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Cardiothoracic surgery is a field of medicine involved in the surgical treatment of organs inside the thorax (the chest), generally the treatment of conditions of the heart (heart disease) and lungs (lung disease).

History

The development of cardiothoracic surgery has been a significant milestone in the history of medicine. The first successful heart surgery was performed by Dr. Daniel Hale Williams in 1893. The field has evolved significantly with the advent of cardiopulmonary bypass in the 1950s, which allowed for more complex procedures to be performed.

Subspecialties

Cardiothoracic surgery encompasses several subspecialties, including:

• Cardiac surgery: Focuses on the heart and great vessels. Procedures include coronary artery bypass grafting (CABG), heart valve repair or replacement, and heart transplantation.
• Thoracic surgery: Involves surgery of the lungs, esophagus, and other organs in the chest. Common procedures include lobectomy, pneumonectomy, and esophagectomy.
• Congenital heart surgery: Deals with heart defects present from birth. Surgeons perform procedures such as the repair of atrial septal defects and ventricular septal defects.

Common Procedures

Coronary Artery Bypass Grafting (CABG)

CABG is a procedure used to treat coronary artery disease. It involves grafting a blood vessel from another part of the body to bypass a blocked coronary artery, improving blood flow to the heart muscle.

Heart Valve Surgery

Heart valve surgery is performed to repair or replace damaged heart valves. This can involve the mitral valve, aortic valve, tricuspid valve, or pulmonary valve.

Lung Resection

Lung resection involves the removal of a portion of the lung, such as a lobectomy or pneumonectomy, often performed to treat lung cancer.

Esophagectomy

An esophagectomy is the surgical removal of all or part of the esophagus, typically performed to treat esophageal cancer.

Techniques

Open Surgery

Open surgery involves making a large incision to access the heart or lungs. This traditional approach is often used for complex procedures.

Minimally Invasive Surgery

Minimally invasive techniques, such as video-assisted thoracoscopic surgery (VATS) and robotic-assisted surgery, involve smaller incisions and the use of specialized instruments, leading to reduced recovery times and less postoperative pain.

Transcatheter Procedures

Transcatheter procedures, such as transcatheter aortic valve replacement (TAVR), allow for the treatment of certain heart conditions without open surgery, using catheters inserted through blood vessels.

Training and Education

Becoming a cardiothoracic surgeon requires extensive training. After completing medical school, a doctor must complete a general surgery residency followed by a cardiothoracic surgery fellowship. This training can take an additional 6-8 years.

Challenges and Innovations

Cardiothoracic surgery is a rapidly evolving field. Innovations such as artificial hearts, ventricular assist devices, and advancements in imaging technology continue to improve patient outcomes.

See Also

• Cardiology
• Pulmonology
• Vascular surgery

External Links

• American Association for Thoracic Surgery
• Society of Thoracic Surgeons