Cardiothoracic Anesthesia and Surgical ICU

Division Chief: Manuel R. Castresana, MD, FCCM 
Cardiothoracic Section Chief: Shvetank Agarwal, MBBS, FASE

The Section of Adult Cardiothoracic and Vascular Anesthesia prides itself with having a team of dedicated, highly skilled, and motivated cardiothoracic anesthesiologists with diverse interests and unique talents. The section echoes the department’s commitment to the tripartite goal of clinical excellence, high-quality research, and state-of art education and provides anesthesia and echocardiographic services for the full spectrum of cardiac, thoracic, major vascular, and electrophysiological procedures.

Over the past year, working alongside surgeons and cardiologists, we have performed almost 250 cardiac surgeries including coronary revascularizations (both off and on pump), laser revascularizations, valve replacements and complex valve repairs, ascending aortic and complex aortic arch repairs, ECMO, and pericardial windows; about 250 thoracic surgeries including segmentectomies, lobectomies, pneumonectomies, esophagectomies, epicardial pacemaker lead placements, and thoracoscopic MAZE procedures; more than 200 major vascular procedures including open and endovascular repair of abdominal and thoracic aortic aneurysms; almost 550 electrophysiological procedures including catheter ablations of AFib, SVT, VT, and other dysrhythmias; and placement of cardiac implantable electronic devices in addition to other cath lab procedures such as balloon valvuloplasties and ASD repairs.

All our faculty are certified in advanced perioperative transesophageal echocardiography and, with the availability of the most modern 2D and 3D TEE technology including speckle tracking and 3D reconstruction of the left ventricle and mitral valve, we are able to provide vital information to guide the surgeon and fine tune the perioperative management of our patients.

Typically, three residents rotate through the section every month. While often busy and demanding, the rotation is cherished by residents who have the chance to take care of the some of our sickest patients. This, coupled with an excellent learning and encouraging environment with one-on-one supervision and exposure to progressively deeper levels of TEE experience, often inspires residents to choose cardiothoracic anesthesia as their future careers. Simulation in TEE and invasive line placement at the state-of-the-art Harrison Education Building are other great experiences.

The section has led the research mission of the department by churning out several abstracts and high-quality manuscripts in the past few years. Multiple ongoing research projects allow opportunities for residents as well as medical students to participate and learn.