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President's Message

Welcome to the new
CCAS Board Members

Pediatric Cardiac
Anesthesia Fellowship Training

Join CCAS at Pediatric Anesthesiology 2008

ARTICLE REVIEW
Aprotinin is Safe in
Pediatric Patients Undergoing Cardiac
Surgery

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00President's Message

By Dean Andropoulos, M.D.

CCAS Board elections were held in October, and we are pleased to have three outstanding new BoardDr. Dean Andropoulos members:  Dr. Vic Baum from the University of Virginia, and two prominent International CCAS Board Members from the UK, Drs. Ian James and Philip Arnold. They will bring us important new viewpoints and expertise as the CCAS seeks to expand international alliances and membership. Please see the article below for additional information.

As we begin a new year, we look forward to our CCAS Program, organized by Dr. Jim DiNardo, held this year on April 3, 2008, the day before Pediatric Anesthesiology 2008 in San Diego. There is a link to the complete program and necessary registration information on the Society for Pediatric Anesthesia and CCAS web pages. Please note that separate registration is required for the CCAS conference. This year we will have an audience response system, that will enhance registrants’ participation, and serve as a platform for interesting debate and discussion about how we care for our patients.

A topic of recent and ongoing interest has been fellowship training and education for pediatric and congenital cardiac anesthesiology. Under the direction of CCAS Board member Dr. Jim DiNardo, the CCAS is developing recommendations and guidelines for training. As many readers know, the Anesthesiology Residency Review Committee proposed a 12 month Pediatric Cardiac Anesthesia Fellowship Program in 2005, after an Adult Cardiac Anesthesia Fellowship had been proposed. The pediatric fellowship proposal had a curriculum and rotation schedule consisting of modified information from the adult program, and was proposed without major input from the SPA, or the Organizing Committee of the CCAS. Because of this lack of input, and disagreement over the structure, length, and even need for a pediatric cardiac anesthesia fellowship certification, the leadership of the SPA and CCAS felt this proposal was premature, and asked the RRC to not consider it further until the issue could be addressed in a more systematic manner. Recent discussions at the CCAS have led to a view by some of the Board that general pediatric anesthesia fellowship training should be a requirement for entrance into pediatric cardiac anesthesia fellowship, or that a substantial period of training in general pediatric anesthesia be part of such a fellowship for those with fellowship training in adult cardiac anesthesia who also desire pediatric training. This has led to the idea that an 18-24 month fellowship training period could be desirable, consisting of 9-12 months of general pediatric anesthesia fellowship training, and 9-12 months of pediatric cardiac anesthesia training. This would thus meet ACGME requirements for a complete 12 month fellowship in general pediatric anesthesia, and also allow adequate time and experience for pediatric cardiac anesthesia fellowship. It must be emphasized that these are preliminary discussions, and no formal proposal has been written, even in draft form. Because of this information, there has been recent comment by Adult Congenital Cardiology leadership that requiring general pediatric anesthesia fellowship training would be a barrier to those who desire to have expertise in anesthesia for adult congenital heart disease. Dr. Frank McGowan, past SPA President and in that role instrumental in the founding and success of the CCAS, has a very interesting perspective on this issue.

Finally, Drs. Denise Joffe and Michael Eisses have an interesting article review on a current, ongoing controversy in our subspecialty—aprotinin use. As you know, at the FDA’s request, Bayer has suspended worldwide marketing of aprotinin in response to safety concerns in the adult cardiac surgery population. The drug can still be used if the risk: benefit ratio  is deemed acceptable, and as such many of our programs continue to use the drug, obtaining their supply of aprotinin from other hospitals. This issue is an important one that will also be a topic of discussion at the CCAS Conference in April.

 

 
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