SCA: The Heart of Cardiovascular Anesthesiology

he Society of Cardiovascular Anesthesiologists (SCA) is an international organization of physicians that represents the anesthesiology colleagues of the cardiovascular medicine community. In 2008, SCA will celebrate its 30th anniversary. The organization continues to grow and now includes 6,984 members (including 2,599 residents and 79 fellows and approximately 1,000 members from 32 countries outside of the United States). The original mission of SCA — to facilitate education, research and clinical excellence in the fields of cardiovascular and thoracic anesthesia — remains and is supported by an increasingly robust set of activities. Providing educational programs for our membership remains at the core of the SCA mission.

Role-Model Organization
The Accreditation Council for Continuing Medical Education refers to SCA as a role model for similar organizations in regard to their educational missions. We believe that we are successful in achieving our goal of providing the highest quality educational offerings for our members — more than 2,100 physicians participated in at least one of our educational endeavors in 2006, compared to less than 800 in 1987. In the past year, SCA sponsored three domestic meetings.

The 10th Annual Comprehensive Review and TEE Update took place in San Diego in February 2007 and included almost 600 physician attendees. In March 2007, our 12th Annual Update on Cardiopulmonary Bypass was held in Whistler, British Columbia, Canada. The multidisciplinary meeting served more than 270 anesthesiologists, surgeons and perfusionists. The 2007 Annual Scientific Program and Workshops in Montreal, Quebec, Canada, received outstanding reviews by the more than 900 participants.

SCA proposed the establishment of accredited training programs in cardiothoracic anesthesiology. In 2006, the Residency Review Committee for Anesthesiology approved our application. More than 20 academic centers have applied for and achieved accreditation for their cardiothoracic anesthesiology training programs.

SCA continues to consult with the National Board of Echocardiography (NBE), which prepares and administers the certification examination in perioperative echocardiography. More than 2,050 physicians have passed the examination, 1701 are testamurs and approximately 400 members of SCA and NBE have completed guidelines for board certification in perioperative transesophageal echocardiography (TEE). These guidelines define the nature and extent of training and experience required for individuals to qualify for board certification. SCA is committed to assisting members of the anesthesiology community in participating in the examination and certification processes and achieving desired status. SCA co-sponsored the revision of the American College of Cardiology/American Heart Association TEE practice guidelines.

Supporting Research
We continue to support research activities by funding grants and by offering opportunities for presentation of original research at our Annual Meeting. Over the last 28 years, SCA awarded more than 33 grants to investigators in the discipline of cardiovascular anesthesia. These awards include both starter and mid-career grants. To enhance our ability to support original research, the SCA Board of Directors is in the process of establishing an independent nonprofit foundation to support our research and education endeavors. The foundation will function with a unique board of directors. Our most ambitious research endeavor was launched in spring 2007.

SCA has undertaken a research initiative to assess the complex environment and interactions that constitute the cardiac operating room (O.R.). This initiative, the Flawless Operative Cardiovascular Unified Systems (FOCUS) Program, will lead to development paradigms and strategies to improve safety for cardiac surgery patients. Enhancing communication between the cardiac surgery community and cardiovascular anesthesiologists is critically important. Patients presenting for cardiovascular surgery today are increasingly aged and suffer a greater number of comorbidities than patients we cared for during the 1990s and earlier. In addition the complexity and technical challenge of many procedures has increased (“beating-heart” surgery, mitral valve repair, aortic valve resuspension, the application of circulatory arrest with ante-grade and/or retrograde cerebral perfusion). Some have called the challenging environment of the cardiac O.R. “an accident waiting to happen.” We believe that this endeavor will help us fulfill the other mandates of our mission, to facilitate …research and clinical excellence in the fields of cardiovascular and thoracic anesthesia. The FOCUS initiative will identify the cardiovascular anesthesiologist as a leader in the cardiac O.R. and as the patient’s most important advocate.

We are proud to fund this project. We believe that we are the correct group of physicians to pursue this endeavor. The cardiovascular anesthesiologist is uniquely qualified to improve the safety and efficiency of the cardiac O.R. suites — we are the professionals most likely to “speak” all of the “dialects” of the O.R. personnel and thus, are able to provide “translation” services on an ongoing basis. Ultimately every cardiac surgery patient will benefit from the FOCUS initiative.

Christina T. Mora Mangano, M.D. is Professor, Department of Anesthesia, and Chief, Division of Cardiovasculr Anesthesia, Stanford University, Stanford, California.