A cardiothoracic surgeon is a trained medical doctor who has many years of post-graduate experience in surgery and has chosen to specialize in cardiothoracic surgery. Cardiothoracic surgery is any surgery relating to the organs of the thoracic cavity (chest). This includes the esophagus, heart, lungs and related structures. Heart and lung surgery are at the forefront of medical and technological advances, and doctors involved in cardiothoracic medicine and surgery are required to stay up-to-date on all current research and best practice. Cardiothoracic surgeons can also work in research or be involved in clinical trials and medical education.
Cardiothoracic surgeons can further sub-specialized in certain areas or procedures, for example in heart transplants, or in congenital heart defects in babies. Surgeons who specialize in the organs of the chest have a particular skill set and only become consultant surgeons after many years of training and practice working under experienced surgeons.
Heart surgeons work with a big team of specialist anaesthetists, nurses, surgical theatre practitioners, ward staff, and more. Patients who have had some cardiothoracic surgery can recover fairly quickly, whereas people having more complex procedures sometimes spend weeks recovering in hospital. They are likely to be on specialist cardiothoracic wards where all the staff are experienced in the care and recuperation of heart and lung surgery patients. People who have undergone surgery often need ongoing reviews and so cardiothoracic surgeons run clinics in outpatient settings as well as performing planned and emergency surgery.
A cardiothoracic surgeon evaluates and prepares patients who need surgery to the organs of the chest cavity. They take referrals for elective patients who need essential but non-urgent procedures, and they also perform life-saving surgery in emergency situations.
The discipline of cardiothoracic surgery comprises a multitude of different procedures and operations. One of the most common types of open heart surgery is the Coronary Artery Bypass Graft – ‘CABG’. This is indicated for people with coronary artery disease that is severe or unable to be managed through less invasive procedures such as coronary artery stenting (angioplasty, or percutaneous coronary intervention). During a CABG, the patient is anesthetized and a cut is made through the breastbone to expose the heart, and a healthy blood vessel (often from the leg) is used to route blood past the diseased areas of the coronary arteries and reinstate blood supply to the heart muscle.
Heart surgeries can also include repair or replacement of the valves of the heart, surgery to fix structural abnormalities of the heart and related structures, and total heart transplants. Heart transplants are relatively uncommon because they rely on an appropriate donor heart and can only be performed on patients with serious enough heart failure to need a new heart but who are still well enough for such a big operation.
During some heart surgery, the patient may need to be attached to a cardiopulmonary (heart and lung) bypass machine which maintains the blood oxygen levels and keeps it flowing around the body while the heart is temporarily stopped for surgery.