Cardiothoracic Critical Care: A New Specialty

The 21st century has been a fascinating and exciting time in the field of cardiothoracic critical care (CCC). Over the past 17 years, we have seen the innovation and development of minimally invasive cardiac surgery (MICS), transcutaneous aortic valve implantation (TAVI) and thoracic endovascular aortic repair (TEVAR). The development of second-generation continuous flow and third-generation electromagnetic ventricular assist devices (VADs) has revolutionized the treatment of end-stage heart failure, both as bridge-to-transplant and as destination therapy. Advances in technology have resulted in rapid expansion of extracorporeal membrane oxygenation (ECMO) programs with VA ECMO for circulatory support, VV ECMO for acute respiratory failure and combined techniques for complex patients. Advances in surgical techniques have increased survival in patients with aortic dissections and aneurysms, and advances in immunosuppression have increased survival in heart and lung transplantation. Patients with congenital heart disease are now surviving to adulthood but may require additional surgical interventions, creating...