A cardiothoracic anesthesiologist provides anesthesia to surgical cases involving the heart, lungs, and other operations of the human chest, including bypass surgery and other procedures ranging from minimally invasive surgery, robotic surgery, and complex multi-stage aortic surgery. The cardiothoracic anesthesiologist is often responsible for supervision of the bypass heart-lung machine. He or she will also monitor a patient's physical condition through use of invasive monitors, in addition to keeping an eye on the patient's bodily reactions to drugs needed during a surgical procedure.. These specialized anesthesiologists also work with non-cardiac procedures like esophageal resection and all types of video-assisted thoracoscopic surgery.
More recently, the responsibility of the cardiothoracic anesthesiologist has evolved into that of a physician accountable for all aspects of the perioperative period and who can assess and reduce risk in patients with complex cardiovascular disease. A cardiothoracic anesthesiologist may also be certified by the National Board of Echocardiography to perform ultrasound assessment of cardiac health, and they may also provide electrophysiology consult service for the reprogramming of pacemakers and implantable cardioverter-defibrillators (ICD).