Do cardiologists have to do surgery?
Cardiology
All cardiologists study the disorders of the heart, but the study of adult and child heart disorders are through different training pathways. Therefore, an adult cardiologist (often simply called "cardiologist") is inadequately trained to take care of children, and pediatric cardiologists are not trained to take care of adult heart disease. The surgical aspects are not included in cardiology and are in the domain of cardiothoracic surgery. For example, coronary artery bypass surgery (CABG), cardiopulmonary bypass and valve replacement are surgical procedures performed by surgeons, not cardiologists. However the insertion of stents and pacemakers are performed by cardiologists
Percutaneous coronary intervention
Coronary angioplasty is widely practiced and has a number of risks; however, major procedural complications are uncommon. Coronary angioplasty is usually performed using invasive catheter-based procedures by an interventional cardiologist, a medical doctor with special training in the treatment of the heart.
Cath lab
The consultant cardiologist is responsible for gaining arterial access, inserting a sheath into either the radial or femoral artery, passing a wire and catheter into the coronary artery and selectively injecting contrast media into the coronary arteries. They then interpret the images taken to ascertain where the narrowed or blocked artery has the problem. They use a variety of techniques and imaging tools to work the size of things such as balloons and stents.
Transplant surgeon
At smaller (Level II or III) institutions in smaller cities, it is still often possible to perform renal and corneal transplantation (especially on adults), and do skin grafts; the extent of their services varies with the personnel and the organ at stake (hearts, livers, and lungs have extensive arterial, venous, and capillary vasculature, extensive connections to muscle, fascia, and connective tissue, connections to ligaments, tendons, and other body parts, and numerous small parts and nerves and nerve junctions, require a number of anastomoses, or joining of tissues, and are near other important structures).
Henry Dalton
Despite these new accomplishments, Dalton and other early cardiac surgeon received little recognition for the successful surgeries they performed and surgeons still thought they should not perform surgery on the heart. Heart surgery would not be widely accepted among surgeons until World War II broke out and forced battlefield surgeons to improve their methods of surgery in order to repair severe war wounds. Despite the earlier lack of recognition for his accomplishments, Dalton later received good recognition for his role in revolutionizing cardiac surgery.
Cardiac surgery
Open-heart surgery is any kind of surgery in which a surgeon makes a large incision (cut) in the chest to open the rib cage and operate on the heart. "Open" refers to the chest, not the heart. Depending on the type of surgery, the surgeon also may open the heart.
Heart nanotechnology
With people that have heart disease or that have suffered a heart attack, their hearts are often damaged and weakened. The more minor forms of heart failure do not require surgery and are often treated with medications ("WebMD - Better Information. Better Health"). The use of nanotechnology on treating damaged hearts will not replace these milder heart problems, but rather the more serious heart problems that currently require surgery or sometimes even heart transplants.
Hypoplastic right heart syndrome
With a series of operations or even a heart transplant, a newborn can be treated but not be cured. Young individuals who have undergone reconstructive surgery must refer to a cardiologist who is experienced in congenital heart diseases, "Children with HLHS are at an increased level for developing endocarditis." Kids that have been diagnosed with HRHS must limit the physical activity they participate in to their own endurance level.
Lourdes Heart institute
LHINC provides cardiac surgery in adult patients including coronary artery bypass surgery, both on pump and off pump surgery, aortic surgery, valve replacement and repair and endovascular aortic stent procedure. The unit did for the first time in Kerala, 'key hole' mitral valve replacement surgery on two patients.
Dextro-Transposition of the great arteries
The heart and vessels are accessed via median sternotomy, and a cardiopulmonary bypass machine is used; as this machine needs its "circulation" to be filled with blood, a child will require a blood transfusion for this surgery. The procedure involves transecting both the aorta and pulmonary artery; the coronary arteries are then detached from the aorta and reattached to the neo-aorta, before "swapping" the upper portion of the aorta and pulmonary artery to the opposite arterial root. Including the anaesthesia and immediate post operative recovery, this surgery takes an average of approximately six to eight hours to complete.
Outline of cardiology
Cardiology – branch of medicine dealing with disorders of the human heart. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology. Physicians who specialize in this field of medicine are called cardiologists, a specialty of internal medicine.
Heart–lung transplant
The patient is connected to a heart–lung machine, which circulates and oxygenates blood. The surgeon removes the failing heart and lungs. Most surgeons endeavour to cut blood vessels as close as possible to the heart to leave room for trimming, especially if the donor heart is of a different size than the original organ.
