What Conditions Do Cardiac Surgeons Treat?
Cardiac surgery, also known as cardiothoracic surgery, involves surgical procedures performed on the heart, major blood vessels such as the aorta, and surrounding structures within the chest. This specialized field plays a critical role in treating life-threatening cardiovascular conditions through advanced surgical interventions. Common procedures include heart transplantation (commonly referred to as "heart replacement"), congenital heart defect repair, valve repair or replacement, coronary artery bypass grafting (CABG), and surgeries involving the large vessels of the heart and aorta.
Major Heart Conditions Treated by Cardiac Surgery
Cardiac surgeons address a wide range of diseases that affect the heart's structure and function. These conditions are generally categorized based on their origin: congenital defects, acquired valve disorders, coronary artery disease, aortic and vascular diseases, and other structural abnormalities.
Congenital Heart Defects
Congenital heart diseases are structural problems present at birth and often require surgical correction early in life. Common examples include atrial septal defect (ASD), ventricular septal defect (VSD), tetralogy of Fallot, and patent ductus arteriosus (PDA). These defects disrupt normal blood flow through the heart and can lead to serious complications if left untreated. Pediatric and adult cardiac surgeons work together to repair these anomalies using techniques tailored to the patient's age and condition.
Valvular Heart Disease
Heart valve disorders occur when one or more of the heart's four valves—mitral, aortic, tricuspid, or pulmonary—fail to open or close properly. Conditions such as mitral stenosis, mitral regurgitation, aortic stenosis, aortic insufficiency, and pulmonary valve stenosis can severely impair heart function over time. Surgical treatments may involve valve repair or replacement with mechanical or biological prostheses, depending on the patient's profile and long-term goals.
Coronary Artery Disease (CAD)
One of the most common reasons for cardiac surgery is severe coronary artery disease, where plaque buildup narrows multiple coronary arteries, reducing blood flow to the heart muscle. For patients with multi-vessel disease or complex blockages, coronary artery bypass grafting (CABG) remains a gold-standard treatment. This procedure uses healthy blood vessels from another part of the body to create new pathways around blocked arteries, restoring adequate oxygen supply to the heart.
Aortic and Major Vascular Diseases
The aorta, the body's main artery, can develop life-threatening conditions such as thoracic aortic aneurysms and aortic dissection. These require urgent surgical intervention to prevent rupture or catastrophic internal bleeding. Surgeons may use open-chest techniques or endovascular approaches, including stent grafts, to repair damaged sections of the aorta and stabilize the patient.
Other Structural Heart and Pericardial Conditions
Beyond the more common diagnoses, cardiac surgeons also manage rare but serious conditions such as chronic constrictive pericarditis—a condition where the pericardium becomes stiff and restricts heart movement—and primary heart tumors like cardiac myxoma, which can cause embolism or obstruct blood flow. Surgical removal is often necessary and curative in these cases.
Evolution Toward Minimally Invasive Cardiac Surgery
Historically, traditional cardiac surgery required a median sternotomy—splitting the breastbone down the middle with a saw—to access the heart. While effective, this approach caused significant postoperative pain, longer hospital stays, and extended recovery times due to trauma to the chest wall and sternum.
Since the 1990s, advancements in technology and surgical techniques have led to the rise of minimally invasive cardiac surgery (MICS). These modern approaches use smaller incisions between the ribs or partial upper sternotomies, avoiding full division of the sternum. Benefits include reduced pain, lower risk of infection, shorter ICU and hospital stays, faster return to daily activities, and improved cosmetic outcomes.
Procedures such as minimally invasive valve replacements, robotic-assisted heart surgery, and hybrid coronary revascularization exemplify how innovation continues to enhance patient care. With ongoing developments in imaging, robotics, and anesthesia, today's cardiac surgeries are safer and less invasive than ever before.
As medical science progresses, the field of cardiac surgery continues to evolve, offering hope and improved quality of life for millions suffering from complex heart and vascular diseases worldwide.