Cardiothoracic surgery is a broad term encompassing almost all surgery that takes place in the chest, and encompasses cardiac, thoracic, and congenital heart surgery. These areas of surgery on the chest are usually divided into three categories with surgeons specializing in one area, but the term cardiothoracic surgery groups them all together. The distinctions of each area of expertise are nevertheless important to understand.
Theoretically, the term cardiothoracic surgery describes surgeries in the chest or thorax. Often, lines are drawn between those surgeries that most specifically treat the lungs and those surgeries that treat the heart and vessels, even if surgeons have roughly equivalent training. A further separation is between cardiovascular and lung surgeons and those doctors who specialize in paediatric cardiothoracic surgery. The paediatric doctor is usually most trained of the three areas, since he or she has completed additional study after becoming board certified as a cardiovascular or thoracic surgeon.
All of these doctors have an average of seven to nine years training after medical school, but paediatric surgeons may add two more years of fellowship training to this, and anyone specializing in transplant technology may spend more time studying. What is important to understand for the layman is that surgeons who specialize in a particular area treat complex diseases of that area best. Someone specializing in paediatric cardiothoracic surgery is most qualified to repair defects in children’s hearts and a person who has specialized in lung transplant would be the best doctor to see if this is required. Most general cardiac surgeons are logical choices for surgical treatments of adult or acquired heart disease.
There are a number of surgical interventions that may be offered by doctors specializing in cardiothoracic surgery. When grouped all together, these offer a plethora of ways to approach heart or lungs from a surgical perspective. Some of the procedures specialists in cardiothoracic surgery might do include the following:
- Repair or palliation of structural, congenital anomalies of the heart such as ventricular or atrial septal defects, transposition of the great arteries, Tetralogy of Fallot, double ventricle right outlet, mitral regurgitation, tricuspid atresia, or hypoplastic right or left ventricle
- Coronary artery bypass
- Widening of stenotic arteries or scaling of arteries with atherosclerosis
- Removal of heart tissue, especially in cases of cardiomyopathy
- Removal of fluid from the heart
- Repair of damage to the heart or great arteries as created by trauma (like a bullet wound or rupture)
- Removal of fluid or built up material, as from bacteria, from the lungs
- Tumour or growth removal in heart or lungs
These are just a sample of some of the interventions cardiothoracic surgery provides, and increasingly, surgeons share repairs with cardiac interventionists who can do things like widen arteries or place stents in catheterization labs. Interventionists are not surgeons
but they’ve discovered non-surgical methods for addressing heart problems that were once only cured through surgery.
Cardiothoracic surgery has come a long way in the past century particularly in the past decade with the introduction of minimally invasive robotic heart surgery techniques. Now a triple bypass can be performed with minimum risk to the patient, rapid recovery, and with a speedy return to normal, everyday living.