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  Published: 28/03/2018





Cardiothoracic surgery is the specialty that involves surgical management of conditions of the heart and thorax. Around 60 per cent of adult cardiac surgery involves coronary artery bypass grafting, with most of the remainder comprising valve operations and aortic surgery. Thoracic surgery includes removal of lung cancers, mediastinal tumours, pleurodesis for pneumothorax and decortication for empyema. Some minimally invasive surgery is performed e.g. thoracoscopic procedures and endovascular aortic stenting. The specialty also encompasses heart and lung transplantation.

In paediatric patients, surgery largely involves repair of congenital heart defects, the majority of which are corrected in the first year of life. Acquired valve defects are also dealt with in older children and teenagers.

Cardiothoracic surgery is increasingly semi-elective (inpatients needing surgery) rather than elective (patients from home). There are also some emergency operations (e.g. acute aortic dissection) when on-call. Surgeons also need to be available to re-operate after hours on their own patients (e.g. bleeding after cardiac surgery). All these factors influence lifestyle.

The main difference compared with other surgical specialties is that cardiothoracic surgery usually involves more operating (2 to 3 full days in theatre), longer operations (typically 4-5 hours), and a higher mortality and morbidity rate (about 1 in 25 patients die after cardiac surgery). The specialty requires a high degree of technical skill, mental stamina, and emotional strength.