cardiothoracic

Lumbar drains are a mainstay for spinal cord protection when patients undergo operations like thoracoabdominal aortic aneurysm (TAAA) repairs and thoracic endovascular aortic repairs (TEVAR) with subclavian artery debranching. Why? Because the anterior spinal...

Over the course of my training as a cardiac anesthesiologist and intensivist, I've come across many manifestations of cardiac compression ranging from hemorrhagic pericardial effusions to massive clots. Although the general teaching is to...

The thoracic duct is the primary conduit which carries chyle (lymphatic fluid containing triglycerides, immune cells, proteins, etc.) from the cisterna chyli to the subclavian-jugular vein junction where it empties into the circulatory system....

Although small amounts of air and fluid in the pleural space are generally well tolerated, pneumothorax, hemothorax, chylothorax, etc., necessitate chest tube placement. Smaller bore tubes can often be utilized and placed more apically...

Deep hypothermic circulatory arrest ("circ arrest") is often required for partial or total aortic arch reconstructions. At this point in the surgery, there is no blood flow anywhere. Because of systemic cooling, we mitigate...

Double lumen endotracheal tubes (DLTs) are considered the gold standard for lung isolation - a procedure where we selectively ventilate a single lung or lobe. This is necessary to "protect" healthy lung tissue from...

Over a dozen different aortic arch great vessel configurations have been described in humans. I’ve illustrated the two most common types in this diagram. The “normal” aortic arch gives rise to three “great vessels.”...

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),...