Anesthesia for Cardiac Surgery
CEP America's cardiovascular anesthesia service encompasses all components of cardiac surgical care including: cardiac preoperative evaluation, cardiac anesthesia, advanced hemodynamic monitoring, transesophageal echocardiography, management of cardiopulmonary bypass, and postoperative care. Our specialized cardiac anesthesiologists are selected for their expertise at delivering this level of care. Some of our cardiac anesthesiologists are specialists in the use of intraoperative echocardiography and are experts in the evaluation of complex cardiac disease.
When do I need a cardiac anesthesiologist?
When will I see my cardiac anesthesiologist?
What can I expect from my cardiac anesthesia care?
Why do I need so many tubes and lines?
Will I be awake during surgery?
What is cardiopulmonary bypass?
How long will I be asleep after heart surgery?
Will I be in pain after surgery?
Frequently Asked Questions about Anesthesia for Cardiac Surgery:
An anesthesiologist from the cardiac anesthesia team is scheduled for all heart surgery procedures regardless of the type.
Occasionally, it is appropriate for a cardiac anesthesiologist to deliver your anesthetic even if you are not having heart surgery. If you have any form of significant heart disease, discuss this with your surgeon in advance. You can also call our office for advice as to whether or not it would benefit you to have a cardiac anesthesiologist deliver your anesthetic.
Your cardiac anesthesiologist typically will visit you before your procedure if you are in the hospital preoperatively. If you are being admitted the morning of your surgery, we will make every effort to reach you by telephone the evening before surgery.
Before your procedure, your anesthesiologist will do a thorough pre-operative assessment of your medical history and present medical condition. This assessment is done by interviewing you about your medical history, doing a physical exam, and by reviewing any test results and other data available in your records.
During the procedure your anesthesiologist will prepare you for anesthesia and surgery by placing any appropriate monitoring devices and catheters. He/she will administer your anesthetic medication while closely monitoring and manipulating multiple physiologic parameters. This is done in harmony with the surgeon and perfusionist.
After the procedure, once you arrive in the Critical Care Unit, your primary care givers will be the highly specialized Cardiac Surgery Critical Care Nurses under the direction of your surgeon. A cardiac anesthesiologist is continually available during this period of time to provide consultative services as necessary for specific issues.
Anesthesia for cardiac surgery is a critical level of care and requires highly specialized physiologic monitoring. Typical tubes and lines in cardiac surgery include an endotracheal tube (to support your breathing), transesophogeal echocardiogram (to ultrasound image your heart), central line IVs (to give fluid, blood and medication) and arterial lines (to monitor your blood pressure continuously). The placement of these tubes is either done after you are asleep, or under local anesthesia and sedation, so there is rarely any discomfort associated with placement.
Awareness under anesthesia for cardiac surgery is exceedingly rare. However, under certain very specific conditions, it is remotely possible you may have some awareness. This is true of any anesthetic. If you have specific concerns about this issue, your anesthesiologist can discuss it in detail with you.
Many procedures require absolute "stillness" of the heart in order to successfully accomplish the procedure. In these cases, the patient is put on an artificial "heart-lung" machine. This machine takes over for the patient's heart and lungs while the surgery is performed on the heart and its vessels. The "heart-lung" machine (cardiopulmonary bypass pump) is operated by a perfusionist, another highly trained individual involved in the care of the cardiac surgery patient. The perfusionist works in concert with your anesthesiologist and surgeon during this critical part of your surgery. After the completion of the surgery, the patient's heart is "restarted" and allowed to then take over its role from the bypass pump.
Patients after heart surgery are typically kept asleep for a period of time in intensive care for observation. The length of time is dependent on the patient's underlying heart condition, the patient's general health and a number of other factors. Typically you will awaken between 2-6 hours after completion of surgery. Occasionally, it may be significantly longer. During this time, you will be on a ventilator (breathing machine). As you awaken, you will be weaned from the breathing machine and the endotracheal tube (breathing tube) will be removed. Your anesthesiologist and surgeon will be able to give you more specific information.
Cardiac surgery is no different than other operations in this respect. Unfortunately, some discomfort is inevitable, but we make every effort to make the experience as pain free as possible. Pain control is primarily achieved with potent intravenous medications, though occasionally other techniques may be utilized on a case by case basis.