Interventional Cardiology Fellowship

About the program

The one-year fellowship training program is structured to provide the fellow with a broad clinical experience that will enable him/her to practice as a consultant in the field of interventional cardiology with the expertise to perform interventional procedures in the coronary system, as well as the peripheral vascular arena.

In addition, depending on the fellow's training/learning goals, training in the performance of a number of structural heart procedures including TAVR, ASD/PFO closure, left atrial appendage occlusion and carotid stenting is available.

Clinical experience

All fellows must have a minimum of 12 months procedural experience with direct oversight by a faculty interventional cardiologist.

Didactics

• Core curriculum – Weekly
• Catheterization conference – Weekly
• Program director's conference – Weekly

Training goals and objectives

The interventional training year is designed to provide the fellow with extensive opportunity to develop skills in disease management of coronary artery disease with emphasis of the pre-procedural risk stratification, the direct procedural-related optimal techniques, and the post-procedural clinical management.

The year experience includes emergent procedures, hemodynamic support options, management of peri-procedural complications, clinical interactions with the cardiovascular surgery team as well as the vascular surgery team in team approach clinical decision process, along with the structural heart procedures and clinical management/evaluation of these focus areas.

The program is structured to provide the fellow training that meets the requirements outlined in the COCATS 4 document as well as the recommendations of the Society of Cardiovascular Angiography and Interventions (SCAI).

Specific curricular milestones are assessed on a quarterly basis, with semi-annual reports submitted to the ACGME. Specific evaluation methods include direct observation and mentoring along with oral and written examination, multisource analysis, and scheduled clinical competency committee meetings twice a year.

Fellow expectations and responsibilities

The interventional fellow must be at the cath lab area for the working day unless on a previously scheduled vacation or CME time approved by the program director. The fellow will function as a junior attending for diagnostic cases, working with the cardiovascular fellows and cath lab support team. Cath reports will be completed by the close of business the day of procedures.

The fellow on-call must be able to arrive at the hospital within 20 minutes of pager activation at night and on weekend/holiday. The fellow will be the primary operator on interventional procedures with direct supervision/assistance by the faculty attending.

The fellow will be responsible for guideline-based appropriate pre- and post-procedure clinical care. The interventional fellow must attend:

• The interventional cardiology fellowship core curriculum didactic series on Monday mornings
• Cath lab conference each Friday (responsible for presenting/discussing cases)
• Program director meeting each Thursday
• Cardiology journal club monthly
• Cardiology mortality review on the last Monday of each month
• The monthly cath lab quality improvement conference held the last Tuesday of each month

Faculty research and publications

Select publications from Dr. Mixon:

• Widmer RJ, Hammonds K, Mixon T, Exaire JE, Chiles CD, Tavilla G, Szerlip MI, DiMaio JM. Acute coronary syndrome revascularization strategies with multi-vessel coronary artery disease. Am J Cardiol. 2024 Apr 4:S0002-9149(24)00236-4. doi: 10.1016/j.amjcard.2024.04.003. Epub ahead of print. PMID: 38582315.
• Exaire JE, Mixon TA. Toward Optimizing Antiplatelet Therapy for Patients at High Bleeding Risk. Am J Cardiol. 2024 Jan 1;210:130-132. Epub 2023 Oct 23.
• Karim Al-Azizi, Emily Shih, J. Michael DiMaio, Timothy A.Mixon, et al. Assessment of TVT and STS Risk Score Performances in Patients Undergoing Transcatheter Aortic Valve Replacement.  JSCAI, 2023; 2(3): 1-7.  https://doi.org/10.1016/j.jscai.2023.100600
• Chris Perez, Timothy A. Mixon. An Uncommon Case of Thermal Burn from Repetitive Implantable Cardioverter-Defibrillator Shocks Seen on Positron Emission Tomography/Computed Tomography Scan.  HeartRhythm Case Reports (2023), doi:https://doi.org/10.1016/j.hrcr.2023.05.007.
• Corry B. Sanford, Jonathan P. Urbanczyk, Timothy A. Mixon. Long-term patency of rescue stenting of an anomalous left circumflex coronary artery after transcatheter aortic valve replacement.  Proc (Bayl Univ Med Cent) 2023; 36(2): 216-218. PMID 36876261
• Nikita Dhir, Travis Haneke, Timothy Mixon. Mechanical circulatory support for thyrotoxicosis-induced cardiomyopathy.  Proc (Bayl Univ Med Cent) 2023; 36(2):211-212. PMID 36876277. 
• Jonathan P. Urbanczyk , Timothy A. Mixon , Konda Subbareddy, Angel E. Caldera. Iatrogenic ventricular septal defects following transcatheter aortic valve implantation.  Proc (Bayl Univ Med Cent) 2023; 36(1): 106-108. PMID 36578605

Select publications from Dr. Widmer:

• Widmer RJ, Hammonds K, Mixon T, Exaire JE, Chiles CD, Tavilla G, Szerlip MI, DiMaio JM. Acute coronary syndrome revascularization strategies with multi-vessel coronary artery disease. Am J Cardiol. 2024 Apr 4:S0002-9149(24)00236-4. doi: 10.1016/j.amjcard.2024.04.003. Epub ahead of print. PMID: 38582315.
• DiMaio JM, McCullough KA, Widmer RJ. A Post Hoc Analysis of ISCHEMIA: Are All Events Created Equal? J Am Coll Cardiol. 2024 Feb 6;83(5):559-561. doi: 10.1016/j.jacc.2023.11.027. PMID: 38296399.
• Samuels BA, Shah SM, Widmer RJ, Kobayashi Y, Miner SES, Taqueti VR, Jeremias A, Albadri A, Blair JA, Kearney KE, Wei J, Park K, Barseghian El-Farra A, Holoshitz N, Janaszek KB, Kesarwani M, Lerman A, Prasad M, Quesada O, Reynolds HR, Savage MP, Smilowitz NR, Sutton NR, Sweeny JM, Toleva O, Henry TD, Moses JW, Fearon WF, Tremmel JA; Microvascular Network (MVN). Comprehensive Management of ANOCA, Part 1-Definition, Patient Population, and Diagnosis: JACC State-of-the-Art Review. J Am Coll Cardiol. 2023 Sep 19;82(12):1245-1263. doi: 10.1016/j.jacc.2023.06.043. PMID: 37704315.
• Widmer RJ, Exaire JE. Extending Our Knowledge of Lifetime Outcomes After ST-Elevation Myocardial Infarction. Am J Cardiol. 2023 Mar 15;191:139-140. doi: 10.1016/j.amjcard.2023.01.003. Epub 2023 Jan 20. PMID: 36682925.

Select publications from Dr. Exaire:

• Widmer RJ, Hammonds K, Mixon T, Exaire JE, Chiles CD, Tavilla G, Szerlip MI, DiMaio JM. Acute coronary syndrome revascularization strategies with multi-vessel coronary artery disease. Am J Cardiol. 2024 Apr 4:S0002-9149(24)00236-4. doi: 10.1016/j.amjcard.2024.04.003. Epub ahead of print. PMID: 38582315.
• Exaire JE, Mixon TA. Toward Optimizing Antiplatelet Therapy for Patients at High Bleeding Risk. Am J Cardiol. 2024 Jan 1;210:130-132. Epub 2023 Oct 23.
• Widmer RJ, Exaire JE. Extending Our Knowledge of Lifetime Outcomes After ST-Elevation Myocardial Infarction. Am J Cardiol. 2023 Mar 15;191:139-140. doi: 10.1016/j.amjcard.2023.01.003. Epub 2023 Jan 20. PMID: 36682925.

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