Perfusionist
Perfusionists form part of the wider cardiothoracic surgical team which includes cardiac surgeons, anesthesiologists and physician assistants. The perfusionist shares responsibility with the cardiac surgeon and anesthesiologist for the management of the physiological and metabolic needs of the cardiac surgical patient, so that the surgeon may operate on a still,or unbeating heart during certain procedures. The cardiac surgeon is in overall command of the operation. This is accomplished through the utilization of the heart–lung machine, as well as its associated components of an oxygenator, filters, reservoirs and tubing. The perfusionist is responsible for the management of circulatory and respiratory functions of the patient which has a great effect on the patient systemic condition and allows the cardiac surgeon to focus on the actual surgical procedure and less on the immediate needs of the patient. Other responsibilities include autologous blood collection and processing, implementation and management of the intra-aortic balloon pump, and management of extracorporeal membrane oxygenation, as well as monitoring of anticoagulation, electrolyte, acid-base balance and blood-gas composition. In many tertiary hospitals, perfusionists are also key personnel in placing and managing patients on ventricular assist devices as a bridge to recovery or heart transplantation and supporting patients receiving lung or liver transplants. In some hospitals, perfusionists can be involved in procurement of cardiothoracic donor organs for transplantation.
Physical therapy
Cardiovascular and pulmonary rehabilitation respiratory practitioners and physical therapists offer therapy for a wide variety of cardiopulmonary disorders or pre and post cardiac or pulmonary surgery. An example of cardiac surgery is coronary bypass surgery. Primary goals of this specialty include increasing endurance and functional independence. Manual therapy is used in this field to assist in clearing lung secretions experienced with cystic fibrosis. Pulmonary disorders, heart attacks, post coronary bypass surgery, chronic obstructive pulmonary disease, and pulmonary fibrosis, treatments can benefit from cardiovascular and pulmonary specialized physical therapists.
Cardiac surgery
Another important source of complications are the neuropsychological and psychopathologic changes following open-heart surgery. One example is , described by Victor Skumin in 1978, which is a "cardioprosthetic psychopathological syndrome" associated with mechanical heart valve implants and characterized by irrational fear, anxiety, depression, sleep disorder, and weakness.
University of Ottawa Heart Institute
The institute's cardiologists conduct more than 12,000 non-surgical interventions annually.
Bloodless surgery
During the early 1960s, American heart surgeon Denton Cooley successfully performed numerous bloodless open-heart surgeries on Jehovah's Witness patients. Fifteen years later, he and his associate published a report of more than 500 cardiac surgeries in this population, documenting that cardiac surgery could be safely performed without blood transfusion.
Nasiriyah Heart Center
The cardiac surgery department is headed by two senior surgeons, Dr. Aqeel Salman and Dr. Hussein Hashim, two registering surgeons, Dr. Rafid Hameed & Munaf Mohammed, and seven cardiothoracic residents. There is a surgical ward with a capacity of 18 beds, an intermediate ward with 6 beds, a surgical ICU, fully equipped, with a capacity of 12 patients, and 4 operating rooms. The surgical department usually does valve replacement surgeries, coronary artery bypass grafting, and repair of congenital heart defects. The department also has teams that help with surgeries and staff development.
Sheng Jing Hospital
Cardio-surgery
Cardiothoracic surgery
Cardiothoracic surgery (also known as thoracic surgery) is the field of medicine involved in surgical treatment of organs inside the thorax (the chest)—generally treatment of conditions of the heart (heart disease) and lungs (lung disease). In most countries, cardiac surgery (involving the heart and the great vessels) and general thoracic surgery (involving the lungs, esophagus, thymus, etc.) are separate surgical specialties; the exceptions are the United States, Australia, New Zealand, and some EU countries, such as the United Kingdom and Portugal.
Sri Jayadeva Institute of Cardiology
Average interventional cardiology workload ranges between 50-60 cases a day of which 150-180 cases per month are percutaneous coronary interventions, there are four Philips digital Cath labs, of which one is the only swing Cath lab in the region, enabling large case volumes and more efficient patient care. SJIC interventional cardiology includes both adult and pediatric cardiology, and every form of interventional procedure, from primary angioplasty, to septal ablation "(Sigwart procedure)" is performed on a regular basis. It has the distinction of performing the highest number of percutaneous mitral valvlotomy procedures in the world for stenosis of the mitral valve. Pediatric cardiology in SJIC performs all standard pediatric interventional procedures, including percutaneous closure for Atrial septal defect, ventricular septal defect and also the relatively rare procedure of percutaneous closure of perimembranous ventricular septal defects.
