Joshua McAnulty, M.S. Alternate Delegate, ASA Medical Student Component
“Completing a cardiothoracic fellowship provides the opportunity to help patients with some of the most advanced disease.”
What is the cardiothoracic anesthesiology fellowship?
The cardiothoracic fellowship is an additional one to two years of training after completing residency in anesthesiology. There are 60 accredited and 15 unaccredited cardiothoracic fellowships available throughout the United States. While residents are exposed to cardiothoracic cases, a fellowship is essential to mastering the invasive monitoring techniques used during these operations and understanding the complex physiology.
What is learned during the fellowship?
Cardiovascular physiology is mastered through clinical experience and didactics. As importantly, the nuances of cardiac lesions or other disease states on the cardiovascular system are learned. Several invasive monitors are used during cardiac surgery to guide management, including arterial lines, pulmonary arterial catheters, spinal drains, and transesophageal echocardiography (TEE). Specifically, gaining experience with TEE is a crucial aspect of the fellowship. TEE is used to diagnose and evaluate the anatomy and function of the heart in real time during surgery. Acquiring the skill to manipulate the endoscope to obtain the appropriate view of the heart is crucial.
What sort of cases do cardiothoracic anesthesiologists perform?
Cardiothoracic anesthesiologists take care of patients with a variety of pathology. Some examples include: surgical repair or replacement of valvular lesions, coronary artery bypass grafting (CABG), heart and lung transplantation, and surgical placement of ventricular assist devices for end-stage cardiac failure. Depending on the practice, the amount of cardiothoracic-specific cases performed varies. Therefore, the variety of cases outside of cardiothoracic surgery can be chosen.
Why choose a cardiothoracic fellowship?
Completing a cardiothoracic fellowship provides the opportunity to help patients with some of the most advanced disease. Part of what makes anesthesiology interesting is using knowledge of the body’s physiology to make pharmacological interventions. With the use of invasive monitoring during cardiothoracic surgery, a more complete picture of the patient’s physiology can be determined to provide the best patient care. Great strides have been made in minimally invasive surgery and intravascular approaches. Cardiothoracic anesthesiologists have the unique skillset for these surgeries and can help to further the progression of these innovations. Find more information about the cardiothoracic anesthesiology fellowship and specific programs at Outside the O.R.: How Anesthesiologists Utilize their Skills on a Global Scale http://www.scahq.org/.
Society of Cardiothoracic Anesthesiologists: http://www.scahq.org/
Jordan Goldhammer, M.D.. Assistant Professor of Anesthesiology at Thomas Jefferson University Hospitals.
Recent graduate of the University of Pennsylvania Cardiothoracic Anesthesiology program.