Cardiac Anesthesia:

Cardiothoracic Anesthesia

The adult Cardiothoracic Anesthesia Group at the University of Michigan provides perioperative anesthesia care for a wide variety of cardiac, thoracic and electrophysiologic procedures. Cardiac procedures include: coronary artery bypass grafting, aortic valve replacement, mitral valve repair, heart transplant, implantation of the HeartMate LVAS and repair of thoracic aortic aneurysms. Each of these procedures requires careful, diligent anesthesia care from a team of specialists. Anesthesiologists are involved with the care of cardiac patients before, during and after their operation. During the operation, close communication is maintained at all times between the perfusionists, surgeons, nurses and anesthesiologists.

Almost all operations are accompanied by intraoperative transesophageal echocardiography (TEE) to 1] assist the anesthetist manage the case and 2] assist the surgeon evaluate the results of the operation. When necessary, cardiologists from the Heart Care Program join us in the operating room to lend their expertise in TEE. The anesthetic is tailored to allow for early awakening and expeditious recovery in the intensive care unit. After the operation our colleagues in critical care provide postoperative care in the Thoracic Intensive Care Unit.

Thoracic surgeons perform operations on the lung, esophagus, thymus, and other structures of the chest. Special techniques are used to allow the surgeons to perform operations on diseased lungs. In fact, surgeons and anesthesiologists have developed remarkable skill in performing "lung volume reduction surgery" on patients with end-stage emphysema. Excellent postoperative epidural analgesia is a critical element in the success of these and other thoracic operations.

Finally, the CTA group assists the cardiologists in the electrophysiology lab when they require sedation, analgesia or anesthesia for placement and testing of implantable cardio-defibrillators.

Dept. of Anesthesiology, Univ. of Michigan Medical School

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