Adult Cardiothoracic Anesthesiology Fellowship Program

Message from Program Director

Fellows in our program are exposed to the full spectrum of contemporary cardiothoracic surgery procedures including coronary vascularization, complex mitral valve repairs, transcatheter aortic valve implantation/mitral valve clip, myectomy, major aortic reconstruction, pulmonary embolectomies and thromboendarterectomies, and complex congenital heart procedures in children and adults. The heart failure program provides remarkable exposure to heart transplantation, mechanical assist devices, and extracorporeal membrane oxygenation. Our center is one of the largest ECMO programs in the region. Also, our clinical practice provides experience with open and thoracoscopic lung resection, mediastinal surgery, tracheal and esophageal reconstruction, and interventional pulmonology procedures. These complex and highly varied cardiac and thoracic cases allow fellows to achieve the highest levels of professional growth while they become expert sub-specialists in Cardiothoracic Anesthesia.

Our highly trained and motivated Faculty actively participate in teaching, both clinical and didactic, in a supportive and congenial environment. Comprehensive and well-organized teaching sessions and the busy cardiothoracic surgical service provide an exceptional educational background for fast-paced, effective and enjoyable learning. We are here to assist you to make your education experience exceptionally meaningful and relevant.

We welcome your interest in our training program.

Sincerely,

Draginja Cvetkovic, MD, FASA
Program Director, Adult Cardiothoracic Anesthesiology Fellowship
Clinical Associate Professor of Anesthesiology
Draginja.Cvetkovic@wmchealth.org

Program Overview

The Adult Cardiothoracic Anesthesiology Fellowship Program at Westchester Medical Center is an ACGME-accredited one-year program offering three positions per year. It is structured to ensure optimal patient care while providing fellows the opportunity to develop sound judgement and advanced subspecialist-level skills in clinical care, as well as prepare the fellows to teach residents and medical students and to conduct clinical research.

Curriculum

Our adult and pediatric caseload is diverse and of high acuity as we provide state-of-the art care for a catchment area of three million residents of Westchester County and further Upstate New York, affording fellows access to extensive clinical learning resources. The curriculum of our Adult Cardiothoracic Anesthesia Fellowship Program includes both clinical experience and didactic teaching.

Didactics

The Fellows attend weekly didactic lectures covering the wide range of topics related to the practice of cardiac and thoracic anesthesiology, as well as transesophageal echocardiography. These well-structured presentations circumscribe all required curricular topics of the Accreditation Council for Graduate Medical Education (ACGME) and the American Society of Echocardiography (ASE).

In anticipation of the new Adult Cardiac Anesthesiology Certification Examination starting in December 2023, the Program completed the revision of didactic lectures such that all areas of the Content Outline for the upcoming test are comprehensively covered. Acquisition of the state-of-the-art Heartworks/Bodyworks ultrasound simulation platform offers our fellows a great introduction to the cardiac ultrasound field and facilitates fast gaining of echocardiography skills. In addition, there is protected weekly time outside of the operating room for echocardiography case review with faculty members. We hold the annual Pig Heart Dissection workshop with our ACTA fellows. This is an interdisciplinary workshop with our cardiac surgeon, demonstrating surgical anatomy and with our cardiac anesthesiologist, demonstrating echocardiographic correlation. This session is designed to improve spatial understanding of echocardiography.

The Fellows attend weekly departmental Grand Rounds and patient safety conferences. They are encouraged to attend relevant conferences and lectures in other hospital departments including cardiac surgery, critical care, general cardiology, cardiac catheterization, electrophysiology, and echocardiography. The Fellows are engaged in teaching of the rotating residents from the core Anesthesiology program and, on occasion, in teaching of New York Medical College medical students and rotating student nurse anesthetists.

Clinical Experience

The Fellows gain clinical experience in the following areas:

