Advanced Interventional Cardiology Fellowship in Structural Heart Disease
This one-year Advanced Interventional Cardiology Fellowship provides training in structural heart disease decision making and interventions to outstanding fellows who have already successfully completed basic interventional cardiology training. The fellowship is based at the UMass Memorial Medical Center, a tertiary referral center serving the Central New England region.
- TAVR with Edwards THV (SAPIEN 3) and Medtronic THV (Evolut R)
- Aortic valvuloplasty
- Transcatheter mitral valve repair (Mitraclip)
- Transcatheter balloon mitral valvuloplasty
- Transseptal puncture and intracardiac echocardiography
- Left atrial appendage closure (Watchman)
- Pulmonary artery sensor implantation (CardioMEMS)
- PFO/ASD/PDA closure (Cardioform, Amplatzer)
- Paravalvular leak closure
- Ongoing advanced coronary work (CTO, multivessel disease, atherectomy etc) with opportunity for independent performance of PCI (at discretion of catheterization laboratory director)
- Advanced LV support (Balloon pump, Impella, ECMO)
The Structural Heart Disease fellow will be expected to publish a minimum of two case reports or original research manuscripts in the field of structural intervention or invasive hemodynamic assessment in collaboration with an attending cardiologist. A variety of ongoing research projects are currently available. The SHD fellow will gain competence in CT image analysis for TAVR planning as well as DICOM-based image sharing for research and clinical purposes.
When not involved in SHD work, the fellow will participate in coronary interventions. At the discretion of the cath lab director, they may be able to assume a junior attending role and perform coronary work, including PCI, as independent operators. Following suitable evaluation and depending on the trainees comfort level, this may be extended to STEMIs.
Fellows are encouraged to assume an active role in the evaluation of patients undergoing SHD interventions. This includes image and hemodynamic analysis, formulation of procedural plans and communication with the referring physicians as appropriate to foster development of independent practice.
The fellow will receive instruction in the imaging evaluation of structural and valvular heart disease (e.g. stress TTE, TEE, intraprocedural TEE) with the echocardiographic attending physician. The fellow is not expected to act as primary operator but will develop the skillset required for SHD procedural success.
Clinics / Consults
Fellows see patients in the Integrated Heart Team clinic (one day per week) in tandem with a structural interventional cardiologist and a cardiac surgeon. In addition, ad hoc patients will be evaluated in the inpatient setting and consults performed and staffed with the interventional attending. Educational goals include physical examination, imaging analysis, patient selection and procedural planning.
The structural fellows will maintain clinical skills by participating in the care of cardiac patients in the role of junior attending. They will serve a minimum of 3 weeks as the inpatient housestaff teaching attending on the consult service.
UMass conferences and Local Public Speaking
Attendance at Wednesday morning interventional cardiology conference and the Friday morning Heart and Vascular Center of Excellence multidisciplinary conference is required. The fellow will present cases at Morbidity and mortality (M&M) conferences and facilitate patient discussion at the Heart Team conference on Wednesday morning. Fellows are expected to give at least two talks on structural heart disease in either regional/national meetings, referral practices or an internal forum. Coaching on presentation preparation and delivery will be provided by the SHD attending physicians. Fellows will be strongly encouraged to submit and present research abstract(s) to selected conferences.