The angioplasty work carried out in hospital is around 32000 per year the highest in India for a government set up.The institute boasts of the latest instruments and for most of the latest procedures in cardiology or Cath Lab,it is the pioneer in India.
Narayana Institute of Cardiac Sciences
NICS is equipped with 23 cardiac operating theaters, five digital catheterisation laboratories including a hybrid catheterisation laboratory, and 200 critical care beds for post-operative care. NICS also has one of the largest pediatric intensive care units in the world.☃☃ The hospital has performed free cardiac procedures for children and successfully treated heart problems on newborns, as well as adults, from several countries. NICS is equipped to perform up to 60 heart surgeries per day.☃☃ The cardiac procedures that are performed in NICS include complex heart valve repair, coronary artery bypass graft, pulmonary endartectomy for chronic pulmonary embolism, Ross procedure, ventricular aneurysm repair, left ventricular remodeling and Dor procedure, electrophysiology and left ventricular assist device (LVAD) implant.
Interventional cardiology
The main advantages of using the interventional cardiology or radiology approach are the avoidance of the scars and pain, and long post-operative recovery. Additionally, interventional cardiology procedure of primary angioplasty is now the gold standard of care for an acute myocardial infarction. It involves the extraction of clots from occluded coronary arteries and deployment of stents and balloons through a small hole made in a major artery, which has given it the name ""pin-hole" surgery" (as opposed to ""key-hole" surgery").
Open heart surgery of the heart is performed by a cardiothoracic surgeon. Some interventional cardiology procedures are only performed when there is cardiothoracic surgery expertise in the hospital, in case of complications.
Perfusionist
A perfusionist, also known as a Clinical Perfusionist, Cardiovascular Perfusionist, Clinical Perfusion Scientist, or Medical Perfusionist, is a healthcare professional who uses the cardiopulmonary bypass machine (heart–lung machine) during cardiac surgery and other surgeries that require cardiopulmonary bypass to manage the patient's physiological status.
Cardiopulmonary rehabilitation
Cardiac rehabilitation (CR) is a branch of rehabilitation medicine/Physical Therapy dealing with optimizing physical function in patients with cardiac disease or recent cardiac surgeries. CR services can be provided during hospitalization for the event or in an outpatient setting. While the "glue" of cardiac rehabilitation is exercise, programs are evolving to become comprehensive prevention centers where all aspects of preventive cardiology care are delivered. This includes nutritional therapies, weight loss programs, management of lipid abnormalities with diet and medication, blood pressure control, diabetes management, and stress management. CR exercise and prevention programs are supported by the American Heart Association and the American College of Cardiology.
History of invasive and interventional cardiology
Another source of controversy in the field of interventional cardiology is the overlapping roles of PCI and coronary artery bypass surgery for individuals with coronary artery disease. This area has been studied in a number of trials since the early 1990s. Unfortunately, due to the rapid changes in technique in both bypass surgery as well as PCI, added to the better understanding of the role of intense pharmacologic therapy in individuals with coronary artery disease, questions still remain on the best form of therapy in many subgroups of patients. Multiple ongoing studies hope to tease out which individuals do better with PCI and which do better with CABG, but in general each case is individualized to the patient and the relative comfort level of the interventional cardiologist and the cardiothoracic surgeon.
Echocardiography
A stress echocardiogram, also known as a stress echo, uses ultrasound imaging of the heart to assess the wall motion in response to physical stress. First, images of the heart are taken "at rest" to acquire a baseline of the patient's wall motion at a resting heart rate. The patient then walks on a treadmill or uses another exercise modality to increase the heart rate to his or her target heart rate, or 85% of the age-predicted maximum heart rate (220 − patient's age). Finally, images of the heart are taken "at stress" to assess wall motion at the peak heart rate. A stress echo assesses wall motion of the heart; it does not, however, create an image of the coronary arteries directly. Ischemia of one or more coronary arteries could cause a wall motion abnormality, which could indicate coronary artery disease. The gold standard test to directly create an image of the coronary arteries and directly assess for stenosis or occlusion is a cardiac catheterization. A stress echo is not invasive and is performed in the presence of a licensed medical professional, such as a cardiologist, and a cardiac sonographer.
