Adult Cardiothoracic Anesthesiology

About Us

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. 

Our Mission

To provide a comprehensive 1-year experience in the field of cardiovascular and thoracic anesthesia to prepare our trainees in all major aspects of perioperative care of our complex cardiovascular and thoracic surgical population.

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 

Benefits  

• 20 Hour of PTO/Discretionary days per ABA
• $1750 in Educational funds (use for conferences, travel, lap tops, lead aprons, books, exam fees, board exam fees, etc) 
• $1300 additional Presentational Funds if approved when accepted to present an abstract at a conference 

Our People

Leadership Team

Faculty:

Current and Recent Fellows

• 2024-2025 Fellows

  Sadaf Chaugle, M.D.
  Medical School: Wayne State University School of Medicine
  Residency: Ohio State University Hospital Program
  Current Position: Private Practice, Houston

  Douglas Nguyen, M.D.
  Medical School: University of Miami Miller School of Medicine
  Residency: Washington University Consortium Program
  Current Position: Private Practice, Dallas

  Vivian Xu-Yen, M.D.
  Medical School: Wakeforest School of Medicine
  Residency: UT Southwestern Medical Center
  Current Position: Private Practice, Dallas

• 2023-2024 Fellows

  Saira Nisar, MBBS
  Medical School: George Washington University School of Medicine
  Residency: George Washington University
  Current Position: University of Maryland

  Zubin Patel, M.D.
  Medical School: Medical College of Wisconsin
  Residency: Medical College of Wisconsin
  Current Position: Northstar

  Derek Starkey, M.D.
  Medical School: SUNY Upstate Medical University
  Residency:SUNY Upstate Medical University Program
  Current Position: Catholic Medical Center

• 2022-2023 Fellows

  Justin Morello, M.D.
  Medical School: University of Kansas School of Medicine
  Residency: Ochsner Clinic Foundation Program
  Current Position: Baylor All Saints, Fort Worth

  Austin Pucylowski, M.D..
  Medical School: Indiana Univeristy School of Medicine
  Residency: UT Southwestern Medical Center
  Current Position: Excel Anesthesia Group

  Mohammad-Ali Shaikh, M.D
  Medical School: UT Southwestern Medical School
  Residency: UT Southwestern Medical Center
  Current Position: UT Southwestern Medical Center
  

• 2021-2022 Fellows

  Arthur Randy Meike, M.D.
  Medical School: Uniformed Services University of the Heatlh Sciences
  Residency: National Capital Consortium
  Current Position: Academics, Mayo Clinic, Rochester, MN

  Jason Smith, M.D.
  Medical School: Chicago Medical School at Rosalind Franklin University
  Residency: Medical College of Wisconsin
  Current Position: Private Practice, US Anesthesia Partners, Excel Division

• 2020-2021 Fellows

  Douglas Huynh, M.D.
  Medical School: University of Texas Medical School at Houston
  Residency: UT Southwestern Medical Center
  Current Position: PIH Health Good Samaritan Hospital

  Kyle Meinhardt, M.D.
  Medical School: Univeristy of Texas Medical Branch
  Residency: UT Southwestern Medical Center
  Current Position: Methodist Medical Center

Curriculum

Clinical Site Rotations 

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. 

Echocardiography Experience

• 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 

Research 

• 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) 

Didactics 

Weekly conferences (TEE didactics, Topics in CT anesthesiology, case conference, journal club)