The Division of Cardiothoracic Anesthesiology is a microcosm of the larger department within which it resides, supporting the tripartite missions of clinical excellence, academic pursuits in anesthesiology, and education. The division is led by Andrew Shaw, MB, FRCA, FFICM, FCCM, and includes 14 faculty members and 11 nurse anesthetists. Each month, three residents rotate through the service. The fellowship program, under the leadership of Dr. Mias Pretorius, expanded in 2013 to three clinical fellows trained annually, and will expand again to 5 fellows in 2016.
Innovation, research, and education are all key components of the division, as is evidenced by its support of novel clinical environments in the hybrid catheterization lab/operating room, the routine use of transesophageal echocardiography as a diagnostic and monitoring tool in both operating rooms and intensive care units, many clinical and translational research initiatives, and the division’s strong commitment to being a national leader in cardiothoracic anesthesia education.
The division works alongside the surgeons and cardiologists of the Vanderbilt Heart and Vascular Institute to perform approximately 1,500 adult cardiac procedures a year. Division members also work with general thoracic surgeons to perform approximately 700 thoracic cases annually, including thoracotomy, mediastinoscopy, lung transplantation, and esophageal procedures. Anesthesia services are also provided for non-OR cases such as interventional pulmonology, cardiology, and electrophysiology procedures, which together account for approximately 3,500 cases annually. A subset of the division’s faculty is also board-certified in intensive care medicine. These individuals rotate through the adult cardiovascular intensive care unit, under the medical direction of division faculty member Chad Wagner, MD.
Division of Cardiothoracic Anesthesiology faculty conduct research in vascular system function, cardiopulmonary conditioning, acute kidney injury, and the perioperative inflammatory response. Extramural grant support comes from the American Heart Association, Dept of Defense, National Institutes of Health.
The division also has a significant external and internal education presence; for example, Dr. Shaw serves as scientific program chair for the Society of Cardiovascular Anesthesiologists (SCA) annual meeting. Division faculty have hosted successful workshops in perioperative TEE and hemodynamic echo, drawing anesthesiology residents, fellows, faculty, and private practitioners from throughout the region. Cardiothoracic anesthesiologist Julian Bick, MD, received a $100,000 Research in Education Grant from the Foundation for Anesthesia Education and Research which is used to train CA-1 residents in TEE. Two TEE/TTE simulators, which provide 3-D, computer-generated views of the heart as a probe is guided through a mannequin, are available for training in the division’s echocardiography lab and at Vanderbilt’s Center for Experiential Learning and Assessment (CELA).