Cardiac & Vascular Anesthesia

The cardiac and vascular anesthesia team provides anesthesia for cardiothoracic surgery and vascular procedures including heart and lung related surgery, and heart transplantation and heart-assist device implantation. Anesthetic delivered directly to the spinal cavity is available for post-operative pain control.

Why do you need a cardiac anesthesiologist?

All anesthesiologists are trained to care for patients with heart disease. In addition to this training, cardiac anesthesiologists have specialized training in the equipment and devices used to monitor heart function during complex surgeries.

What is trans-esophageal echocardiography (TEE)?

TEE is a form of heart monitoring which uses ultrasound to watch the heart muscle and valves to determine how well they are working. While the patient is asleep, a probe is inserted down into the esophagus to perform the TEE exam.

How does the heart-lung machine work?

The heart-lung machine or cardiopulmonary bypass (CPB) machine siphons the blood out of the patients’ body from the vena cava (before it can enter the heart) and then pumps it back into the aorta replacing the pumping function of the heart. This allows the surgeon to operate on the heart while it is temporarily stopped. The CPB machine also "breathes" for the patient by eliminating carbon dioxide and providing oxygen to the blood.

What is a vascular anesthesiologist?

A vascular anesthesiologist provides anesthesia for patients undergoing surgery on blood vessels such as the carotid arteries, aorta, or the arteries or veins of the leg. A vascular anesthesiologist is considered an expert in the use of medications to raise and lower blood pressure and also for the insertion of monitoring catheters.

Why is this important?

Patients undergoing vascular surgery often also have problems with their heart or arteries (arteriosclerosis) or blood sugar (diabetes). Expert knowledge of these problems is critical to the patients' care during surgery.

Why do patients often receive an epidural for vascular surgery?

Epidurals are very helpful for relieving pain after any abdominal or leg surgery while not making the patient sleepy. Also, after surgery that is intended to improve blood flow to the legs, there is evidence that epidurals make the blood flow even better.

What is an epidural?

An epidural is a tiny catheter that is inserted between vertebrae in you back to provide a continuous flow of pain medicine during and after surgery.

What are the risks of an epidural?

Complications are very rare but include a “wet tap” in which the needle through which the catheter is inserted goes all the way into the spinal canal. This can cause a leak of spinal fluid which can cause a headache. Also, damage to a nerve or bleeding can happen which can put pressure on your spinal canal, but fortunately these problems are very, very unusual.