Our Approach to Cardiothoracic Anesthesiology
Montefiore Einstein Cardiothoracic Anesthesiology is renowned for excellence in clinical care, research and education. We provide integrated perioperative and periprocedural care for more than 1,500 patients undergoing complex cardiac and thoracic surgeries and interventional cardiology and electrophysiology (EP) procedures each year. Our team of internationally-recognized, fellowship-trained cardiothoracic anesthesiologists collaborates closely with cardiothoracic surgeons, cardiologists and other specialists to deliver compassionate and comprehensive patient-centered care and ensure a safe and optimized operation and recovery. Driven by evidence-based medicine, we use the most advanced equipment and techniques to continually improve patient outcomes. We are an integral part of the Montefiore Einstein Center for Heart & Vascular Care, serving patients in the Bronx, Hudson Valley, Westchester and beyond who require specialized care for a wide range of cardiovascular diseases. As key members of the perioperative care team, we develop personalized treatment plans tailored to each patient. Montefiore Einstein is ranked in the top 1% of all hospitals in the nation for cardiology, heart and vascular surgery according to U.S. News & World Report.
Unparalleled Expertise
As part of the perioperative care team for the nation’s first successful coronary artery bypass grafting (CABG) operation and the world’s first HIV-positive to HIV-positive heart transplant, our cardiothoracic anesthesiologists have unparalleled expertise caring for the most complex and high-risk cases. Our cardiothoracic anesthesiologists are double board-certified in anesthesiology and perioperative transesophageal echocardiography (TEE). Utilizing TEE imaging is an integral diagnostic component of modern cardiothoracic and vascular care, and serves as a guiding resource during surgical procedures and interventions. Members of our Cardiothoracic Anesthesiology team are additionally certified in Critical Care Medicine and provide postoperative care to our patients in the Cardiothoracic Intensive Care Unit, ensuring comprehensive monitoring and optimal recovery. Our faculty also serve as consultants across subspecialties and campuses for patients with existing cardiothoracic and vascular pathologies who require non-cardiac operations and procedures. We are committed to enhancing patient safety, facilitating comfort, and delivering the highest level of perioperative care to all patients undergoing procedures for cardiovascular conditions.
Advanced Diagnostics & Treatments
We use the latest anesthesiology techniques and technologies to provide specialized and evidence-based care. We employ the most advanced perioperative monitoring techniques, including hemodynamic monitoring, echocardiography, and neurological monitoring, to ensure optimal outcomes. As experts in perioperative transesophageal echocardiography (TEE), our team uses the most advanced 3D cardiac imaging and other modern imaging modalities.
We provide personalized care for patients with cardiovascular and thoracic conditions undergoing the full range of cardiothoracic surgeries and interventional cardiology and EP procedures, including:
- Coronary artery bypass grafting (CABG) surgery
- Open valve replacement and repair
- Open and thoracic endovascular aortic repair (TEVAR)
- Complex adult congenital heart surgery
- Heart transplantation
- Robotic heart surgery
- Cardiac catheterization
- Angioplasty
- Structural heart interventions including trans-catheter heart valve interventions such as transcatheter aortic valve replacement (TAVR), transcatheter mitral valve replacement (TMVR) and transcatheter edge-to-edge repair (TEER)
- Catheter ablation
- Left atrial appendage occlusion/closure
- Pacemaker and implantable cardioverter-defibrillator (ICD) insertion
Mechanical circulatory support and temporary and durable ventricular assist device (VAD) implantation for advanced heart failure
- Lung transplantation
- Robotic lung resections for lung cancer
- Endovascular procedures
- Aortic aneurysm repair
Our anesthesiologists are early adopters of fast-track cardiac anesthesia (FTCA), providing faster and more complete recovery for high-risk patients using short-acting anesthetics and adjunctive regional anesthesia.
Clinical Trials
We are spearheading numerous clinical trials through which patients can access emerging technologies and innovative treatments that may otherwise not be available to the general public.
- Phase 3
PANDORA: Delirium Prevention After Cardiac Surgery Using IV Acetaminophen to Prevent Postoperative Delirium in Older Cardiac Surgical Patients
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Start Date
August 11, 2020
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Conditions
Delirium in Old Age, Delirium, Coronary Artery Disease
- Phase 3
Minimizing ICU Neurological Dysfunction With Dexmedetomidine-induced Sleep (MINDDS II) (MINDDS II)
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Start Date
January 6, 2025
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Conditions
Delirium
- Phase 4
Suvorexant and Sleep/Delirium in ICU Patients
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Start Date
February 28, 2020
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Conditions
Insomnia, Sleep Fragmentation, Sleep Initiation & Maintenance Disorders, Postoperative Delirium
Research
We are leading collaborative research and spearheading numerous studies and clinical trials, some of which are funded by the National Institutes of Health (NIH), to improve clinical care and safety for patients undergoing various cardiac, thoracic, and vascular surgical procedures.
The Montefiore Einstein Cardiothoracic Anesthesia team regularly publishes peer-reviewed articles and contributes to ongoing multicenter research projects. Our researchers have received several grants to study the use of advanced monitoring to predict right ventricular failure and to investigate predictors for transfusion during cardiac surgery among other funded studies.
Our recent research and quality improvement projects have been focused on early mobilization after cardiac surgery, opioid-sparing anesthesia, and utilizing regional anesthesia techniques for a more complete recovery. In a recent study, our researchers found that multimodal interventions significantly reduced the use of opioids among cardiac patients, both immediately following surgery and after discharge, resulting in a lower risk of patients becoming dependent on opioids and fewer of the drugs going into the community.
Cardiothoracic Anesthesiology Education & Training
At Montefiore Einstein Anesthesiology, we are committed to training the next generation of cardiothoracic anesthesiologists. Residents and fellows are provided extensive clinical and research opportunities, structured didactics, and broad exposure to a wide range of cardiothoracic surgeries and cardiac interventions. Our trainees are involved in all aspects of perioperative patient care. Our Adult Cardiothoracic Anesthesiology Fellows gain experience in perioperative transesophageal echocardiography (TEE) from our team of expert faculty who are fellowship-trained and board-certified echocardiographers. Our goal is to foster the careers of our trainees, preparing them for modern clinical practice.
Your Cardiothoracic Anesthesiology Team
Jonathan D. Leff, MD, FASE
Peter Von Homeyer, MD, FASE
The Montefiore Einstein Cardiothoracic Anesthesiology team comprises fellowship-trained cardiothoracic anesthesiologists who are board-certified in Anesthesiology and perioperative echocardiography. Our internationally-recognized doctors are essential members of the perioperative care team and create a customized treatment plan for each patient in collaboration with medical and surgical specialists to ensure a safe and optimized operation and recovery.
