Cardiac Surgeon

What is a cardiac surgeon?

A cardiac surgeon is a medical doctor who performs surgery on the heart and the major blood vessels around it. There are several different medical specialties that a cardiac surgeon may fall under, some of which have overlapping areas of focus.

What is cardiac surgery?

Cardiac surgery is any kind of surgical procedure performed on your heart or any related blood vessels near where they connect to the heart. In some cases, these surgeries may involve the tissues or structures immediately next to the heart.

What are the different types of cardiac surgeons?

Cardiac surgeons typically fall into two professional specialties. While there are many similarities and overlaps in their practice, a few differences are big enough to group them differently.

Cardiothoracic surgeon

Sometimes called a cardiothoracic surgeon or a general thoracic surgeon, this specialty gets its name from the Greek word for "chest." As the name suggests, cardiothoracic surgeons specialize in surgeries on most organs and tissues found in the chest. This can include surgeries on the heart and connected major blood vessels, the lungs, esophagus (which connects your mouth to your stomach) and trachea (windpipe). Some thoracic surgeons may choose to only focus on conditions involving the heart, pericardium (a sac around the heart) and major blood vessels of the heart. Others may choose to focus on other conditions excluding the heart and major blood vessels.

Congenital/pediatric heart surgeon

A congenital or pediatric heart surgeon focuses on repairing structural problems or anomalies that a person has when they're born. This can include problems with heart valves, holes in the walls between the heart's chambers, and more.

While some surgeons focus on doing these surgeries in adults — as it is not uncommon that a congenital heart problem diagnosis happens when someone is an adult — others specialize in these surgeries on children, infants and newborns. Their practice is extremely specialized and there are very pediatric heart surgeons compared to those who practice only on adults.

What experience and training do cardiac surgeons need?

The amount of education and training that all cardiac surgeons must receive is enormous, taking at least 15 years in total. For those who choose to go into a particular heart surgery specialty, it can take more than 20 years.

All cardiac surgeons must do the following:

• Three to four years of college (bachelor’s degree).
• Four years of medical school (medical doctor or doctor of osteopathic medicine degree).

They then must choose one of the following:

• Five years of general surgery residency and two to three years of cardiothoracic surgery residency.
• Six years of integrated cardiothoracic surgery residency (ICTSR).

For those who choose to be congenital heart surgeons, they must also do a one-year fellowship.

What does a cardiac surgeon treat?

Cardiac surgeons can treat any disease, condition or injury that requires surgery to repair or correct. This can include anything from trauma — like from a car crash, stab wound or gunshot — to correcting heart damage from a disease or a condition a person had when they were born. Some of the most common conditions that require a cardiac surgeon include:

• Heart valve diseases.
• Heart rhythm disorders (arrhythmias).
• Heart failure.
• Aortic dissection.
• Congenital heart problems like holes between chambers of the heart, including ventricular septal defect and atrial septal defect.

What procedures are done by cardiac surgeons?

Cardiac surgeons perform a wide range of surgeries and procedures. Some of the most common include:

• Maze procedure.
• Coronary artery bypass grafting (CABG).
• Congenital heart surgeries.
• Heart valve repair and replacement procedures.
• Device implantation [pacemakers, implantable cardioverter defibrillators (ICDs), etc., which may be performed by a physician who specializes in electrophysiology].
• Hypertrophic cardiomyopathy (enlarged heart) surgery.
• Heart transplants.

Surgeons often train in multiple methods of performing the same type of surgery. This can include surgeries that are:

• Minimally invasive: These procedures are similar to open procedures but use much smaller incisions and specialized surgical tools. Smaller incisions heal easier, are less painful, lose less blood and generally have fewer risks.
• Robot-assisted: A specially trained surgeon can use a robot to help them do surgery. Sitting at a console near the operating table, the surgeon “drives” the robot, using tools attached to various arms of the robot. The robot also includes a special camera inserted into the body through one of the incisions. These cameras let the surgeon see inside, often in 3-D (just like most people see because they have two eyes). In addition, the robot lets the surgeon maneuver more easily inside and has a greater range of motion (the tools can often rotate 360 degrees, much more than a surgeon's wrist).

What are the responsibilities of a cardiac surgeon?

A cardiac surgeon isn’t just responsible for performing surgeries. Their duties often include — but aren’t limited to — the following:

• Documenting. Cardiac surgeons must document the surgeries and provide detailed notes and records on what they did.
• Teaching. Cardiac surgeons often practice in academic teaching hospitals. That means they care for patients and teach future physicians and surgeons about heart surgery and how it impacts patients.
• Training. These surgeons also train and work alongside other doctors, surgeons and operating room staff, much like actors train in a dress rehearsal, so that things go smoothly and safely during actual operations.
• Continuing education. All doctors must constantly keep learning and training. Depending on what state or country they’re in, surgeons must meet varying levels of requirements. If they don't, they will lose their license to practice. This also includes rigorous board certification education and tests, with some of the tests taking several hours or even days to complete.

Why see a cardiac surgeon and what should I expect?

Heart surgery is typically a very serious procedure. It is most often done when there are no better alternatives — meaning no other procedure is as safe and likely to help you.

In many cases, you’ll have time in advance to learn about the type of heart surgery you’ll need, what to expect, how to prepare and more.

In rarer emergency cases, you may need immediate heart surgery without any delay. In those instances, a surgeon will talk to your family, loved ones or any person who can speak and make medical decisions for you. The surgeon will do all they can to help your loved ones understand what is happening, why you need surgery and what to expect.

Do I need a referral to see a cardiac surgeon?

Yes, seeing a cardiac surgeon almost always takes a referral. That referral will most likely come from a cardiologist or some other specialist. This is almost always the case because another specialist or physician would first have to identify a condition or problem that needs surgery. In emergency cases, an attending physician or specialist can consult an on-call cardiac surgeon and ask them to assess your condition, recommend options and suggest the best possible procedures or approaches to treating you.

A note from Cleveland Clinic

Needing heart surgery can be an intimidating, even frightening, situation to face. Fortunately, you won't be facing it alone. Behind every patient who needs heart surgery is a team of healthcare providers and professionals, ranging from technicians and support staff to nurses, specialist physicians and surgeons. To become a heart surgeon takes an enormous commitment, and it is a demanding profession, with only the best achieving this title. That means you’ll have a huge number of talented, trained, educated and diligent medical professionals doing everything they can to help you recover and return to your life.