Anaesthesia for cardiothoracic surgery has evolved dramatically. The specialty evolved from the shadows of the cardiothoracic surgeon in the last quarter of the twentieth century to become an independent, self-sufficient, and fiercely competitive specialty. Cardiothoracic anaesthesiologists quickly became experts in vascular access and patient hemodynamic management. They were in high demand to handle life-threatening situations. Cardiovascular anaesthesiologists are now regarded as echocardiography gurus. They master the trans-esophageal echocardiography (TEE) probe and guide the heart surgeon to optimise patient outcomes. Until the introduction of cardiopulmonary bypass (CPB), cardiac surgery was confined to correcting basic congenital heart abnormalities. The development of safe CPB broadened the purview of cardiac anaesthesiology. The complications of anaesthetic treatment are overcomplicated. The introduction of coronary artery bypass surgery increased the number of patients and broadened the scope of the speciality. Cardiac anaesthesiology thrived as a specialty, attracting top personnel. This new stream attracted a considerable number of anaesthesiologists. Cardiac anaesthesiology broke out of its shell and became one of the most sought-after specialties.
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