Cardiac Care Unit
During this rotation, fellows take a leadership role in managing patients with complex cardiovascular disease. Patients with acute myocardial infarction, refractory cardiogenic shock, complex life-threatening arrhythmias, and severe decompensated pulmonary hypertension are managed by a team of physicians including medical students, interns, and residents. Fellows in the CCU work seamlessly with a faculty member to direct supervise and coordinate all aspects of care. The CCU fellow also takes on a primary role in the education of the team in all aspects of cardiovascular disease. Fellows will also supervise residents while performing procedures in the CCU such as temporary pacer placement, right heart catheterization, intravascular hypothermia, or intra-aortic balloon placement.
The Hans Hecht Cardiac Catheterization Laboratory at the University of Chicago, under the leadership of Drs. Atman Shah and Sandeep Nathan, performs nearly 2,500 procedures annually and provides the full spectrum of catheter-based and hybrid treatment options for patients with complex cardiac and vascular disease. General Cardiology Fellows become proficient in the performance of diagnostic coronary angiography, right heart catheterizations, endomyocardial biopsies, intra-aortic balloon pump placement, temporary pacemaker implantation, and the interpretation of coronary and peripheral angiography as well as complex hemodynamics. In addition to complex coronary artery interventions, General Fellows are exposed to peripheral (including carotid, renal, iliac, femoral, and infrapopliteal) and structural (transcatheter aortic valve implantations, aortic/mitral valvuloplasty, and ASD/VSD/PDA/PFO closures) interventions. A significant emphasis is placed on understanding interventional decision-making and judgment in addition to the safe and effective performance of these procedures.
During this rotation, fellows serve as the point person for all inpatient and emergency department cardiovascular consultations. Working closely with a faculty member to help lead a team of residents and medical students, the consult fellow plays the primary role in patient triage, approach to diagnostic testing, and management. The consult fellows also take on a primary role in the education of the team which includes medical students and residents.
In this rotation, fellows spend time with in our nationally renowned Section of Cardiac and Thoracic Surgery, under the direction of Dr Val Jeevanandam. Fellows go the operating room to observe a full spectrum of cardiac surgeries including valve replacements/repairs, open and minimally invasive coronary artery bypass grafting, congenital heart disease repair, and VAD implanations. In addition, fellows participate in all aspects of inpatient pre and post-operative care.
Congestive Heart Failure and Transplantation
In this rotation directed by Dr. Nir Uriel, fellows play a vital role in Chicago’s leading advanced heart failure, mechanical circulatory support, and cardiac transplant program. Fellows participate in the CHF inpatient and intensive care unit consult service which addresses all aspects of advanced heart failure care. As one of the country’s largest VAD implant centers, the fellows participate in the LVAD evaluation process (for destination or bridge therapy), VAD management, and have the opportunity to see VAD implantations in the Operating Room. As a large cardiac and multi-organ transplant center, fellows are exposed to all aspects of pre-transplant management/selection, organ procurement, and post-operative management. Fellows also perform right heart catheterizations and right ventricular endomyocardial biopsies, interpret the hemodynamic tracings, and review the biopsy slides at a biweekly pathology review.
The University of Chicago Echocardiography Laboratory, under the Director of Dr. Roberto Lang, annually performs more than 12,000 echo procedures, including TTE, TEE, Stress, 3D, and contrast echocardiography. Fellows on this rotation become skilled in all aspects of the performance and interpretation of transthoracic and transesophageal imaging. Our laboratory is a national leader in 3D echocardiography pioneering many of 3D techniques, and fellows gain unique exposure to the use to 3D in both TTE and TEE. With the election of advanced clinical training in echo in the 3rd year, fellows are eligible to sit for the National Board of Echocardiography. In addition, fellows will gain exposure to all aspects of performance and interpretation of cardiac CTA and cardiac MRI.
The Heart Rhythm Center, under the direction of Dr. Roderick Tung, provides comprehensive therapy for arrhythmia patients. We perform over 1500 procedures annually in the 3 electrophysiology laboratories (one with magnetic navigation capability). Aside from a busy AF and VT ablation program, the Heart Rhythm Center is recognized as one of the leading centers in the nation for lead management and extraction. General fellows on this rotation become integral members of the Arrhythmia Service and are exposed to complex ablation, cardiac resynchronization therapy, consultative electrophysiology and interpretation of electrocardiograms. At the end of the rotation fellows become proficient in device interrogation and reprogramming, cardioversion, tilt table testing, understanding arrhythmia mechanisms and guideline based therapy for various arrhythmias.
Northshore University –Evanston
In the only off-site rotation of our fellowship program, fellows experience clinical and procedural cardiology at Evanston Hospital, an outstanding community affiliate of the University of Chicago in Evanston, Illinois. In a month-long rotation during each of the first two fellowship years, fellows participate in inpatient and outpatient clinical cardiology care. During this time, fellows have dedicated procedure time in the cardiac cath lab as well as ability to perform TEEs in the imaging center. Fellows also take lead role in teaching while on inpatient consult service at Evanston. This extremely popular rotation provides fellows a longitudinal patient care experience, which differs from the traditional focused rotations here at U of C.
Nuclear Cardiology and Stress Testing
In this rotation, fellows will spend time in the University of Chicago Nuclear Cardiology laboratory, which performs over 3000 nuclear cardiology procedures per year. Fellows supervise exercise and pharmacologic nuclear stress tests and learn contraindications, complications, and all aspects of interpretation of stress testing. Fellows will also become proficient in the performance, interpretation and diagnostic and prognostic implications of SPECT myocardial perfusion imaging as well as first pass and equilibrium RNA. Fellows learn all aspects of radiation safety and by choosing to do advanced rotations in their 3rd year will be eligible to sit for the certification board in nuclear cardiology.
In this rotation, fellows attend outpatient clinics with Dr Michael Davidson (advanced lipidology), Dr Matthew Sorrentino (all aspects of cardiovascular prevention), and Dr George Bakris from the Section of Endocrinology (advanced hypertension). In addition, fellows attend cardiovascular genetics, participate in our cardiac rehabilitation program, and gain exposure to outpatient vascular imaging. This is an extremely popular 1-month rotation in which fellows gain an understanding of the pathophysiology as well as the diagnostic and therapeutic approaches to all aspects of the primary and secondary prevention of cardiovascular disease.
Outpatient Continuity Clinic
Fellows are assigned to Cardiology Faculty member’s clinics held in the Duchossois Center for Advanced Medicine (DCAM). Our busy outpatient practice provides an ideal training environment including both common cardiovascular conditions among the South Side of Chicago population we serve, as well complex cardiovascular disease as a regional and national secondary and tertiary referral center.