Vascular Anesthesiology

Overview of the Program

The Department of Anesthesiology and Pain Medicine offers yearly a clinical fellowship in vascular anesthesiology. The program consists of twelve months of clinical training and is based at the Civic Campus of The Ottawa Hospital, a tertiary care centre in the Province of Ontario, Canada. Our team encompasses 6 specialty trained surgeons, 4 core specialty anesthesiologists, several vascular anesthesiology passionate staff, and many vascular trained nurses and health allies.

Our fellowship over the years has attracted high-quality fellows both nationally and internationally. Our trainees have been coming from Australia, Brazil, Canada and England, just to name a few countries. We are very proud of our program and are hoping to share our vision with our fellows through education, research and QI programs.

The fellowship year is structured to meet the needs of the individual fellow who seeks high quality training in vascular anesthesia and engagement in academic endeavours.

 

Goals and Objectives

The main objective of the Vascular Anesthesia Fellowship is to allow the Fellow to acquire the practical and intellectual skills necessary to care for high-risk vascular patients. It also allows the Fellow to develop the necessary academic skills to become a leader in the specialty.

By the end of the Fellowship the fellow shall be able to independently manage the perioperative period of the patients coming to the OR for:

  • TEVARs
    • Spinal cord protection
    • Endocardiac ventricular pacing VS pharmacological management of the blood pressure
  • EVARs, FEVARs, BrEVARs
  • Open TAAA
    • With Supra-Celiac Aortic X-clamping +/- lung isolation and afterload reduction/retrograde perfusion (e.g. Axillo-Femoral Bypass Graft)
      • Of note, we do not perform our open TAAA repairs heart bypass as an adjunct
    • Spinal cord protection
  • Open AAA
    • With supra/infra Renal Aortic X-clamping
  • Celiac Artery Bypasses
  • Peripheral Vascular Surgeries
  • Carotid-End-Arterectomies
    • Awake – with appropriate regional technique and monitoring
    • Asleep – understanding the need for shunting
  • AV Fistula Creations
  • Amputations
  • Angioplasties
  • First rib resection (e.g. thoracic outlet syndrome)

 

During the Fellowship, the emphasis is put on the exposure and on the management of a broad spectrum of vascular procedures, in an elective and emergent context. In addition, the fellow will be leading an academic project of his/her choice, supported by faculty members, either in research, education or quality improvement/patient safety. By doing so, the fellow will enter a friendly academic competition into which he/she may obtain supplemental non-clinical time in order to work on his/her project. The fellow is also expected to participate in teaching activities for the residents, students and faculty member and is also expected to present a formal grand round presentation on a related topic of his/her choice.

The Civic Campus of The Ottawa Hospital is a high-volume vascular centre. On average we perform 935 elective vascular surgeries and 451 emergency vascular surgeries per year.

Our volume is grossly subdivided as follow: ≥ 92 open aortic repairs (TAAA/AAA), ≥ 129 endovascular abdominal aortic repairs, ≥ 19 endovascular thoracic aortic repairs, ≥ 5 endovascular fenestrated aortic repairs, ≥ 168 endovascular subintimal/balloon angioplasties, = 194 vascular peripheral grafts, ≥ 123 carotid-endarterectomies, and ≥ 83 AV fistulae creations/revisions.

Our Fellow works primarily with a core group of staff specialized in vascular anesthesia and/or perioperative hemodynamic transesophageal echocardiography as well as with most of the anesthesiologists practicing vascular anesthesia. This enables the Fellow to learn various vascular anesthesia approaches and techniques.

By the end of the fellowship year, the Fellow is expected to manage independently medically complex patients undergoing surgically complex vascular procedures.

