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
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