Episode 79: Pediatric Cardiothoracic Anesthesia with Dheeraj Goswami

In this episode, episode 79, I welcome Dr. Dheeraj Goswami to the show to discuss pediatric cardiothoracic anesthesiology.  We discuss the training required to do these cases, the most common cases and concerns, and how it differs from other forms of anesthesia.

4 Replies to “Episode 79: Pediatric Cardiothoracic Anesthesia with Dheeraj Goswami”

  1. Excellent review of peds cardiophys. In contrast to the discussion about pre and post ductal saturations in the setting of an Intra-cardiac shunt, is it at all common to encounter extra-cardiac shunting in the pediatric population significant enough to change management?

    1. Hi Vincent, here is Dr. Goswami’s response:
      The first point I want to clarify is that in some cases the duct is where we are getting the primary component of shunting, i.e. pulmonary hypertension etc. However, as discussed mixing through the level of the PDA is not enough for most congenital lesions and is why intracardiac shunts are created (through an ASD, Rashkind procedure).

      The cases of extra cardiac shunting usually involve complicated congenital patients where blood flow due to AVM’s or other abnormally formed vessels bypass the lung and oxygenation completely. These type of issues are rarely found in the neonatal population are usually secondary or due to a complication from a previous congenital procedure.

  2. Thanks for the excellent review. I just started in paediatric cardiac anaesthesia and found this episode really helpful. Working in a low-volume centre in Europe I wanted to ask if you could post the mentioned references regarding requirements to become a certified paediatric cardiac anaesthetist.
    Thank you

    1. Hi Stefan,

      I don’t think there are published requirements. Dr. Goswami was speaking of the most common pathways that people take in this country. I imagine it varies quite a bit from country to country as well.

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