A typical week is organized as such: two-three days of vascular anesthesia (with a mentor), two-three days of independent practice (performing anesthetics for a wide variety of urological, gynecological, orthopaedic, general, and ENT surgeries) and depending on the weeks a day of non-clinical time (to work on the academic projects). There are no overnight calls during this fellowship but if an interesting case occurs during the late hours or during the weekend, the fellow is expected to come in if available (e.g. for emergency TEVAR). The Fellow has four weeks of vacation per year plus a minimum of 7 days off over the holiday period. The Fellow is also expected to come in on a few weekends during the year (Saturday/Sunday and on Monday if a long week-end) to relieve the attending anesthesiologist covering the pain service. It is also possible to obtain an additional 5 days for a conference leave if the Fellow is presented at a related conference and on a previously approved topic.

 

Core Team

Dr. Jonathan Hooper (Vascular Fellowship Lead)

Dr. Hooper is a consultant Anesthesiologist at The Ottawa Hospital with the University of Ottawa Department of Anesthesiology and Pain Medicine and a member of the Department of Critical Care. He did his residency training at Dalhousie, followed by a clinical fellowship with an interest in vascular anesthesia. He then came to Ottawa for his Critical Care Fellowship and has been here since. He has had several administrative roles, including Site Chief for Critical Care and Department Chief for Critical Care. He is the lead for the Ottawa Hospital Critical Care Outreach Team. He has spent considerable working and teaching anesthesia in developing countries.  When he is not at the hospital Dr. Hooper enjoys triathlons and skiing.

 

Dr. Elizabeth Miller

Dr. Miller is an anesthesiologist with the University of Ottawa Department of Anesthesia and Pain Medicine.  She recently completed her anesthesiology residency training in Ottawa in 2017, and a fellowship in cardiac anesthesiology at the University of Ottawa Heart Institute in 2018 with training in transesophageal echocardiography (TEE).  She completed the National Board of Echocardiography Examination of Special Competence in Advanced Perioperative TEE in 2018.  Throughout her training, she learned point-of-care ultrasound (POCUS) from her mentors in critical care and anesthesia and is passionate about sharing her interest in POCUS by helping to develop the POCUS training program for anesthesia residents and faculty.  Aside from her practice in anesthesia and perioperative echocardiography, she enjoys running, hiking, and cross-country skiing.

 

Dr. Asad Mir Ghassemi

Dr. Asad Mir Ghassemi is an anesthesiologist in the Ottawa Hospital and an Assistant Professor with the University of Ottawa Department of Anesthesiology and Pain Medicine.  He completed his anesthesiology residency training in Ottawa in 2016, and subsequently a fellowship in perioperative echocardiography at the University of Ottawa in 2017.  He completed the National Board of Echocardiography Examination of Special Competence in Perioperative TEE.  He is currently enrolled in a masters program in healthcare quality at Queen’s University and Critical care ultrasound certification program at American Academy of Chest physicians. He was  Assistant Professor at Queen's University from 2017-2018 and joined the University of Ottawa in October 2018. His clinical activities include Vascular Anesthesia, Perioperative Hemodynamic Echocardiography and Perioperative POCUS. He has combined his passion for education in vascular anesthesia, echocardiography and POCUS and he is the vascular anesthesia lead for the residency CBD program. His research areas of interest are Perioperative Echocardiography and Point of care ultrasound. He is a regular instructor of POCUS workshops. Aside from anesthesia, he enjoys biking and soccer.

In addition to the Core Members our Team is composed of the following incredible teachers:

Dr. C. McFaul, Dr. H. Talab, Dr. P. Sullivan, Dr. I. Zunder and Dr. S. Aucoin

 

Positions Available

Position available: 1 candidate per year

Duration of Fellowship: 12 months (July 1st - June 30th)

Please see Application Instructions if you are interested in applying. Thank you for your interest in our program and we look forward to hearing from you!

 

Contact Us

Mrs. Kelsey Rice
Fellowship Program Coordinator
Department of Anesthesiology and Pain Medicine
1053 Carling Avenue, Room B310
Ottawa, ON K1Y 4E9
Telephone: 613-798-5555 x15600
Email: krice@toh.ca

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