The Cardiovascular and Thoracic PA
What is a cardiovascular and thoracic PA?
The Cardiovascular Physician Assistant (CVPA) is a physician assistant that is credentialed by the National Commission on Certification of Physician Assistants (NCCPA), holds a license to practice medicine by the state in which they practice, and practices medicine with the supervision of surgeons in the field of cardiovascular and/or thoracic surgery.
How is the cardiovascular and thoracic PA trained?
The supervising cardiovascular surgeon is responsible for determining the skill level of the physician assistant to assure that all clinical duties are performed safely and competently. Therefore, primary instruction and training for the CVPA in the postgraduate setting is provided by the supervising cardiovascular surgeon. This primary instruction and training can be augmented by programs specific for cardiovascular surgery such as continuing medical education programs or by technical skills workshops. The CVPA also has the opportunity to participate in an accredited post-graduate residency program in cardiovascular surgery, a one year training program designed to enhance the decision making and surgical skills of the CVPA.
In the practice setting, the CVPA must be properly credentialed and be granted privileges by the hospitals in which they will practice. This is accomplished by receiving appropriate instruction and training in all procedures and also must perform a predefined number of procedures with the direct supervision of their supervising physician prior to being granted full privileges.
Click here to read the APACVS Position Paper on Post Graduate Education for the CVPA.
What does a cardiovascular and thoracic PA do?
Few other specialties provide a physician assistant with more autonomy in the operating room or the critical care units as does the field of cardiovascular surgery.
In addition to performing routine duties such as histories & physical exams, pre and postoperative patient care, patient education, and discharge summaries, the CVPA can have advanced knowledge of hemodynamic management, ventilators, and artificial cardiac devices, allowing extensive responsibility in the cardiac intensive care unit.
Under the supervision of a cardiovascular surgeon, they may also perform procedures that include:
- First assisting in surgery
- Opening and closure of sternotomy
- Conduit procurement for coronary artery bypass surgery including:
1. endoscopic greater and lesser saphenous vein harvest,
2. endoscopic radial artery harvest and internal mammary artery take-down;
- Arterial line placement
- Central line placement
- Pulmonary artery catheter placement
- Placement of, and removal of, intra-aortic balloons
- Placement and removal of chest tubes
- Organ procurement for transplantation