJ, Lasola JJ, Henderson RA. Perioperative Platelet Transfusion: Not All Platelet Products Are Created Equal. Curr Anesthesiol Rep. 2022;320-328.
- 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. 2022;68(5):e77-e79. PMID: 34081052.
- Yang S, Williams B, Kaczorowski D, Mazzeffi. Overt Disseminated Intravascular Coagulation with Severe Hypofibrinogenemia During Veno-Venous Extracorporeal Membrane Oxygenation. J Extra Corpor Technol. 2022;54(2):148-152. PMID: 35928342.
- Mondal S, Faraday N, Gao WD, Singh S, Hebbar 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. 2022;11(14):3980. PMCID: PMC9319456.
- Choi S, Mazzeffi MA, Henderson R, Mondal S, Morita Y, Deshpande S, Tanaka K. The FIBTEM paradox: Do coronary artery bypass grafting patients with high baseline FIBTEM clot firmness need more allogeneic blood transfusion?. Transfusion. 2022;62(10):2020-2028. PMID: 36053950.
- 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;14(2):e22591. PMID: 35371650.
- Makkad B, Deshpande SP. Con: Interviews for Adult Cardiothoracic Anesthesiology Fellowship Program: In Favor of the In-Person Interview. J Cardiothorac Vasc Anesth. 2022;36(4):1209-1213. PMID: 34903455.
- del Valle M, Hollander K. Diffuse Coronary Artery Spasm After Coronary Artery Bypass Graft Surgery. J Cardiothorac Vasc Anesth. 2022;36(8 Pt A):2575-2577. PMID: 34583853.
- Morita Y, Williams B, Yamada Y, Kariya T. Effect of Anesthesia Machine Ventilator and ICU Ventilator on Intraoperative Oxygenation and Ventilation. J Cardiothorac Vasc Anesth. 2022;36(8 Pt B):3175-3186. PMID: 35624038.
- Bergbower EAS, Odonkor P. Con: Acute Normovolemic Hemodilution Should not be used in Infective Endocarditis. J Cardiothorac Vasc Anesth. 2022;36(8 Pt A):2815-2818. PMID: 35501262.
- Strauss ER, Li S, Henderson R, Carpenter R, Guo D, Thangaraju K, Katneni U, Buehler PW, Gobburu JVS, 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. 2022;36(8 Pt A):2473-2482. PMID: 35094925.
- Mondal S, Bergbower ES, Cheung E, Grewal AS, Ghoreishi M, Hollander KN, Anders MG, Taylor BS, Tanaka KA. Role of cardiac anesthesiologists in intraoperative Enhanced Recovery After Cardiac Surgery (ERACS) protocol - A retrospective single center study analyzing preliminary result of yearlong ERACS protocol implementation. J Cardiothoracic Vasc Anesth. 2022;S1053-0770(22):00794-7. PMID: 36517338.
- 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. 2022;36(8 Pt A):2811-2814. PMID: 35431117.
- Fabbro M 2nd, Patel PA, Henderson RA Jr, Bolliger D, Tanaka KA, Mazzeffi MA. Coagulation and Transfusion Updates From 2021. J Cardiothorac Vasc Anesth. 2022;36(9):3447-3458. PMID: 35750604.
- Silverman H, Odonkor PN. Reevaluating the Ethical Issues in Porcine-to-Human Heart Xenotransplantation. Hastings Cent Rep. 2022;52(5):32-42. PMID: 36226875.
- Mohiuddin MM, Goerlich CE, Singh AK, Zhang T, Odonkor P. Progressive Genetic Modifications of Porcine Cardiac Xenografts Extend Survival to 9 Months. Xenotransplantation. 2022;29(3):e12744. PMID: 35357044.
- Shah A, Goerlich CE, Pasrija C, Hirsch J, Fisher S, Odonkor P, Strauss E, Ayares D, Mohiuddin MM, Griffith BP. Anatomical Differences Between Human and Pig Hearts and Their Relevance for Cardiac Xenotransplantation Surgical Technique. JACC Case Rep. 2022;4(16):1049-1052. PMID: 36062051.
