I pursued dual training in anesthesia and critical care medicine at Johns Hopkins and the University of Utah. During my Pediatric Anesthesia fellowship at Johns Hopkins, I was able to spend 40% of my clinical time doing cardiac anesthesia for children with congenital heart disease. I then returned to complete my training in Pediatric Critical Care Medicine (PCCM) here at the University of Utah. This latter fellowship had a heavy emphasis on the perioperative care of children with congenital heart disease (CHD). Throughout my training, I found myself most attracted to the care of patients with CHD, both in the operating room (OR) and in the intensive care unit following their surgeries. This both provided the background and set the stage for the sub-specialization that occurred in my career over the following almost twenty years.Beginning in 2000, a decision was made to focus our perioperative care of children with CHD via sub-specialization within the fields of anesthesia and critical care. Specifically, this meant that a small group of individuals would devote their clinical time to the care of patients with CHD. With a small group of physicians involved, the exposure to rare forms of CHD would be maximized and, thus, care would be optimized. In the OR, five anesthesiologists were chosen to provide the anesthesia for cardiac procedures. This number was chosen carefully to ensure a minimum number of cardiopulmonary bypass cases per anesthesiologist per year. Shortly after this, I was asked to be one of five cardiac intensivists, and by 2001, a Cardiac ICU (CICU) was born. This finally allowed me to focus care on the patients that interested me the most, from the operating room to the intensive care unit afterwards. Soon after this, I was named Head of the Division of Cardiac Anesthesia and continue to serve in that position to the present time. In brief, over the last ten years, these groups have thrived and our perioperative care of these complex children has expanded both in the OR and ICU. We now have a 16 bed CICU and deliver over 700 cardiac anesthetics per year.
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