Icahn School of Medicine at Mount Sinai - Imaging Fellowship for Structural Heart Interventions

The Structural Heart Interventions Imaging Fellowship is targeted for fellows who have completed a cardiology fellowship program and are interested in seeking additional knowledge and technical skills in imaging of patients with structural and valve cardiac diseases.  The duration of the program is a one-year fellowship after a formal completion of the regular cardiology fellowship training program. 

Requirements include:

• Completion and passing of all three USMLE steps
• A valid ECFMG certificate for all foreign medical graduates
• ABIM board certified or board eligible
• The accepted applicant must obtain a full New York license (limited license if on visa)
• Completion of previous cardiology fellowship is required.  Additional experience in Echocardiography and/or cardiac CT and CMR will be preferred.

Goals and Objectives for Training:

The Structural Heart Interventions Imaging Fellowship is a 12-month Non-ACGME program targeted for cardiology fellows who have completed their regular cardiology fellowship program and are seeking additional knowledge and technical skills in imaging for structural and valve interventions. The aim is to learn to use multimodality imaging but   mostly Transthoracic and Transesophageal Echocardiography including 3D Echocardiography as well as Cardiac Computed Tomography for screening the appropriate patients for the  appropriate procedure, use imaging for planning the appropriate procedure, determine the selection of the appropriate device, guide with imaging and mostly Echocardiography the performance of the procedure as well as use imaging for following up the patients post procedure.

The Fellow will not only obtain technical proficiency in imaging for complex structural heart procedures but also gain proficiency in all aspects of a busy structural heart program. The fellow will gain knowledge regarding patient referral, patient evaluation, procedural imaging, procedure performance, inpatient management, and follow up outpatient care. The fellow will also get knowledge about ongoing trials in the field and will actively be participating in enrolling patients in these trials.

Applicants for this position must have completed a regular cardiology fellowship training program. There is one fellow for the Structural Heart Interventions Imaging Fellowship per year. During the 12-month fellowship, the fellow will gain procedural expertise to confidently, safely, and independently perform imaging for the following procedures:

• Transcatheter Aortic Valve Replacement (TAVR)
  • Balloon-expandable valves
  • Self-expanding valves
• MitraClip
• Transcatheter Mitral Valve Replacement (TMVR)
• Transcatheter Pulmonary Valve Replacement
• ASD closures
• PFO closures
• Balloon Aortic Valvuloplasty (BAV)
• Balloon Mitral Valvuloplasty (BMV)
• Pulmonary Valvuloplasty
• Percutaneous therapies for congenital heart disease such as PDA closure
• Alcohol Septal Ablation
• Transeptal Left Heart Catheterization
• Paravalvular Leak Closure
• Left Atrial Appendage Closure
• Transcatheter Tricuspid Valve Repair (Emerging technology)

Patient Care:

All fellow must provide patient care that is compassionate, appropriate, and effective for the prevention and treatment of cardiovascular diseases.

1. Fellow will obtain and document relevant information from the patient’s history, physical exam, and laboratory work up, in order to make sure that appropriate imaging procedures are done safely.
2. Fellow also will follow up on orders for appropriate imaging testing.
3. Fellow will actively participate in the interpretation of the imaging studies, will do a preliminary read and review the study for the final and official report   with the supervising attending.

Specific Learning Goals and Objectives:

Fellow should be able to: participate in core conference curriculum, complete assigned readings, attend and participate in morning report and attending rounds regularly. Fellow should be able to: apply clinical epidemiologic and cardiovascular knowledge to the care of the patient, demonstrate analytical thinking approach to clinical situations, consistently teach and support team members.

System-Based Practice:

Fellow should be able to: develop, implement, and evaluate imaging plans for patients that are considered to undergo structural and valve intervention. The fellow should be able to interact with nurses, social workers, physical therapists, and case managers to coordinate patient care. The fellow should be able to advocate for quality patient care and assist patients in dealing with health care complexity. In addition, the fellow should be able to: use systematic approaches to reduce errors in imaging, practice effective health care allocation that does not compromise quality of care and be knowledgeable about types of medical practices and health care delivery systems.

Clinical Responsibilities at Structural Heart Disease Valve Clinic

The Heart Valve Clinic is a busy multi-disciplinary clinic on Wednesdays staffed by interventional cardiologists, cardiac surgeons, and nurse practitioners. In this clinic, the fellow will review all the relevant imaging modalities and together with the other members of the team will be planning the intervention and the follow up. A dedicated nurse practitioner is present for the structural heart and valve clinic as well.

Inpatient Structural Heart Service:

The fellow will be responsible for seeing the patients who undergo a Transesophageal Echo during the intervention and make sure that there is no complication. Also will be responsible for coordinating the performance of the necessary imaging examinations.  The fellow will be also be responsible for seeing inpatient structural heart disease consults as they arise.

For further information, please contact:

Maria Directo / Program Coordinator

Tel: 212.241.3419 / maria.directo@mountsinai.org

Dr. Stamatios Lerakis, MD, PhD / Program Director

404.931.6414 / Stamatios.Lerakis@mountsinai.org