The concept of a denervated heart is a significant consideration in patients receiving orthotopic heart transplants. When these donor hearts are procured, there’s no way to preserve native autonomic regulation (ie, vagal input). After...

CentriMag devices are implanted for acute right and/or left-sided circulatory support but often times used for extended periods of time for patients with acute heart failure awaiting a heart transplant. With CentriMag devices, patients...

Left ventricular assist devices (LVADs) like the HeartMate 3 are routinely being implanted as a mechanical circulatory bridge-to-transplant (BTT) or destination therapy (DT). My anesthetic plan for LVAD placement includes general endotracheal anesthesia, arterial...

A bubble study is often utilized to confirm the presence of shunting across the interatrial septum (IAS) via patent foramen ovale (PFO) or atrial septal defect (ASD). This study is combined with color flow...

Yesterday while at work, I received an email from the National Board of Echocardiography stating that I passed my critical care echocardiography examination! This exam was a great primer for examination I’ll have in July...

Orthotopic heart transplantations (OHTs) are some of my favorite procedures as a cardiothoracic anesthesiologist! After establishing general endotracheal anesthesia (GETA) with standard monitors, an arterial line, a central line (often with pulmonary artery catheter),...

The United Network for Organ Sharing (UNOS) is a non-profit organization that oversees national transplant waiting lists, collects data about every organ transplant that occurs in the United States, promotes awareness about the importance...

The overwhelming majority of anesthetics I provide for transcatheter aortic valve replacements (TAVR) are monitored anesthesia care (MAC) - sedation with an anesthesiologist that can escalate the anesthetic. Typically, patients undergoing TAVR are older...