• Preoperative patient assessment and optimization of clinical status prior to cardiothoracic surgery
• Interpretation of noninvasive cardiac diagnostic tests and cardiac catheterization data
• Interpretation of pulmonary function tests
• Interpretation of arterial and venous blood gases
• Anesthesia consultation for preoperative cardiothoracic patients
• Insertion of intravascular monitoring catheters and interpretation of hemodynamic data
• TEE probe placement, examination, and interpretation of study
• Ischemic heart disease and elective or emergency revascularization procedure
• Complex repair and replacement of heart valves
• Percutaneous valve repair and replacement (TAVR, MitraClip)
• Dilated, restrictive and hypertrophic obstructive cardiomyopathies
• Heart transplantation
• Ventricular Assist Device implantation (LVAD, RVAD, BIVAD)
• Extracorporeal Membrane Oxygenation (ECMO) device implantation
• Intra Aortic balloon pump counterpulsation (IABP), Impella device
• Intracardiac masses and tumors
• Pericardial tamponade
• Thoracic aortic surgery, including ascending, arch, and descending thoracic aorta
• Thoracic endovascular aortic repair (TEVAR)
• Pulmonary embolectomy and pulmonary thromboendarterectomy surgeries
• Pediatric and adult palliation or correction of congenital heart lesions
• Cardiopulmonary bypass (CPB) – perfusion strategies, temperature management, and fluid management
• Assessment of vital organ dysfunction during and after CPB
• Deep hypothermic circulatory arrest
• Coagulation/anticoagulation management before, during and after CPB
• Pharmacologic support of the heart and circulation during all phases of cardiac surgery
• Extensive perioperative transesophageal echocardiography in preparation for the National Board of Echocardiography Advanced PTeXAM® certification
• Thoracic surgeries, including pulmonary wedge resection, lobectomy or pneumonectomy for neoplasm, vascular malformation or infectious processes
• Thoracic cage surgery
• Lung isolation/one lung ventilation techniques
• Fiber optic bronchoscopy
• Interventional transbronchial pulmonary and mediastinal surgery
• Tracheal surgery (stent placement, dilation and resection)
• Esophageal surgery
• Ventilation management during cardiac and thoracic surgery
• Regional anesthesia and pain management for patients undergoing cardiothoracic procedures
• Care of critically ill patients post-cardiothoracic surgery (CTICU)
• Cardiac electrophysiologic diagnostic and/or arrhythmia ablation procedures
• Cardiac pacemakers (permanent or temporary) and ICD implantation

Rotations

• Eight (8) four-week rotations in adult and pediatric cardiothoracic operating rooms and other cardiac anesthetizing sites.
• One (1) four-week rotation in the 15-bed Cardiothoracic Intensive Care Unit.
• Eight weeks of elective rotations; each elective rotation is a minimum two weeks in duration; each Fellow has the opportunity to choose potential elective rotations from: thoracic anesthesia, pediatric cardiac anesthesia, interventional catheter-based cardiac anesthesia, extracorporeal perfusion technology, cardiology echo lab and quality improvement and patient safety. Fellows involved in a research project in cardiothoracic anesthesia could potentially substitute research time for an elective clinical rotation.
• Four (4) weeks of vacation

Scholarly Activity

The Fellows are required to participate actively in scholarly activities during their fellowship. Each Fellow must complete at least one academic assignment on a cardiothoracic anesthesia-related topic. Academic projects may include: Grand Rounds presentations, case reports, preparation and publication of review articles, book chapters, manuals for teaching or clinical practice, and clinical research investigation. The Fellow is encouraged to either participate in the ongoing clinical studies or develop an independent research project with Faculty support. The Division of Cardiothoracic Anesthesiology at the Westchester Medical Center is academically involved in national professional societies and meetings. We encourage our Fellows to present abstracts and interesting cases at major meetings; assist with workshops and problem-based learning discussions. Financial support is available if presenting original work. Our highly motivated Faculty members act as mentors and assist Fellows as necessary with the scholarly activity of their interest. Fellows have access to statistical support and research design at New York Medical College.

Evaluation

Faculty members responsible for teaching review the Fellows’ performance using a confidential online system. Feedback from multi-source evaluations by Faculty, peers, Anesthesiology residents, surgeons, OR and ICU nurses, perfusionists, anesthesia technicians and program coordinator is shared with the fellow, and with Clinical Competency Committee, who utilize this information to assess the fellow’s Milestones which are communicated by the Program Director. The Program Director meets with the Fellows to provide formative written feedback on all elements of the Fellows’ performance at least semi-annually. After completion of 12 months of education, the Program Director provides a written Summative Evaluation.

