The objective of the cardiovascular anesthesia rotation is to provide a broad-based training for our residents to acquire the fundamental cognitive knowledge and technical skills in caring for patients undergoing cardiovascular surgery. The rotation is structured to promote independent thinking, self-appraisal, and a commitment of knowledge acquisition throughout the training process. This rotation will also provide a framework for residents who are interested in pursuing additional training in cardiovascular anesthesia in an accredited fellowship program or as an advanced CA3 elective rotation at Stanford Hospital or the Palo Alto Veteran Administration Hospital.
Introduction to cardiovascular anesthesia begins with a two-month intense and focused rotation at Stanford Hospital during the end of the CA1 or beginning of the CA2 year. Residents are exposed to a variety of cases ranging from routine surgeries for coronary artery bypass grafting (both on-pump and off-pump), valvular repair and replacement, carotid endarterectomy, aortic aneurysm repair, to emergency surgeries for coronary artery revascularization and repair of aortic dissection and aneurysm rupture. In addition, residents also actively participate in the anesthesia management of advanced cardiovascular cases such as heart, lung, and heart-lung transplantations, adult congenital cardiac surgery, placement of ventricular assisted devices, minimally invasive and robotic cardiac surgeries, transmyocardial revascularization, and cardiac remodeling surgery. Aside from learning how to care for patients with cardiovascular diseases, residents will also become proficient in cardiovascular physiology and pharmacology, catheterization and interpretation of hemodynamic monitoring devices, basic transesophageal echocardiography, lung isolation technique, and the practice of profound hypothermic circulatory arrest and spinal cord protection. Additionally, residents will also learn how to care for high-risk cardiac patients undergoing cardioversion, cardiac ablation, implantable cardioverter defibrillator, and cardiac resynchronization procedures.
Didactic teaching during the rotation takes several forms. First, the one-on-one coverage in the operating room is designed to provide ample opportunity for discussion of topics related to the daily clinical cases or other related subjects. Second, a weekly journal club provides a forum for residents and faculty to critically evaluate and discuss scientific studies pertinent to the subspecialty. Third, a biweekly transesophageal echocardiography conference with faculty of the echocardiography laboratory offers residents the unique opportunity to review interesting clinical cases with leading TEE experts outside of the department. Fourth, residents will gain surgical perspective by attending the Cardiothoracic Surgical Grand Rounds once a month. Finally, residents are also encouraged to get involved in the Departmental Grand Rounds hosted by the Division of Cardiovascular Anesthesia.
Residents who are interested in research opportunity are encouraged to discuss with those cardiovascular anesthesia faculty who are actively engaging in clinical research projects.