Cardiac Anesthesia

Cardiac Anesthesia

2 Blocks

Leads

Dr. Jean Yves Dupuis

Welcome Message

The Cardiac Anesthesia Module comprises two rotations over Core I and Core II. During those two rotations, it is expected that, through your exposure to a wide variety of cardiac pathologies and high-risk cardiac surgical patients, you develop the required knowledge and skills to competently manage patients with common cardiac diseases for non-cardiac surgery.

EPAs & Milestones

• Management of cardiac surgery using cardiopulmonary bypass
  • Demonstrates a good knowledge of techniques for invasive vascular access and their related complications
  • Demonstrates an anesthetic plan for uncomplicated elective cases, including immediate postoperative care
  • Demonstrates an understanding of the physiology of the patient with cardiac disease at induction of anesthesia and weaning from bypass
  • Demonstrates an understanding of the cardiopulmonary bypass machine
  • Demonstrates an understanding of anesthetic considerations of coronary artery disease, valvular heart diseases and other common cardiac anomalies, including their respective relevant pharmacotherapy
  • Demonstrates competency in advanced cardiovascular monitoring including: 1) placement and management of central venous and pulmonary artery catheters; 2) interpretation of arterial, central venous and pulmonary artery tracings; 3) basic interpretation of a comprehensive perioperative transesophageal echocardiography examination 
  • Demonstrates management of common cardiac anesthesia emergencies including re-opening for bleeding
  • Demonstrates management of common complications such as massive hemorrhage, coagulopathy, protamine reaction, arrhythmias and low cardiac output
  • Demonstrates perioperative management of the patient with unstable cardiovascular disease and/or the patient undergoing high-risk catheterization
• Management of cardioversion/cardiac eletrophysiology procedures
  • Demonstrates management of patient for cardioversion with a stable arrhythmia
  • Demonstrates perioperative management of the patient with stable cardiovascular disease for electrophysiology procedures or cardiac diagnostic tests
  • Demonstrates management of a patient for cardioversion or ablation for unstable arrhythmias
  • Demonstrates management of the patient with unstable cardiovascular disease for high-risk catheterization/electrophysiological procedures
• Optional enhanced expertise milestones applicable to both EPAs
  • Demonstrates understanding of the physiology of adult congenital cardiac disease
  • Demonstrates perioperative management for complex elective and emergency cases
  • Demonstrates an ability to obtain and interpret perioperative transesophageal echocardiography images for cardiac surgery
  • Demonstrates teaching and research in perioperative management of patients with cardiovascular disease or high risk cardiac catheterizations
  • Demonstrates teaching and research in the management of patients undergoing cardioversion or ablation with stable or unstable arrhythmias

Academic Curriculum

Learning Cases

Core 1

• Coronary Artery Disease and Cardiopulmonary Bypass
• Cardiac Tamponade
• Atrial Fibrillation
• Congestive Heart Failure
• Pacemaker/Implantable Cardioverter Defibrillator
• Aortic Valve Stenosis

Core 2

• Aortic Valve Regurgitation
• Heart Transplant Patient
• Mitral Regurgitation
• Mitral Stenosis
• Hypertrophic Cardiomyopathy
• Right ventricular failure and pulmonary hypertension

Assessment Tools

• Submitted the required number of CCATs (12)
• Demonstrated evidence of self-learning
• Compliant with Resident Logbook
• Completed the MCQ pre-test (Core 2)
• Completed the MCQ post-test (Core 2)
• Documented clinical experience of required cases
• Completed 6 CardiacAnesthesiology learning cases appropriate specific to each CORE module
• Completed the self-learning questionnaire on cardiovascular monitoring (Core 2)

Resources

• Barash. Clinical Anesthesia, 7th ed. (2013)
  • Chapter 10: Cardiac Anatomy and Physiology
  • Chapter 38: Anesthesia for Cardiac Surgery
• Miller. Anesthesia, 8th ed. (2015)
  • Chapter 45: Cardiovascular Monitoring
• Kaplan. Cardiac Anesthesia (2017)
  • Chapter 14: Perioperative Echocardiography