Cardiac Anesthesia for CRNAs
Cardiac anesthesia represents a subspecialty area where CRNAs with specific training can command premium compensation.
What Cardiac Anesthesia Involves
Case Types
| Procedure | Complexity | CRNA Role Varies |
|---|---|---|
| CABG (coronary bypass) | High | Depends on setting |
| Valve replacement | High | Team approach common |
| TAVR | Moderate-High | Growing CRNA involvement |
| Cardiac catheterization | Moderate | CRNAs common |
| EP procedures | Moderate | CRNAs common |
| Thoracic surgery | High | CRNA or team |
Skills Required
| Skill | Why Essential |
|---|---|
| TEE interpretation | Cardiac imaging |
| Hemodynamic management | Complex physiology |
| Vasoactive drips | Precise titration |
| Swan-Ganz catheter | Monitoring |
| CPB management | Bypass understanding |
| Post-bypass care | Recovery phase |
Compensation Premium
Cardiac vs General
| Setting | General CRNA | Cardiac-Capable CRNA |
|---|---|---|
| Academic | $200,000 | $220,000-240,000 |
| Community | $215,000 | $235,000-260,000 |
| Private practice | $225,000 | $250,000-280,000 |
Premium range: 10-20% above comparable general positions
Why the Premium?
- Specialized skills in high demand
- Limited candidate pool
- Higher complexity/responsibility
- Call intensity often greater
- Direct impact on outcomes
Getting Cardiac Experience
Training Pathways
| Path | Duration | Cost |
|---|---|---|
| Fellowship (formal) | 6-12 months | Often paid |
| On-job training | 12-24 months | Paid employment |
| Simulation + mentorship | Variable | Facility-provided |
Where to Get Training
- Academic medical centers — Formal programs
- Large cardiac hospitals — Mentorship models
- Travel cardiac assignments — Build experience
- CT surgery fellowship — Formal credential
Job Availability
Settings Hiring Cardiac CRNAs
| Setting | Availability | Notes |
|---|---|---|
| Academic centers | High | Team model |
| Community cardiac | Moderate | Growing |
| Private cardiac groups | Limited | Selective |
| Rural cardiac | Rare | Low volume |
Geographic Hotspots
- Major metro areas with cardiac surgery programs
- Academic medical centers
- Regional heart centers
Reality of Cardiac Practice
Demands
| Factor | Reality |
|---|---|
| **Case length** | 4-8 hours common |
| **Complexity** | High stakes |
| **Call** | Often intense |
| **Stress** | Significant |
| **Physicality** | Long standing hours |
Rewards
| Factor | Benefit |
|---|---|
| **Compensation** | Premium pay |
| **Skill level** | Top of profession |
| **Variety** | Complex cases |
| **Outcomes** | Life-saving work |
| **Respect** | Known expertise |
Is Cardiac Right for You?
Good Fit
- Experienced general CRNAs (5+ years)
- Those who thrive on complexity
- High stress tolerance
- Interest in critical care
- Long-term career investment
Consider Carefully
- Impact on lifestyle (call intensive)
- Training commitment required
- Stress levels involved
- Not for new graduates
Conclusion
Cardiac anesthesia offers CRNAs premium compensation and challenging practice, but requires significant training investment and comes with demanding call schedules. For experienced CRNAs seeking career advancement through subspecialization, cardiac training provides excellent return on investment both financially and professionally.
Career data from Anesearch, January 2025.