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Oxford University Hospitals NHS Foundation Trust
Anaesthetic Fellowships

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Cardiothoracic Anaesthesia and Cardiothoracic Intensive Care Fellowship

The Oxford Heart Centre

The Oxford Heart Centre carries out over 1000 adult cardiac surgical cases per year, (10 lists per week) with a full range of procedures including elective and emergency surgery undertaken. Coronary artery surgery (on and off cardiopulmonary bypass), Aortic Valve repair/replacement, Mitral Valve repair / replacement, Tricuspid Valve repair / replacement and complex aortic surgery are all performed routinely with the exception of transplantation. Additionally, there are over 500 elective and emergency thoracic cases (4.5 lists per week) with many complex and high-risk cases including open and video assisted surgery, lung reduction surgery, diagnostic procedures, chest reconstruction surgery and interventional bronchoscopy.

Our Units

There are 5 cardiac laboratories, which undertake a wide variety of procedures including ablation and TAVI under GA and sedation (7 lists per week). The TAVI programme is well established with femoral, apical and aortic approaches used, (2 lists per week).

There are 2 consultant-led pre-assessment clinics per week and 1 Cardiothoracic Critical Care Unit (CTCCU) follow up clinic per month.

The 21-bedded Cardiothoracic Critical Care Unit provides both Level 2 and Level 3 care to patients after cardiac surgery, thoracic surgery and cardiological procedures. The unit receives over 1500 admissions per year. Most are planned admissions but the unit also receives emergency admissions including patients after emergency percutaneous coronary intervention (24-hour service) and out of hospital arrest. CTCCU patients are able to receive a full range of organ support including ventricular assist and haemodiafiltration.

What to expect

Fellows join a team of 15 Consultant Cardiothoracic Anaesthetists/Intensivists, and 2 Speciality doctors working a 40-hour week plus on call; 1 in 6. All Fellows are allocated mentors.

Fellows will gain consultant supervised anaesthetic experience in cardiac, thoracic theatres and cardiac EP/catheter laboratories.

Transoesophageal echocardiography is routinely practised by TOE accredited Consultant Cardiac Anaesthetists/Intensivists, and a dedicated Consultant in Peri-operative Echocardiography; Fellows are allocated dedicated TOE days. There is an out of theatre teaching programme and a TOE simulator available, Fellows are encouraged to sit relevant exams.

In addition, Fellows work on the Cardiothoracic Critical Care Unit alongside resident anaesthetic/ICM /FY2 trainees. There, they have the opportunity to learn US guided techniques, FICE and TTE.

On call, Fellows will support the resident anaesthetic / ICM trainee, and assist the 2 on call Consultants (Anaesthetic and Intensivist) covering intensive care, surgical and cardiology emergencies.

Fellows are expected to actively participate in developing research, teaching and audit programmes and take an active part in the clinical governance requirements of the directorate. There is on-going teaching program in cardiothoracic anaesthesia and intensive care (held weekly).

Contact

Dr Amar Keiralla

Head of Cardiothoracic Anaesthesia Fellowship Programme

Email: amar.keiralla@ouh.nhs.uk