Perioperative Cardiovascular Medicine and TTE Training
Cardiothoracic anesthesiologists are at the forefront of the expanding scope of anesthesia into perioperative medicine. The combination of advanced clinical and echocardiography skills obtained while managing complex cardiac patients in the operating room has poised our department to be successful perioperative consultants. We aid in pre-operative risk stratification, intra-operative management, and post-operative care for patient undergoing a wide range of surgical and interventional procedures. Cardiothoracic anesthesiologists are intimately involved in all perioperative clinical consult services including the post anesthesia and intensive care units.
Transesophageal echocardiography (TEE) is the mainstay for perioperative management of critically ill patients with cardiac disease. We staff a 24hr echocardiography consult service with both transesophageal and transthoracic echocardiography performance and analysis available throughout the hospital. Transthoracic echocardiography (TTE) is a non-invasive imaging modality with proven utility for perioperative patient management. Transthoracic echocardiograms can be performed by the cardiac anesthesia department at any time during the patients’ clinical course. We have a state of the art echocardiography lab where two and three dimensional TTE including speckle tracking strain imaging takes place to help aid in cutting edge clinical decision making.
Given the demonstrated benefit in patient management from transthoracic echocardiography, we have currently begun training all UCLA anesthesia residents and faculty to perform and interpret focused TTE exams. Anesthesia residents receive a two week foundation in TTE during their post anesthesia care unit rotation. This includes; training on a transthoracic echocardiography simulator and supervised patient exams guided by our ultrasonographer and cardiothoracic anesthesia perioperative physicians. This foundation is then reinforced longitudinally throughout the duration of residency training. Faculty members are enrolled in a comprehensive TTE training program consisting of successive sessions utilizing the TTE simulator, supervised patient exams, and advanced clinical application.