Division of Cardiothoracic Anesthesia
As part of The University of New Mexico Department of Anesthesiology and Critical Care Medicine residency program, the Division of Cardiothoracic Anesthesia contributes significantly to the research and educational mission of the institution.
For residents, the cardiothoracic/cardiovascular rotation offers an exciting, challenging and rewarding experience. The focus lies on perioperative evaluation and management of patients with cardiothoracic and cardiovascular disease. Training will also cover the following objectives:
- Cardiothoracic (CT) physiology and pathophysiology
- Invasive monitoring
- Hemodynamic optimization
- Cardiovascular (CV) pharmacology
- Management of cardiopulmonary bypass
- Total circulatory arrest
Residents will become proficient in the placement of arterial lines, central venous and pulmonary artery catheters, double lumen endotracheal tubes, bronchial blockers, and thoracic epidurals. In addition, they receive hands-on transesophageal echocardiography (TEE) training in the operating room (OR) and on the TEE simulator, which integrates into their comprehensive echocardiography curriculum throughout their entire residency training.
Residents rotate through the mandatory CT/CV block in their CA2 year, which consists of two months of CT anesthesia at University of New Mexico Hospital (UNMH) and the Raymond G. Murphy VA Medical Center (VA), followed by one month in the CTICU at UNMH. In addition, they are offered the option of deepening their experience by choosing a CT/CC advanced track in their CA3 year, and by completing an external rotation at the cardiovascular center at UC San Diego.
The didactic program throughout the CT block is offered by our CT-anesthesia faculty in the form of:
- One-on-one clinical teaching
- Lectures following rotational objectives
- Provided reading material
- Bi-monthly echo lectures
- Transesophageal echocardiography (TEE) simulator sessions
The division is made up of 10 anesthesiologists specializing in the perioperative care of patients coming in for a broad variety of heart, thoracic and vascular surgery. Procedures performed at UNMH include:
- Coronary artery bypass grafting (CABG) and off-pump CABG,
- Valvular and minimally-invasive valvular surgery
- Aortic surgery requiring cardiopulmonary bypass
- Deep hypothermic circulatory arrest (DHCA)
- Thoracic, esophageal and major vascular surgery
The division is equipped with the newest monitoring and anesthesia systems to provide optimal intraoperative care for these complex surgeries. The initial postoperative care is performed in a specialized cardiothoracic ICU under the department's leadership.
Aside from the clinical integration of echocardiography, the Department of Anesthesiology and Critical Care Medicine has dedicated itself to the training of residents and fellows in perioperative TEE. A formal monthly TEE lecture series is part of the core curriculum aimed to prepare the residents for the Basic Perioperative Transesophageal Echocardiography (PTE) certification offered by the American Society of Echocardiography (ASE). For advanced TEE education, the monthly “Echorounds” lecture series details the clinical use of echocardiography by reviewing selected echocardiography studies. Informal educational sessions are offered in ICUs to teach residents and fellows the use of bedside TEE and TTE imaging.
With the addition of our new CAE echocardiography simulator, residents and fellows have the ability to practice their TEE and TTE skills prior to integrating the technique into their daily training in the OR. The simulator has capabilities to show normal as well as pathological studies. Basic didactics are part of the regular anesthesia Sim-lab sessions, whereas advanced scenarios are integrated into a separate cardiothoracic echocardiography lecture series during the CT-ICU rotation.
Once familiar with TEE-probe handling and basic image acquisition, residents advance their skills during their months in the CT-OR, CT-ICU, and general ICU. They are able to perform and read the number of echocardiography exams to fulfill the requirements for full PTE certification.
As perioperative echocardiography has become a major diagnostic and monitoring tool for the daily use by anesthesiologists, residents graduating from UNM are prepared to be competitive and competent anesthesiologists in the private and academic setting.
As part of the Division of Cardiothoracic Anesthesiology in the UNM Department of Anesthesiology and Critical Care Medicine, a team of qualified cardiothoracic and critical care anesthesiologists provides 24-hour transesophageal echocardiography (TEE) services throughout the perioperative setting. We offer services for:
- Trauma, Burn and Surgical ICUs
- Neuro ICU
With four state-of-the-art Philips iE33 & CX50 echocardiography systems (located in the main-OR, pediatric-OR, and the CT-ICU), 2D, 3D and portable TEE and TTE imaging is readily available for all elective and emergent situations in our critically-ill patients. For clinical use, there are two echocardiography reading stations located in the CT-OR and the CT-ICU. Another workstation, located in our echocardiography office, is dedicated for educational and research purposes.