Cardiac Anesthesia at UVA

As a resident at UVA there is always an exciting case going on during your TCV rotation.  Residents spend several weeks each year rotating through Thoracic, Cardiac, and Vascular surgery (TCV).  In the operating room you will work closely with both cardiac surgeons and perfusionists.  The environment is one in which everyone works together to provide the best care for the patient.  Here is a summary of a typical day on the cardiac rotation. 

The day before surgery, residents will look up pertinent information on their patient and discuss the anesthetic plan with the attending.  From preoperative concerns to intraoperative management of the patient, you will be able to learn how to approach a disease from different perspectives.   The day of surgery is an early start beginning around 6:15 making sure your room is ready and all drugs have been carefully prepared.   Next the resident meets the patient in the preoperative area.   The resident then places an arterial line, a central venous line, and a pulmonary artery catheter if appropriate.  There is lots of hands on learning and the attendings are great at giving us just enough supervision to allow us to feel comfortable but at the same time allowing us to be independent.  The patient is taken to the OR for intubation, and then the surgery begins.  During the case there is abundant teaching by the attending.  This includes discussing the particular patient’s pathologic state and completing a focused TEE study.   

At UVA we get to do some of the biggest and most complicated cardiovascular cases.  Some of the cases I did this week on my rotation included a heart transplant, LVAD insertion, esophagectomy, and thoracic aortic aneurysms, in addition to standard cardiac procedures such as CABG and valve replacements.  As you can tell, there is a huge amount of variety.  Our patients have many comorbidities and interesting pathology that allows each resident the opportunity to become familiar with how to care for critically ill patients.  One of the things I enjoy most is visiting these patients postoperatively in the ICU and seeing the difference all our hard work makes.  Overall, I think you will really enjoy your TCV rotation.  We have some of the best faculty teaching us, plenty of interesting and complex cases, and of course a great working environment that you will find is one of our institution’s strongest attributes.

Diana Lobo, CA2