Heart
If the narrowings in coronary arteries are unsuitable for treatment with a percutaneous coronary intervention, open surgery may be required. A coronary artery bypass graft can be performed, whereby a blood vessel from another part of the body (the saphenous vein, radial artery, or internal mammary artery) is used to redirect blood from a point before the narrowing (typically the aorta) to a point beyond the obstruction.
Cardiothoracic anesthesiology
Fellows are trained to provide perioperative anesthetic management for patients with severe cardiopulmonary pathology. Some of the cardiac surgeries they train for include the following: coronary artery bypass surgery (CABG) both on cardiopulmonary bypass as well as on a beating heart, heart valve surgery, aortic reconstruction requiring deep hypothermic arrest, mechanical ventricular assist device (VAD) placement, thoracic aortic aneurysm repair, aortic dissection repair, heart transplants, lung transplants, heart/lung transplants, and adult congenital heart surgery.
Cardiac fibroma
Cardiac fibroma is commonly treated through surgical excision procedures. The removal of cardiac tumors require an open heart surgery. During the surgery, the surgeon removes the tumor and tissues around it to reduce the risk of the tumor returning. A heart-lung machine is used to take over the work of the heart and lungs because surgery is complicated and requires a still heart. The recovery is usually between 4–5 days in the hospital and 6 weeks in total. An echocardiogram is taken every year to make sure the tumor has not returned or formed any new growth.
Nawaz Sharif
Sharif underwent heart surgery in May 2016 in London. It was his second open-heart operation. His deteriorating health forced him to undergo an open heart surgery only three days before the presentation of the country's annual budget. Many opposition leaders and the legal fraternity, including former Chief Justice Iftikhar Muhammad Chaudhry, raised questions about a possible constitutional crisis in Pakistan. Chaudhry called for electing a new interim prime minister to avoid the crisis.
Catheter ablation
For atrial fibrillation, several experienced teams of electrophysiologists in US heart centers claim they can achieve up to a 75% success rate. However one recent study claims that the success rates are in fact much lower – at 28% for single procedures. Often, several procedures are needed to raise the success rate to the 70–80% range. One reason for this may be that once the heart has undergone atrial remodeling as in the case of chronic atrial fibrillation sufferers, largely 50 and older, it is much more difficult to correct the 'bad' electrical pathways. Young people with AF with paroxysmal, or intermittent, AF therefore have an increased chance of success with an ablation since their heart has not undergone atrial remodeling yet.
Minimally invasive cardiac surgery
After a minimally invasive procedure, patients recover more quickly than from sternotomy and suffer fewer complications. Most patients can expect to resume everyday activities within a few weeks of their operation. After surgery, patients are administered an anaesthetic pain pump and drains that will be removed prior to discharge. Patients are encouraged to move around as much as possible after their operation to recover quickly. Once discharged from hospital, patients require no further post-operative assistance.
Cardiology
Cardiology is a specialty of internal medicine. To be a cardiologist in the United States, a three-year residency in internal medicine is followed by a three-year fellowship in cardiology. It is possible to specialize further in a sub-specialty. Recognized sub-specialties in the United States by the ACGME are cardiac electrophysiology, echocardiography, interventional cardiology, and nuclear cardiology. Recognized subspecialties in the United States by the American Osteopathic Association Bureau of Osteopathic Specialists (AOABOS) include clinical cardiac electrophysiology and interventional cardiology.
General surgery
Most cardiothoracic surgeons in the U.S. (D.O. or M.D.) first complete a general surgery residency (typically 5–7 years), followed by a cardiothoracic surgery fellowship (typically 2–3 years).
Respiratory therapist
Respiratory Therapists are able to fulfill the role of Perfusionist with appropriate training. The perfusionist is a highly trained member of the cardiothoracic surgical team (often time an RT with extra training) which consists of cardiac surgeons, anesthesiologists, physician assistants, surgical technicians, other Respiratory Therapists, and nurses. The perfusionist's main responsibility is to support the physiological and metabolic needs of the cardiac surgical patient so that the cardiac surgeon may operate on a still, unbeating heart. Perfusionist certifications are maintained and awarded by The American Board of Cardiovascular Perfusion.
