Pediatric Cardiothoracic Anesthesiology

Mission

The Pediatric Cardiothoracic Anesthesia (PCTA) Division is the academic and clinical home for this ACGME-accredited subspecialty at Columbia University Irving Medical Center and New York-Presbyterian Morgan Stanley Children’s Hospital (CHONY).  The division aims to provide outstanding anesthesia care to infants, children, and young adults with congenital or acquired heart disease in a variety of clinical settings.  In addition, we are committed to excellence in education, preparing PCTA fellows to become the next generation of skilled pediatric cardiac anesthesiologists and subspecialty leaders.  Furthermore, the division is actively engaged in research, promoting critical thinking about anesthetic mechanisms of action and toxicity and advancing scientific knowledge of how children are impacted by anesthetic exposures during development.

Services

We provide anesthesia care for more than 500 open and closed heart procedures and over 1200 cardiac catheterization procedures per year.  In addition, we are the highest volume center in the country for heart transplantation in infants and children and a high-volume center for extracorporeal membrane oxygenation and ventricular assist devices.  Our surgical colleagues perform extraordinarily complex operations with exceptional results following valve surgeries, neonatal cardiac surgery, hybrid procedures, minimally invasive operations, and robotic surgery.  In addition to providing anesthesia care in the cardiac operating rooms and catheterization laboratories, we also provide services for cardiac imaging (cardiac MRI and cardiac CT scan) and for children with congenital or acquired heart disease undergoing non-cardiac surgery or procedures. 

Education

The Pediatric Cardiothoracic Anesthesia (PCTA) fellowship develops the next generation of clinical experts and academic leaders in the subspecialty.  Our objective is to provide outstanding clinical training in pediatric cardiac anesthesiology, building upon prerequisite pediatric anesthesia or adult cardiothoracic anesthesia education.  The PCTA fellowship, as a “superfellowship,” emphasizes an interdisciplinary approach to the care of the pediatric patient with congenital or acquired cardiac disease and supports scholarly activities under the mentorship of a highly qualified team.  The formal training program develops PCTA fellows into clinical experts, capable of providing exceptional anesthesia care for infants, children, and young adults with even the most complex congenital or acquired heart disease undergoing open and closed heart surgery, diagnostic and interventional procedures in the cardiac catheterization lab, and related procedures.

Research

Members of the division engage in a variety of research and scholarly activities.  These efforts are funded at the federal level by the National Institutes of Health and are supported locally by the department.  Basic science investigation focuses on the role of mitochondria in anesthetic mechanisms and toxicity.  Specifically, investigators are developing novel anesthetics and are exploring new therapies to prevent propofol-induced cardiotoxicity.  Patient-oriented research efforts focus on long-term neurodevelopmental outcomes following perinatal and early childhood anesthetic exposures.  Specifically, our work examines how anesthesia, surgery, and related perioperative factors influence the risk of behavioral disorders and other neurodevelopmental deficits in children.  By integrating epidemiologic methods with various data systems, members of the division are seeking to distinguish between anesthesia exposure-related risks and confounding influences with the overarching goal of informing safer perioperative practices for vulnerable pediatric populations.  Finally, the division helps to support research activities within the Children's Heart Center at NewYork-Presbyterian at large.  Our collaboration facilitates investigation of noninvasive monitoring devices as well as pre-clinical cardiac xenotransplantation.