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Program Structure

The Cardiothoracic Aortic and Endovascular Surgery Fellowship provides advanced training in both minimally invasive and open approaches to aortic repair/replacement including valve repair, TAVR, and TEVAR. The Fellowship provides broad, extensive experience in all aspects of aortic surgery. While there are a handful of programs that can provide an adequate experience in one of these fields, Duke is unique in providing a large clinical experience in all of these disciplines. In addition to gaining operative experience, fellows will participate in both outpatient clinic and as well as all aspects of inpatient care. Fellows will be involved from initial patient diagnosis, work-up, and pre-surgical evaluation to both short-term and long-term follow-up. At all times, trainee will function under the supervision and direction of the program faculty. The trainees will not be independent providers.

In this role, the fellow will train alongside residents enrolled in the accredited Thoracic Surgery and General Surgery programs at Duke University, as well as with advanced practice providers in both the inpatient and outpatient setting. The fellow will actively participate in all educational conferences and activities. The fellows are also encouraged to participate in a full range of research opportunities, including both basic science and clinical research. The fellow will be able to work with several faculty who have formal training in clinical research and can provide mentorship as well as guidance in statistical analysis. Through these faculty, the fellow will have access to a large instuitional database as well as national and international registries in order to perform both hypothesis testing and hypothesis generating research. The fellow will have approximately 10% of the fellowship protected in order to pursue a research interest.

It is expected that at the completion of 1 year of training, the fellow will have participated in numerous ascending aortic, arch and descending replacements, valve repairs and replacements, TAVRs and TEVARs. This will include the preoperative assessment of these patients, the operative procedure, and the inpatient and outpatient postoperative care of these patients.

The fellow will participate in the following educational conferences:

  • TAVR Case Conference (Weekly)
  • Morbidity and Mortality (Monthly)
  • Grand Rounds (Weekly)

While the core program is 1 year in duration, some trainees can elect to spend an abbreviated 6 months of training if deemed fit. Upon completion, these fully trained cardiothoracic surgeons will be able to function as the Surgical Director of a program immediately upon completion of the fellowship.  

Supervision and Evaluation

All trainees function under the supervision of the program faculty at all times. They will not be functioning as independent providers during this fellowship. Over the course of the program, there is graduated responsibility as appropriate based on the trainee’s clinical skill and needs. The trainees are informally evaluated by the faculty with which they are working at the time and point of contact. They are formally evaluated by the faculty monthly and by the program director quarterly. These formal evaluations are written in nature and directly address the components of care: preoperative evaluation, donor evaluation, recipient selection, intraoperative skills, critical care, and postoperative care.