Current and Past Fellows

Class of 2024-2025

Paul Mah, MD
Medical School: American University of the Caribbean School of Medicine
Residency: Wayne State university School of Medicine

Dinesh Parmar, MD
Medical School: St. George’s University School of Medicine
Residency: St. Joseph’s University Medical Center

Avanti Suresh, MD
Medical School: Rutgers Robert Wood Johnson Medical School
Residency: Rutgers, Robert Wood Johnson, Medical School

2023-2024 Fellow Graduates

Lauren Berrol, MD
Medical School: Rutgers New Jersey Medical School
Residency: Hackensack University Medical Center Program

Nicholas Knowland, MD, MPH
Medical School: Tufts University School of Medicine
Residency: Loma Linda University Health Education Consortium Program

2022-2023 Fellow Graduates

Diana Fidrocki, MD
Medical School: Western Michigan University Homer Stryker M.D. School of Medicine
Residency: SUNY Downstate Health Sciences University

Matea Malinovic, MD
Medical School: University of Kansas School of Medicine – Wichita
Residency: University of Kansas School of Medicine – Wichita, Department of Anesthesiology

2021-2022 Fellow Graduates

Daniel Denis, DO
Medical School: Rowan University School of Osteopathic Medicine
Residency: Lincoln Medical and Mental Health Center (Transitional Year); Rutgers New Jersey Medical School (Anesthesiology - General)

Michael Wagner, DO
Medical School: Arizona College of Osteopathic Medicine of Midwestern University
Residency: UCLA David Geffen School of Medicine/UCLA Medical Center (Surgery); University of Arizona College of Medicine (Anesthesiology)

2020-2021 Fellow Graduates

Virgilio De Gala Jr., MD
Medical School: University of Santo Tomas Faculty of Medicine and Surgery
Residency: SUNY Health Science Center at Brooklyn

John Kim, MD
Medical School: SUNY Upstate Medical School
Residency: Hofstra/Northwell

2019-2020 Fellow Graduates

David Cheng, MD
Medical School: University of Texas Southwestern Medical Center at Dallas
Residency: University of Texas Health Science Center at San Antonio
Currently: Baylor Scott and White - The Heart Hospital, Plano, TX

Diana Virella Saenz, MD
Medical School: University of Puerto Rico School of Medicine
Residency: SUNY Health Science Center at Brooklyn
Currently: Staten Island Hospital, Staten Island, NY

Faculty

Draginja Cvetkovic, MD, FASA
Program Director, Adult Cardiothoracic Anesthesiology Fellowship
Clinical Associate Professor of Anesthesiology, New York Medical College

Dr. Cvetkovic joined the Westchester Medical Center Department of Anesthesiology in 2011. She earned her MD from the School of Medicine at the University of Belgrade, Serbia. Dr. Cvetkovic completed her residency in anesthesiology at Beth Israel Medical Center and a Cardiothoracic Anesthesiology Fellowship at Mt. Sinai Medical Center, both in New York City. She is a Diplomate of both the American Board of Anesthesiology and of the National Board of Echocardiography in Advanced Perioperative Transesophageal Echocardiography. Dr. Cvetkovic is also an ABA Diplomate in Pediatric Anesthesiology.

Peter J. Panzica, MD
Chair, Department of Anesthesiology
Associate Professor of Anesthesiology
Director, Anesthesiology Services, Westchester Medical Center

Dr. Panzica earned his medical degree from Stony Brook School of Medicine, State University of New York. He completed residency training in anesthesiology, followed by a Cardiothoracic Anesthesiology Fellowship at Beth Israel Hospital in Boston. He has also completed training in liver transplant anesthesia at Mt. Sinai Medical Center in New York. Dr. Panzica is a Diplomate of the American Board of Anesthesiology and holds a Testamur certificate of the National Board of Echocardiography in Advanced Perioperative Transesophageal Echocardiography. Dr. Panzica joined the Westchester Medical Center as Director of Anesthesiology as well as Chairman of the Department of Anesthesiology in 2019.

Alexander Mittnacht, MD, FASE
Section Chief, Adult Cardiac and Pediatric Cardiac Anesthesia
Professor of Anesthesiology

Dr. Mittnacht earned his medical degree from Julius-Maximilians-Universität in Würzburg, Germany. He completed his residency in anesthesiology at University of Würzburg in Germany and a Cardiothoracic Anesthesiology Fellowship at Mt. Sinai Medical Center in New York City. Dr. Mittnacht is a Diplomate of both the American Board of Anesthesiology and the National Board of Echocardiography in Advanced Perioperative Transesophageal Echocardiography. He is also an ABA Diplomate in Pediatric Anesthesiology. Dr. Mittnacht joined the Department of Anesthesiology at Westchester Medical Center in 2019.

Iwan Sofjan, MD
Associate Program Director, Adult Cardiothoracic Anesthesiology Fellowship 
Assistant Professor of Anesthesiology
Division of Cardiothoracic Anesthesiology

Dr. Sofjan earned his medical degree from University of Texas Health Science Center at San Antonio. He completed residency training in anesthesiology at the University of Pittsburgh Medical Center (UPMC), followed by a Cardiothoracic Anesthesiology Fellowship at the Cleveland Clinic. Dr. Sofjan is board certified by the American Board of Anesthesiology and by the National Board of Echocardiography in Advanced Perioperative Transesophageal Echocardiography. He has been on staff at Westchester Medical Center since 2017. He chairs the Fellowship Program Clinical Competence Committee.

Richard Yeom, MD
Assistant Professor of Anesthesiology
Division of Cardiothoracic Anesthesiology

Dr. Yeom Joined Westchester Medical Center Department of Anesthesiology in 2022. He earned his medical degree from Rutgers University, New Jersey Medical school in May of 2017. Dr. Yeom Completed his Residency at Thomas Jefferson University in July 2018-June 2021. Dr. Yeom completed his fellowship for Adult Cardiothoracic Anesthesiology at Brigham and Women’s Hospital at Harvard’s Medical School.

Sarah Smith, MD
Clinical Associate Professor of Anesthesiology
Division of Cardiothoracic Anesthesiology

Dr. Smith joined the Department of Anesthesiology at Westchester Medical Center in 2016. She earned her medical degree from Columbia University College of Physicians and Surgeons. Dr. Smith completed her residency in anesthesiology and then an Adult Cardiothoracic Anesthesiology Fellowship at Columbia University’s NewYork-Presbyterian Hospital-Columbia. She is a Diplomate of the American Board of Anesthesiology and of the National Board of Echocardiography in Advanced Perioperative Transesophageal Echocardiography. She is currently pursuing a Master’s degree in Medical Ethics at Columbia University. She chairs the Fellowship Program Evaluation Committee.

Cheng Feng, DO
Assistant Professor of Anesthesiology
Division of Cardiothoracic Anesthesiology

Dr. Feng joined the Westchester Medical Center Department of Anesthesiology in 2011. He earned his medical degree from Texas College of Osteopathic Medicine. Dr. Feng completed his residency in anesthesiology at Nassau University Medical Center in Nassau County, NY, and Cardiothoracic Anesthesiology Fellowship at Mt. Sinai Medical Center. He is a Diplomate of the American Board of Anesthesiology and of the National Board of Echocardiography in Advanced Perioperative Transesophageal Echocardiography.

Kaya Sarier, MD
Assistant Professor of Anesthesiology
Division of Cardiothoracic Anesthesiology

Dr. Sarier joined the Westchester Medical Center Department of Anesthesiology in 2017. He earned his medical degree from Rutgers New Jersey Medical School. Dr. Sarier completed his residency in anesthesiology at Mt. Sinai Medical Center in NY. He holds a Testamur certificate of the National Board of Echocardiography in Advanced Perioperative Transesophageal Echocardiography.

Paolo Trubiano, MD
Assistant Professor of Anesthesiology
Division of Cardiothoracic Anesthesiology

Dr. Trubiano earned his medical degree from Albany Medical College. He completed residency training in anesthesiology at St. Luke’s-Roosevelt Hospital Center (now Mount Sinai Morningside) in New York City and a Cardiothoracic Anesthesiology Fellowship at New York-Presbyterian Hospital-Columbia. Dr. Trubiano is a Diplomate of the American Board of Anesthesiology and of the National Board of Echocardiography in Advanced Perioperative Transesophageal Echocardiography. He joined the Anesthesiology Department at Westchester Medical Center in 2018.

Kevin J. Donnelly, MD
Assistant Professor of Anesthesiology
Division of Cardiothoracic Anesthesiology

Dr. Donnelly earned his medical degree from Ross University School of Medicine in Dominica. He completed residency training in anesthesiology at John H. Stroger Jr. Hospital of Cook County in Chicago and a Cardiothoracic Anesthesiology Fellowship at the University of Colorado. Dr. Donnelly is a Diplomate of the American Board of Anesthesiology and holds a Testamur certificate of National Board of Echocardiography in Advanced Perioperative Transesophageal Echocardiography. He joined the Anesthesiology Department at Westchester Medical Center in 2019.

How to Apply

Applicants must meet the following qualifications prior to starting:

• Completion of an ACGME-accredited Anesthesiology Residency Program
  

Applicants should register with the San Francisco Match at www.sfmatch.org. Selected applicants will be invited for a formal interview.

Please direct all questions regarding the application/interview process to:

Dorian DuBois, BS
Fellowship Coordinator
Dorian.DuBois@wmchealth.org

For all other information, please contact the Fellowship Program Director at: draginja.cvetkovic@wmchealth.org

Contact Us

Please contact:

Dorian Dubois
Fellowship Coordinator
Dorian.Dubois@wmchealth.org