- Odonkor P, Strauss E, Williams B. Ethical considerations during a pioneering surgical procedure: porcine cardiac xenotransplantation. Br J Hosp Med (Lond). 2022;83(6):1-7. PMID: 35787171.
- 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. 2022;15(5):1100-1107. PMID: 35175554.
- Mueller JH, Hollander K. Use of intraoperative coronary angiography to guide surgical intervention in coronary artery bypass graft surgery. Ann Card Anaesth. 2022;25(4):525-527. PMID: 36254922.
- 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;129(5):659-669. PMID: 36184294.
- Strauss E, Taneja, M, Booth R, et al. Antifibrinolytics in Cardiac Surgery: What Is the Best Practice in 2022?. Curr Anesthesiol Rep. 2022;12:501–507.
- 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. 2021;35(2):406-417. PMID: 32811752.
- 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. 2021;132(4):930-941. PMID: 33093359.
- Sankova S, Deshpande S, Miller SP, Tanaka K. Anesthesia in the Postgenomic Era: Commercial Polymorphism Screening in a Cardiac Surgery Patient. Anesth Analg. 2021;132(6):1781-1785. PMID: 33780384.
- Grewal A, Odonkor P, Ghoreishi M, Deshpande SP. Anesthetic Considerations in Endovascular Repair of the Ascending Aorta. J Cardiothorac Vasc Anesth. 2021;S1053-0770(21):S1053-0770. PMID: 34059437.
- Deshpande SP, Makkad B. Pro: Length of Adult Cardiothoracic Anesthesiology Fellowship Training Should Be Extended Beyond One Year. J Cardiothor Vasc Anesth. 2021;35(8), 2513-2516. PMID: 33653577.
- 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. 2021;61(3):788-798. PMID: 33423288.
- 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. 2021;112(6):1954-1961. PMID: 34419436.
- Patel PA, Henderson RA, Bolliger D, Erdoes G, Mazzeffi MA. The Year in Coagulation: Selected Highlights from 2020. J Cardiothorac Vasc Anesth. 2021;35(8):2260-2272. PMID: 33781668.
- 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. 2021; 67(8):878-883. PMID: 33606392.
- 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. 2021;56(4):601-610. PMID: 33394971.
- Mondal S, Hollander KN, Ibekwe SO, Williams B, Tanaka KA. Heyde Syndrome-Pathophysiology and Perioperative Implications. J Cardiothorac Vasc Anesth. 2021;35(11):3331-3339. PMID: 33132021.
- Goerlich CE, Griffith B, Avneesh S, Mohamed A, Shreya 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 D, Mohiuddin M. Blood Cardioplegia Induction, Perfusion Storage and Graft Dysfunction in Cardiac Xenotransplantation. Front Immunol. 2021;12:667093. PMID: 34177906.
Kanwarpal Bakshi, MD
- Residency: The George Washington University Hospital
Ross Carpenter, MD
- Residency: University of Maryland Medical Center
Steven Miller, MD
- Residency: University of Maryland Medical Center
How to Apply
Applicants who have successfully completed their anesthesiology residency in an ACGME accredited program with an interested in Critical Care Anesthesiology are encouraged to apply. Applicants should register with the San Francisco Match at www.sfmatch.org. For fellowship positions for 2021-2022, we start accepting applications on November 12, 2019. Selected applicants will be invited for a formal interview between December 2019 and April 2020.
Your file is complete when we receive:
- A completed Central Application Service (CAS) form from SFMatch.org
- Current curriculum vitae
- Personal statement
- Copy of medical school transcript
- USMLE I, II, & III/COMLEX scores
- Anesthesiology In-Training Exam or board scores
- Three letters of reference, one of which should be from the chariman or program director of your training program
Interested applicants should inquire with Dr. Seema Deshpande (firstname.lastname@example.org).