The Adult Cardiothoracic Anesthesiology (ACTA) rotation is an exciting and important component of the residency program. ACTA division comprises sixteen faculty members whose clinical practice focuses on Cardiothoracic Anesthesiology. Six ACTA faculty are also members of the division of Critical Care Medicine.
During their ACTA rotation, Anesthesiology residents are exposed to a wide variety of cardiac, thoracic, and major aortic cases. Cardiac surgery exposure ranges from common procedures (such as coronary revascularization surgery, valve repair and replacement) to more complex surgeries (such as repair of aortic dissection or aneurysm and surgery for adult congenital heart disease). In addition, residents gain extensive experience in the perioperative care of patients requiring assist devices ranging from intra-aortic balloon pumps to ventricular assist devices. Time in the cardiac catheterization lab provides residents with the experience with interventional therapeutic cardiology procedures (such as transfemoral or transapical aortic valve replacement), and electrophysiology laboratory procedures. Residents also care for patients undergoing a wide variety of thoracic surgical procedures, including lung volume reduction surgery, tracheal surgery and esophageal surgery. In addition, residents gain experience with heart and lung transplantation surgery.
Residents rotate through ACTA starting in the second half of their CA1 year and all residents complete 3 months of cardiothoracic anesthesia by the end of their CA3 year. Additional time on the service may be arranged for those interested. Because of the large number of procedures performed both residents and fellows are able to personally perform the majority of their own cases.
During the ACTA rotation, residents become proficient in the placement of arterial, central venous and pulmonary artery catheters, double lumen endotracheal tubes, bronchial blockers, and thoracic epidurals. Transesophageal echocardiography (TEE) skills are developed with intraoperative hands-on experience, and with the use of the ACTA-dedicated TEE simulator.
In addition to the rich and exciting clinical experience, the ACTA rotation includes a structured Resident Lecture Series program, providing a combination of didactic teaching by faculty, resident-led journal club discussions and ACTA fellow-led lectures. Residents’ performance at the end of their rotation is done by direct faculty evaluation, as well as by an Objective Structure Clinical Examination relevant to the practice of Cardiothoracic Anesthesiology.
During their ACTA rotation, residents are encouraged to participate in academic projects. Our residents regularly attend, alongside ACTA faculty, regional and national meetings with challenging cases and poster abstract presentations, as well as case report submissions.
Martin Chen, MD
Marc Dickstein, MD
Jonathan Hastie, MD
Mark Heath, MD
Maya Jalbout Hastie, MD
Taylor Johnston, MD
Desmond Jordan, MD
Bessie Kachulis, MD
Sansan Lo, MD
Steven Miller, MD
Teresa Mulaikal, MD
Ervant Nishanian, MD, PhD
Jack Shanewise, MD, Division Chief
Sarah Smith, MD
Jessica Spellman, MD
Dr. Jack Shanewise became Chief of the Division of Cardiothoracic Anesthesiology in July 2004. He was Director of the Division of Cardiothoracic Anesthesiology at Emory University, Atlanta, Georgia, from 2001 until he was recruited to Columbia. While a staff cardiac anesthesiologist at Emory (1992-2004) he developed a special interest in echocardiography and is a founding member of the National Board of Echocardiography, for which he is a past president. He has published extensively in the area of cardiovascular anesthesia and has served on the boards of directors for the Society of Cardiovascular Anesthesiologists and the American Society of Echocardiography. His recruitment recognizes our commitment to intraoperative echocardiography. The education of residents and fellows in cardiothoracic anesthesiology is a priority for Dr. Shanewise.
For further information, write or contact:
Ms. Monica Roberts
Administrative assistant to Jack Shanewise, MD
Division of Cardiothoracic Anesthesiology
Columbia University Medical Center
Department of Anesthesiology
P&S Box 46
630 West 168th St.
New York, New York 10032
Telephone: (212) 342 2210
Fax: (212) 342 2211