Bluhm Cardiovascular Institute (BCVI) at Northwestern University’s Feinberg School of Medicine

The Bluhm Cardiovascular Institute (BCVI) at Northwestern University’s Feinberg School of Medicine offers a 3 year ACGME accredited fellowship in cardiothoracic surgery. Northwestern University has a lineage of influential faculty members including Dr. David A. Fullerton, now chief of cardiothoracic surgery at the University of Denver, Colorado. Dr. Keith Horvath pioneered transmyocardial revascularization at Northwestern in 1999 and is now director of cardiothoracic surgery at the National Heart, Lung and Blood Institute, National Institute of Health.

In 2004, the program underwent a major renovation with the help of a generous endowment by Neil Bluhm, a prominent real estate developer. Dr. Patrick M. McCarthy, was recruited as director of the Bluhm Cardiovascular Institute and was named the first Heller-Sacks Professor of Surgery at Northwestern. To accomplish the mission of the institute, he immediately began recruiting an all-star cast of cardiothoracic surgeons and cardiologists from some of the most prominent institutions around the country. Until March of 2004 Dr. McCarthy was the surgical director of the Kaufman Center for Heart Failure at the Cleveland Clinic where he practiced from 1990-2004. Dr. McCarthy has achieved national and international recognition in the field of complex adult cardiac surgery including, heart valve repair and replacement, cardiac transplantation, mechanical ventricular assist devices, coronary artery bypass surgery, minimally invasive surgery, aneurysm repair and atrial fibrillation ablation. Dr. McCarthy and his staff have developed a cardiovascular institute in the heart of Chicago that combines surgical and nonsurgical specialties including cardiac surgery, cardiology, cardiovascular anesthesia, vascular surgery and radiology. The outcomes of the department are exceptional and are detailed under the Clinical Activities and Outcomes Report at http://www.nmh.org/nm/bluhm+cardiovascular+institute.

Dr. McCarthy has successfully recruited several established senior faculty members including Dr. Richard Lee, a pioneer in minimally invasive arrhythmia surgery formerly from Washington University in St. Louis and the Cleveland Clinic. He has also recruited Dr. Malcom DeCamp who was program director of lung transplantation at the Cleveland Clinic Foundation between 2001-2004 and chief of cardiothoracic surgery at Beth Israel Deaconess Medical Center until 2009. Other notable faculty members include Dr. Edwin McGee, formerly of the Cleveland Clinic and now head of the heart transplant program at BCVI; Dr. Carl Backer, head of cardiovascular and thoracic surgery at Children’s Memorial Hospital; Dr. S. Chris Malaisrie from Baylor College of Medicine with special interest in aortic surgery; Dr. Alberto De Hoyos with primary interest in lung cancer; Dr. Hyde Russell with special interest in congenital and adult congenital heart surgery and Dr. Sunjay Kaushal with special interest in pediatric heart failure and devices.

The complexity and volume of cases at BCVI are extensive. Chiefs graduate with a niche in mitral valve repairs and arrhythmia surgery. They finish with over 150 valve operations, 40-50 of which are mitral valve repairs. Arrythmia surgery including the classic, modified and minimally invasive MAZE are routine at BCVI. More than 90% of atrial fibrillation patients are treated with a maze at the time of their primary operation. Fellows do enough heart transplants to obtain UNOS certification by the end of their training. Fellows are now involved with FDA approved clinical trials in percutaneous valve replacements and endovascular aortic arch repairs. They graduate with expertise in aortic root replacement, dissections and minimal access aortic valve replacements. Fellows also gain sufficient thoracic experience to meet ABTS requirements. While thoracic surgery has received less of a training emphasis in the past, the recent addition of Dr. Malcom DeCamp is sure to increase the volume of video assisted benign and malignant lung operations. Lung transplantation is expected to begin at BCVI within the next 2-3 years.

Residents train under direct supervision for the critical aspects of cases with progressively more surgical responsibility granted over time. Residents are expected to open, cannulate, harvest grafts and close independently by the second month on the cardiac service. By the second or third month on the cardiac service, residents are actively performing coronary anastamoses. Fellows become comfortable with redo coronary procedures and about 20% of all coronaries are performed off pump. While there are currently no simulators available, first year residents are expected to attend the TSDA boot camp sessions.

Generally, there are 3- 4 rooms running every day with three residents available and one advanced fellow. In-house call is on average every fourth night. The first 6 months are devoted to thoracic surgery. The next 6 months are devoted to adult cardiac surgery. The next 3 months are spent at Children’s Memorial Hospital. The resident then spends 3 more months on thoracic. The remainder of the fellowship (15 months) is tailored to the resident’s specific case requirements and interest. One fellow, for instance, spent half of the last year at Children’s Memorial as a prelude to his congenital heart fellowship and eventual job as a staff heart surgeon at Children’s Memorial. Children’s Memorial Hospital is among a handful of congenital programs that are now accredited by the ACGME. Another fellow sought additional months in the cardiac catheterization lab to gain advanced credentialing in diagnostic and therapeutic interventions.

BCVI’s cardiothoracic surgery program boasts a 100% employment rate as well as a 100% ABTS passing rate. Eighty percent of graduates have gone into academics. The research options available at BCVI are extensive. Research is mandated at BCVI. Once a year an invited lecturer visits Chicago, meets with the residents and spends a complete day discussing papers authored and presented by the residents. This activity is designed to strengthen the resident’s expertise in a specific area of interest. The Clinical Trials Unit (CTU) was established in 2005 to assist faculty and residents with biostatistics, trial design and regulatory compliance and submission issues. There are individual nurses devoted to the atrial fibrillation and valve databases. There are always a number of clinical trials being performed at BCVI (please refer to http://www.nmh.org/nm/bluhm+cardiovascular+institute ).

The hospital buildings of the medical complex were built in 2003 and the new Children’s Memorial building is slated to open in 2012. The facilities are well maintained and centered around providing efficient and safe patient care. There are multiple PA’s and critical care physicians available to assist the residents and attendings. BCVI is located in the scenic Streeterville area overlooking Lake Michigan. There is plenty to do in Chicago during time off.

The mission of Dr. McCarthy’s cardiothoracic training program is simple: “We aim to produce surgeons that partners want to hire. These are surgeons who add specific expertise in complex areas of cardiac surgery such as arrhythmia and valve surgery.” The volume is clearly sufficient to achieve this goal. The excellence of faculty members also ensures that this mission is accomplished. In conclusion, BCVI is a premier cardiothoracic surgery training program in the Midwest. It is resident-centered and tailored to the resident’s individual interest. Graduates of the program are sure to be competitive in the field of advanced cardiac and thoracic surgery.

Acknowledgments:

Special thanks to Dr. Patrick M. McCarthy (Director of BCVI and Chief of Cardiothoracic Surgery at BCVI) and Dr. Hyde M. Russell (Children's Memorial Hospital, Division of Cardiovascular-Thoracic Surgery) for their contributions to this article.

Additional Resources:

http://www.feinberg.northwestern.edu/education/gme/residencies/cardiothoracic_surgery.html

Program Contact Information: