If your child is having heart surgery, the teams who care for your child before, during, and after surgery will probably include an anaesthesiologist, cardiac perfusionist, intensivist, and surgical coordinator. This page explains the role of each of these professionals.
Anaesthesiologist
Anaesthesiologists are the medical professionals who deliver anaesthesia to patients. A general anaesthetic is a mix of a deep sleep. While in this deep sleep your child will not feel any pain. You may also hear general anaesthetic called "sleep medicine."
Anaesthesiology involves the relief of pain and total care of the patient before, during, and after a diagnostic procedure or surgery. You may hear this health care professional referred to as an anaesthetist or an anaesthesiologist. In Canada, both words mean the same thing. All professionals who provide anaesthesia are medical doctors.
Anaesthesiologists want to ensure a good experience at the hospital and a safe and successful procedure for your child. They generally specialize in a particular clinical area, so your child will be looked after by a cardiac anaesthesiologist. You will probably meet an anaesthesiologist on your pre-catheterization or pre-operative visit to the hospital a few weeks before the procedure.
Anaesthesiologists also provide pain relief after a procedure or surgery, and may be involved with children who are not having a test or surgery but simply need pain management for a medical condition.
Cardiac perfusionist
Perfusionists provide care for patients who are having open heart surgery and major vascular surgery, and need circulatory or respiratory support. To do this, perfusionists operate advanced life support equipment like heart-lung machines that take over breathing or blood circulation during surgery. Perfusion refers to the movement of fluid (blood) through tissue.
Perfusionists perform various procedures to help protect the brain and stop the heart during surgery.
While a patient is on bypass, the perfusionist carefully watches things like blood pressure, blood coagulation, blood gases, and urine output. The perfusionist's goal is to make sure the patient's body is functioning normally and that everything is "in balance" during the procedure.
The perfusionist is part of the surgical team. Sometimes the perfusionist is a registered nurse or respiratory therapist with critical care experience who has completed advanced training in cardiac perfusion.
Intensivist
Intensivists are medical doctors who practise intensive care medicine. They are able to continuously assess patients, with an eye to addressing early any changes in their condition.
Once intensivists have completed training in anaesthesiology, surgery, medicine, or emergency medicine, they do subspecialty training in critical care. While a number of doctors work with critically ill patients, it is the intensivist who is responsible for making final care decisions while the child is in intensive care.
Surgical coordinator
The cardiovascular surgical coordinator arranges for your child's surgery and all the appointments they may need before the surgery, such as blood work, X-ray, or ECG. If your child has just been referred to the hospital, the surgical coordinator will refer your child to a cardiologist. They also serve as a source of information for you, if you have questions about your child's treatment. They often provide counselling over the phone, much like a contact nurse.
Before the surgery, the surgical coordinator will confirm that your child is in good enough health to proceed with the surgery as planned. You should let them know in advance if your child has symptoms of the flu, a cold, or diarrhea.
They will meet with you on the day of the surgery and let you know how the day will play out and whether the surgery needs to be postponed for any reason (such as an emergency case). On any given day, they will book from one to four heart surgeries. Most take up to about 6 hours, though children having repeat surgeries may take longer.
The surgical coordinator is also available to discuss directed and autologous blood donation with you if this is something you are interested in. Initial screening can be done over the phone. They can advise you on how to get tested and set up appointments.
After the surgery, the surgical coordinator is involved with rounds, so they will have the opportunity to see how your child is doing after the operation.
