Cardiothoracic anesthesiology is a subspeciality of the medical practice of anesthesiology, devoted to the preoperative, intraoperative, and postoperative care of adult and pediatric patients undergoing cardiothoracic surgery and related invasive procedures.

It deals with the anesthesia aspects of care related to surgical cases such as open heart surgery, lung surgery, and other operations of the human chest. These aspects include perioperative care with expert manipulation of patient cardiopulmonary physiology through precise and advanced application of pharmacology, resuscitative techniques, critical care medicine, and invasive procedures. This also includes management of the cardiopulmonary bypass (heart-lung) machine, which most cardiac procedures require intraoperatively while the heart undergoes surgical correction.

All anesthesiologists obtain either a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree prior to entering post-medical school graduate medical education. After satisfactory completion of an Accreditation Council for Graduate Medical Education (ACGME) or American Osteopathic Association (AOA) accredited one year internship in either internal medicine or surgery and a three-year residency program in all subspecialties of anesthesiology, formal advanced training in Cardiothoracic Anesthesiology is available via a one-year fellowship.Cardiothoracic Anesthesia Fellowship - Department of Anesthesiology - Miller School of Medicine at the University of Miami Society of Cardiovascular Anesthesiologists.

The first Cardiothoracic Anesthesiology fellowship was formed at Harvard Medical School and the Massachusetts General Hospital in 1971. Massachusetts General Hospital Department of Anesthesia, Critical Care and Pain Medicine - Fellowships Since then, Cardiothoracic Anesthesiology has become an ACGME approved fellowship (2007), and there are 64 ACGME accredited programs and 212 match positions for the 2017-2018 application year.^{[citation needed]}

This fellowship consists of at least eight months of adult Cardiothoracic Anesthesiology, one month dedicated to transesophageal echocardiography, one month in cardiothoracic intensive care unit and two months of elective rotation which includes inpatient or outpatient cardiology or pulmonary medicine, invasive cardiology, medical or surgical critical care and extracorporeal perfusion technology.^{[citation needed]}

Fellows are offered the opportunity to participate in clinical research and encouraged to present at national or international conferences after completion of a research project. The arenas of research can be as diverse as neuroprotection, myocardial protection, blood conservation strategies, and port access surgery.

Fellows are trained to provide perioperative anesthetic management for patients with severe cardiopulmonary pathology. Some of the cardiac surgeries they train for include the following: coronary artery bypass surgery (CABG) both on cardiopulmonary bypass as well as on a beating heart, heart valve surgery, aortic reconstruction requiring deep hypothermic arrest, mechanical ventricular assist device (VAD) placement, thoracic aortic aneurysm repair, aortic dissection repair, heart transplants, lung transplants, heart/lung transplants, and adult congenital heart surgery.^{[citation needed]}

Adequate exposure and experience provided in the management of adult patients for cardiac pacemaker and automatic implantable cardiac defibrillator placement, surgical treatment of cardiac arrhythmias, and the complete gamut of invasive cardiologic (catheter-based) and electrophysiological procedures is expected as well.