Physical examination
While the format of examination as listed below is largely as taught and expected of students, a specialist will focus on their particular field and the nature of the problem described by the patient. Hence a cardiologist will not in routine practice undertake neurological parts of the examination other than noting that the patient is able to use all four limbs on entering the consultation room and during the consultation become aware of their hearing, eyesight, and speech. Likewise an orthopaedic surgeon will examine the affected joint, but may only briefly check the heart sounds and chest to ensure that there is not likely to be any contraindication to surgery raised by the anaesthetist. A primary care physician will also generally examine the male genitals but may leave the examination of the female genitalia to a gynecologist.
Organ replacement in animals
Open-heart surgery for dogs requires a six- to eight-person team to carefully monitor the patient before and during the invasive surgery. The entire surgery lasts five hours, during which time the dog is connected to a blood oxygenator and the heart is bypassed. The defective heart valve is removed and the replacement valve, typically from bovine pericardium, is precisely sewn into place. The dog’s heart is then restarted and monitored for at least two hours after the surgery is completed. Due to the expense, this is not a common procedure.
Cardiotomy
A cardiotomy is a surgical procedure where an incision is made in the heart.
Sri Sathya Sai Institute of Higher Medical Sciences, Puttaparthi
The CTVS department in the hospital conducts all types of cardiac surgeries, except heart transplants. One-third of the cardiac surgeries are congenital heart diseases, one-third valve replacements/repair and the remaining, coronary revascularizations with 90% of them being off-pump procedures.
Minimally invasive direct coronary artery bypass surgery
MIDCAB is a form of off-pump coronary artery bypass surgery (OPCAB), performed "off-pump" - without the use of cardiopulmonary bypass (the heart-lung machine). MIDCAB differs from OPCAB in the type of incision used for the surgery; with traditional CABG and OPCAB a median sternotomy (dividing the breastbone) provides access to the heart; with MIDCAB, the surgeon enters the chest cavity through a mini-thoracotomy (a 2-to-3 inch incision between the ribs).
Multan Institute of Cardiology
The project of establishing a state of the art tertiary care center for cardiac patients went through various ups and downs in its early days. It was the desire of millions of people living in south Punjab yet was delayed by bureaucracy. In early 2003, Ch Pervaiz Elahi, the honorable Chief Minister of Punjab, took it the center as one of his top priority development projects. The seriousness of his resolve manifested itself when he appointed Col. (Ret) Prof M A Cheema as the Project Director of MIC. Prof. M A Cheema is one of the pioneers of cardiac surgery in Pakistan and had previously established Cardiac Surgery in the Mayo Hospital and Punjab Institute of Cardiology Lahore. Under his leadership the project moved forward with great success and its outdoor service started functioning in 2005. The indoor service was also established within less than one year after the formal opening of the outdoor service. Prof. Cheema carefully built up the team of clinicians for this young institute. He managed to bring local and expatriate experts in the fields of cardiology, cardiac surgery and anesthesia who played a vital role in establishing world class services within such a short period of time. The notable personalities who joined the institute as a result of Prof. Cheema's motivation included Prof Haider Zaman (Cardiac Surgeon), Dr. Anjum Jalal (Cardiac Surgeon) Dr. Bilal Qureshi (Cardiologist), Dr. Haroon Babar (Cardiologist) and Dr. Rana Altaf Ahmed (Anesthetist). The first open heart surgery was performed on 29 October 2007 and by March 2008 over 50 open heart operations were conducted without any surgical mortality.
Pulmonology
Surgery of the respiratory tract is generally performed by specialists in cardiothoracic surgery (or thoracic surgery), though minor procedures may be performed by pulmonologists. Pulmonology is closely related to critical care medicine when dealing with patients who require mechanical ventilation. As a result, many pulmonologists are certified to practice critical care medicine in addition to pulmonary medicine. There are fellowship programs that allow physicians to become board certified in pulmonary and critical care medicine simultaneously. Interventional pulmonology is a relatively new field within pulmonary medicine that deals with the use of procedures such as bronchoscopy and pleuroscopy to treat several pulmonary diseases. Interventional pulmonology is increasingly recognized as a specific medical specialty.
Cardiac surgery
The first successful intracardiac correction of a congenital heart defect using hypothermia was performed by Drs. C. Walton Lillehei and F. John Lewis at the University of Minnesota on 2 September 1952. In 1953, Alexander Alexandrovich Vishnevsky conducted the first cardiac surgery under local anesthesia. In 1956, Dr. John Carter Callaghan performed the first documented open-heart surgery in Canada.
