The cardio-thoracic anesthesia rotation exposes residents to anesthetic management of a variety of cardiac surgeries including coronary bypass surgeries, valvular repairs and replacements, aortic repairs, vascular surgeries, and intra-thoracic cases. Residents develop a solid understanding of cardiac anesthesia and the steps to go on/off cardiopulmonary bypass. However, given our complex patient population, residents not only learn the basics of cardiac anesthesia but also how to manage the myriad of other conditions during bypass. Our cardiac attendings are assigned to one cardiac room per day which allows for direct resident teaching every day. Residents learn how to place arterial lines, central lines, pulmonary artery catheters, and perform intraoperative transesophageal (TEE) for each patient.
Residents also participate in thoracic cases involve wedge resections, lobectomies, pneumonectomies which are either preformed open, thoracoscopic or robotic. During these cases the resident will learn placement and management of double lumen tubes, one lung ventilation, and invasive monitoring. Major vascular cases include carotid endarterectomies, major aortic surgery (AAA) and all different kind of vascular bypass surgeries.
TEE is an integral part of our cardiac practice and is an invaluable tool for the general anesthesiologist when patients are decompensating intra-operatively. Residents are assigned to a two week TEE rotation prior to the cardio-thoracic anesthesia rotation. During this block, residents complete an online course with several didactic lecture and learning modules. Additionally, they can practice obtaining various images on the TEE simulator with a dedicated echo attending. During this rotation, residents are an integral part of the cardiac team and participate in all intra-operative TEE and any hospital based inpatient TEE/TTEs with our hospital cardiologists.
Residents also participate in several off-site cardiac services:
- TAVR Thursday:
In addition to the open heart cases we perform multiple transcatheter aortic valve replacement (TAVARs), balloon valvuloplasties and left atrial appendage occlusion devices (watchman procedure) every Thursday in our hybrid OR. We also participate in laser lead extractions in the hybrid OR for removal of infected or broken defibrillator and pacemaker leads which require a general anesthetic with invasive monitors including placement and interpretation of TEE.
- Cardiac Catheritization Lab:
We have a very active electrophysiology program and there are ample opportunities to take care of patients undergoing cardiac ablation procedures for supraventricular and ventricular arrhythmias in the cath lab. We also participate in laser lead extractions. It is critical for our residents to gain experience in these areas of care as general anesthesiologists routinely manage these patients throughout their career.
After completing the echo rotation, one month cardio-thoracic rotation, and one month of liver anesthesia, our residents rotate through Loyola Medical Center CV Anesthesia for one month of operating room anesthesia and one month of cardiovascular ICU. Loyola performs some of the most complex CV cases in Chicago. We are fortunate to draw on the strengths of Loyola and expose our residents to their expertise in CV care. Our residents are well versed in cardiovascular care and get to develop their skills further in this complex environment.
- Daily Intra-operative teaching.
- Monday/Tuesday Subspecialty Cardio-Thoracic Conference. Residents on this rotation have specialized lectures from the CV faculty on topics including: invasive monitoring, hemodynamic management, cardiopulmonary bypass, coagulopathy, inotropes, extracorporeal membrane oxygenation, balloon pumps, ventricular assist devices, and much more.
Cardiac Anesthesia Attendings
Associate Professor, Division Chief Cardiac Anesthesia