It’s Medical Monday!

Welcome back, everyone! Behind every successful treatment plan is a team of specialists working together to provide care. Last week, we kicked off our month-long dive into the healthcare professionals who make up an aortic care team. Today, we’ll be discussing cardiac surgeons and their role in diagnosing and managing patients with aortic pathologies. 

From routine valve operations to life-saving emergency procedures, cardiac surgeons play a central role in the treatment of complex aortic conditions. 

What does it take to become a cardiac surgeon?

A cardiac surgeon is a physician who specializes in surgical procedures involving the heart, aorta, and other structures within the chest.

There are a couple of different pathways to becoming a cardiac surgeon, but all require many years of training:

• Four years of medical school

• Five to eight years of general, cardiothoracic, or vascular surgery residency

• Possible two to three additional years of specialized cardiothoracic surgery fellowship training, depending on training pathway

• Many surgeons then pursue additional training in aortic surgery, heart valve surgery, or other advanced areas

There are several pathways one can take to become a cardiac surgeon. Source: Hasasna, I., Rothenberg, P., Awori Hayanga, J.W. (2024). So you Want to Be a Cardiothoracic Surgeon?. In: Gillis, A., Aarons, C.B. (eds) A How To Guide For Medical Students. Success in Academic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-66011-5_8

By the time they begin independent practice, cardiac surgeons have typically completed more than a decade of training after college.

What types of aortic conditions do cardiac surgeons treat?

Cardiac surgeons commonly care for patients with diseases affecting the ascending aorta and aortic arch, the portions of the aorta closest to the heart. Many cardiac surgeons also perform procedures involving the aortic valve, including valve repair and replacement when needed.

More than just surgery

While cardiac surgeons are known for operating, their role often begins long before a patient enters the operating room.

They help determine:

• Whether surgery is needed

• When surgery should be performed

• Which operation is most appropriate

• How to balance surgical risks and long-term benefits

  
  

They work closely with cardiologists, vascular surgeons, anesthesiologists, radiologists, nurses, and advanced practice providers to create a personalized treatment plan.

When Emergency Surgery is Necessary

One of the most critical conditions treated by cardiac surgeons is an acute Type A aortic dissection. As discussed in previous posts, a Type A dissection involves the ascending aorta—the portion of the vessel that sits directly next to the heart. Because this area supplies blood to the coronary arteries, brain, and upper body, complications can develop rapidly.

For this reason, an acute Type A dissection is considered a true surgical emergency and falls squarely within the expertise of cardiac surgeons. These operations often require immediate intervention, sometimes in the middle of the night, to save a patient's life.

The importance of experience

Aortic surgery is among the most technically demanding areas of cardiac surgery. Procedures involving the aortic root, arch, or acute dissection often require specialized techniques and coordination among a highly trained surgical team.

Research has consistently shown that patients tend to have better outcomes when complex aortic procedures are performed at experienced centers with dedicated aortic programs.

Bottom line

Cardiac surgeons are an essential part of the aortic care team. Their extensive training prepares them to manage a wide range of conditions involving the heart and aorta, from elective aneurysm repairs to life-saving operations for acute dissections and other surgical emergencies.

While patients may only meet their cardiac surgeon during a stressful time, these specialists bring years of expertise and experience to some of the most challenging conditions in cardiovascular medicine.

Tomorrow, we'll be discussing the other half of the surgical aortic care team: vascular surgeons. In the meantime, Think Aorta!

Till next time,

Anirudh Karla