Over one half million cardiac surgery procedures are performed annually in the United States. The population of adult patients having cardiac surgery has evolved to one of increasing age and extensive medical therapy, often with a previous history of angioplasty or bypass surgery. Perioperative care for patients undergoing cardiac surgery involves some of the greatest challenges in our specialty. The Cardiothoracic Anesthesiologists with Presbyterian Anesthesia Associates provide anesthesia for coronary artery bypass surgery (CABG), valve replacement surgery, reparative cardiac surgery, and an array of other cardiac interventions. When we care for patients who require anesthesia for the repair and replacement of diseased heart valves, we typically assist the surgeon with the use of transesophageal echocardiography (TEE) Anesthesiologists in Presbyterian Anesthesia Associates have special expertise and qualifications in the use of this technique. Departmental protocols have been developed which provide strict blood sugar control during cardiac surgery, a technique demonstrated to reduce complications such as infection known to be associated with elevated intraoperative and postoperative blood sugar. We have implemented “Fast-Track” cardiac anesthesia techniques which facilitate earlier wake up after surgery, and early tracheal extubation.

Patients undergoing operation on the aorta and its major branches present a formidable anesthetic challenge. The high incidence of severe coexisting disease and advanced age, combined with the abrupt and severe physiologic impact of the operations, impose a significant burden on these patients. Several factors have played an important role in enhancing perioperative anesthetic care and reducing complications in this group of patients, including the use of cerebrospinal fluid (CSF) drainage and deep hypothermic circulatory arrest (DHCA).

Modern anesthetic management of thoracic surgery patients requires expeditious preoperative evaluation and preparation, specialized intraoperative monitoring techniques, and efficacious postoperative analgesia. Additionally, separation of the lungs by one-lung ventilation (OLV) differentiates thoracic anesthesia from other subspecialties in anesthesiology. Thoracic operations requiring OLV have numerous disease-and procedure-specific anesthetic requirements, and our anesthesiologists are experts in providing this specialized intraoperative management.

The interventional cardiologists require our services as well. Our department anesthetizes patients who require closure of a patent foramen ovale (PFO) or require implantation of an automatic internal cardioverter-defibrillator (AICD) for life threatening heart dysrhythmias or severe cardiomyopathies.

The vast experience and specialization of the physicians in Presbyterian Anesthesia Associates keep our patients safe through the most difficult cardiothoracic procedures.