Joseph J. Quinlan, MD
UPMC Presbyterian/Montefiore is the largest quaternary care hospital of the UPMC Health System and the largest in Western Pennsylvania. It remains the department’s core hospital in terms of clinical activity and resident education and is a nexus for clinical research. The Department of Anesthesiology’s UPMC Presbyterian clinical site is larger than many entire academic departments found elsewhere in the country. Procedures span the entire spectrum of surgical and special procedures, from combined thoracic and abdominal transplantation to anesthesia for electroconvulsive therapy. Locations where services are provided included the gastroenterology lab, bronchoscopy suite, electroconvulsive therapy suite (at Western Psychiatric Institute and Clinic of UPMC), electrophysiology suite, cardiac catheterization lab, interventional radiology, and the MRI suite (where craniotomies are now occasionally performed).
Anesthesiology services at UPMC Presbyterian are highly subspecialty-oriented. Many of the advanced subspecialty resident rotations in anesthesiology (liver transplantation, cardiac, ENT, thoracic, trauma, and neuroanesthesia) are based there. Many novice residents and SRNAs perform their first cases at UPMC Presbyterian.
For more information about the UPMC Presbyterian/Montefiore Anesthesiology Division, including the most recent faculty member, CRNA, and case counts, please see the department’s most recent annual report.
Transplantation Anesthesiology Division
Neurosurgical Anesthesiology and Supportive Care Division
Same Day Services
Transplantation Anesthesiology, UPMC Presbyterian/Montefiore
Raymond M. Planinsic, MD
Anesthesiologists in the Division of Transplantation Anesthesiology (TA) are responsible for the care of patients undergoing liver, intestinal, multivisceral, kidney, pancreas, and composite tissue allograph transplantation. In addition, TA provides anesthesiology care and work-up for patients undergoing major hepatic resections.
The primary responsibilities of TA include preoperative assessment of transplant candidates, participation in candidate selection, intraoperative management, and postoperative visits. Preoperative consultation of transplant candidates is the main strength of the service. As true consultants, anesthesiologists provide hepatologists and surgeons with valuable information on extrahepatic organ function. All candidates are evaluated at the Thomas E. Starzl Transplantation Outpatient Clinic or as inpatients at UPMC.
UPMC continues to serve as the referral center for high-risk patients because of our diverse expertise and multidisciplinary approach to managing patients with multiple organ dysfunction. As a result, an increasing number of patients over 65 years of age and those with significant cardiopulmonary disease and/or a complicated surgical history (often rejected as candidates by other programs) underwent successful organ transplantation. Several Jehovah's Witness patients have undergone successful liver transplantation without the use of blood products at UPMC. In addition, UPMC is one of the only centers that performs liver transplantation on patients with known HIV disease.
Neuroanesthesiology and Supportive Care, UPMC Presbyterian
Ferenc E. Gyulai, MD
The Neurosurgical Anesthesiology service at UPMC Presbyterian provides anesthetic care for neurosurgical procedures including expanded endonasal approaches, craniotomy for tumor, retromastoid craniectomy for microvascular decompression of various cranial nerves, and spinal surgery. Two separate Neurosurgical Intensive Care Units at UPMC Presbyterian have continued to facilitate innovative approaches to the acute care of cerebral vascular pathologies in addition to promoting optimal care for patients with neurotrauma and other acute neurological injury. We are involved in the anesthetic management of the patients in the Center for Neurointerventional and Neuroendovascular Therapy. Services include embolization of cerebral vascular aneurism; arterio-venous malformations; tumors and dural and cavernous sinus fistulae; treatment of refractory epistaxis; sclerotherapy; temporary balloon occlusion testing with blood flow evaluation; stroke thrombolysis and thrombectomy; dural sinus thrombolysis and thrombectomy; petrosal sinus sampling, carotid, vertebral artery, subclavian artery, and intracranial arterial stenting; vessel sacrifice; Wada testing; vertebroplasty (methylmethacrylate vertebral body injections); alcohol sclerotherapy; and routine angiography. The Center for Minimally Invasive and Cranial Base Surgery pioneers cutting-edge endoscopic minimally invasive craniotomy techniques, the team has attracted national and international recognition. The rest of the clinical caseload includes various stereotactic procedures, such as magnetic resonance imaging-guided and computed tomography-guided stereotactic surgery and three-dimensional localization. In addition, deep hypothermic circulatory arrest is used in conjunction with cardiopulmonary bypass for the clipping of particularly inaccessible intracranial aneurysms.
Same Day Services UPMC Presbyterian/Montefiore
Patrick J. Forte, MD
Same Day Services at UPMC Presbyterian/Montefiore includes both Same Day Surgery (SDS) and the Preoperative Evaluation Center (PEC). Most patients scheduled for both outpatient surgical procedures or same day admit procedures at UPMC Presbyterian and Montefiore receive care at the SDS unit. The PEC receives referrals from surgeons for prior anesthetic problems, complex medical conditions, patient concerns, or pre-surgical history and physical. Patients who are not seen in the PEC are called and evaluated the day before surgery by SDS nurses. The goal of the unit is 100% patient review prior to surgery, resulting in minimal unforeseen delays and cancellations on the day of surgery. Current data shows that the patients who are seen in the PEC are significantly less likely to have their scheduled surgeries delayed or cancelled.
The clinic performs preoperative evaluations via telemedicine between the Oakland campus and UPMC Bedford. Patients scheduled for surgery in Pittsburgh are able to receive a comprehensive preoperative evaluation from a nurse practitioner or resident in Oakland utilizing a mobile remote camera, electronic digital stethoscope, and hand held camera for detailed examinations of the airway. Telemedicine evaluations from the Endocrine Surgery service at Falk Clinic has gone live and patients are now able to receive their comprehensive preoperative anesthetic evaluation without leaving the surgery clinic.