Division of Cardiac Anesthesiology
Albany Medical Center is a tertiary care center and we are the only institution in the area that offers a cardiac transplant service, placement of ventricular assist devices and extra corporeal membrane oxygenation. We also take care of patients with severe cardiacy dysfunction - aquired and congenital. At present we are involved in the care of about 700 patients requiring cardiac surgery. The cardiac program at this hospital was deemed to be in the top ten academic programs in the country. (The survey involved 88 other academic programs).
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There are six dedicated cardiac anesthesiologists involved in the care of patients undergoing cardiac surgery. All the cardiac anesthesiologists are felloship trained in cardiac anesthesia and most are also board certified in Transesophageal echocardiography (TEE). The cardiac anesthesiologists also share call with the cardiologists to provide in house coverage for patients requiring TEE exams. We work in close cooperation with a group of excellent cardiac surgeons, perfusionists and highly skilled nurses. The working relationship is very collegial and is we are known for working well as a team. In the cardiac operating rooms we have the latest in monitoring devices and all the heart rooms have dedicated TEE machines. In 2009 we hope to add a 3-D TEE machine to help in the care of patients undergoing valve repairs. |
We also provide one to one coverage for the residents and there is an active didactic program that involves ECHO rounds, Morbiditiy and Mortality conferences and clinical presentations. The Division of Cardiac Anesthesia is also active in making presentations at national meetings.
A day in the life of a Cardiac Anesthesia Resident
"My day starts at 6am in the Cardiopulminary (CPS) unit where I go to round on our previous day’s patients or to check on patients who may have had complications such as needing prolonged presser support, continued mechanical ventilation, intra aortic balloon pump dependence, etc. After rounding we head to the OR to set up our cardiac rooms for the day. Next, we proceed to find our patients in the holding area, review the chart, answer any questions from the patients and family, then take our patients to the operating room. Once there, we prepare to place our invasive monitors. We usually place a brachial A-line, triple lumen catheter, and a swan ganz catheter. Next, we proceed with induction and intubation. Next will come the trans esophageal echo (TEE) assesment and monitoring. We use the TEE to look for ventricular function and size, valve structure/ pathology and over-all cardiac performance.
We anti-coagulate the patient, then the surgeon performs the CABG or vlave surgery. We do both on or off cardiopulminary bypass depending on the surgeon and depending on the case. Once we wean the patient off by-pass, we re-examine the patient with TEE. After we have examined the patient’s chest x-ray for line placement, pneumothorax and ETT position, we eventually transport the patient on full monitors to CPS. We give report and hand off care to the receiving RN and, head back down stairs to start another case or to check the schedule for add-ons. Once this is done, we find and preop the inpatients scheduled for next the day."
Dennis Cirilla, D.O.