Minimally invasive cardiac surgery
Minimally Invasive Cardiac Surgery, also known as MICS CABG (Minimally Invasive Cardiac Surgery/Coronary Artery Bypass Grafting) or The McGinn Technique is heart surgery performed through several small incisions instead of the traditional open-heart surgery that requires a median sternotomy approach. MICS CABG is a beating-heart multi-vessel procedure performed under direct vision through an anterolateral mini-thoracotomy.
Adventist HealthCare Washington Adventist Hospital
Washington Adventist Hospital expanded its cardiac services in 2010, adding a new medical director of cardiac surgery and team of surgeons from Cardiac Vascular and Thoracic Surgery Associates (CVTSA)
Washington Adventist Hospital was the first in the region to perform open-heart surgery and numerous cardiac procedures, including mitral valvuloplasty, and the first in the mid-Atlantic to perform a revolutionary type of surgery called Mini- Maze that can correct atrial fibrillation (AF), a common form of heart rhythm abnormality and a major cause of stroke.
Perfusion
During major surgery, especially cardiothoracic surgery, perfusion must be maintained and managed by the health professionals involved, rather than left to the body's homeostasis alone. As the lead surgeons are often too busy to handle all hemodynamic control by themselves, specialists called perfusionists manage this aspect. There are more than one hundred thousand perfusion procedures annually.
Cardiothoracic surgery
Pediatric cardiovascular surgery is surgery of the heart of children.The first operations to repair cardio-vascular defects in children were performed by Clarence Crafoord in Sweden when he repaired coarctation of the aorta in a 12-year-old boy. The first attempts to palliate congenital heart disease were performed by Alfred Blalock with the assistance of William Longmire, Denton Cooley, and Blalock's experienced technician, Vivien Thomas in 1944 at Johns Hopkins Hospital. Techniques for repair of congenital heart defects without the use of a bypass machine were developed in the late 1940s and early 1950s. Among them was an open repair of an atrial septal defect using hypothermia, inflow occlusion and direct vision in a 5-year old child performed in 1952 by Lewis and Tauffe. C. Walter Lillihei used cross-circulation between a boy and his father to maintain perfusion while performing a direct repair of a ventricular septal defect in a 4 year old child in 1954. He continued to use cross-circulation and performed the first corrections of tetratology of Fallot and presented those results in 1955 at the American Surgical Association. In the long-run, pediatric cardiovascular surgery would rely on the cardiopulmonary bypass machine developed by Gibbon and Lillehei as noted above.
Circulatory system
Many diseases affect the circulatory system. This includes cardiovascular disease, affecting the cardiovascular system, and lymphatic disease affecting the lymphatic system. Cardiologists are medical professionals which specialise in the heart, and cardiothoracic surgeons specialise in operating on the heart and its surrounding areas. Vascular surgeons focus on other parts of the circulatory system.
Adventist HealthCare Washington Adventist Hospital
Washington Adventist Hospital also claims to be a recognized leader in the transradial approach to cardiac catheterizations, which allows interventional cardiologists to use an artery in the wrist to gain access to heart arteries. In November 2013, the hospital became the first Transradial Catheterization Training Center in Maryland, allowing physicians from around the country to learn from Washington Adventist Hospital cardiologists how to perform this innovative, interventional heart procedure.
Washington Adventist Hospital’s board-certified cardiologists, electrophysiologists, interventional radiologists and cardiac and vascular surgeons provide the following cardiac and vascular care.
Cardiology
The main advantages of using the interventional cardiology or radiology approach are the avoidance of the scars and pain, and long post-operative recovery. Additionally, interventional cardiology procedure of primary angioplasty is now the gold standard of care for an acute Myocardial infarction. This procedure can also be done proactively, when areas of the vascular system become occluded from Atherosclerosis. The Cardiologist will thread this sheath through the vascular system to access the heart. This sheath has a balloon and a tiny wire mesh tube wrapped around it, and if the cardiologist finds a blockage or Stenosis, they can inflate the balloon at the occlusion site in the vascular system to flatten or compress the plaque against the vascular wall. Once that is complete a Stent is placed as a type of scaffold to hold the vasculature open permanently.
Cardiac surgery
The procedure is typically performed because of coronary artery disease (CAD), in which a plaque-like substance builds up in the coronary artery, the main pathway carrying oxygen-rich blood to the heart. This can cause a blockage and/or a rupture, which can lead to a heart attack.
University of Ottawa Heart Institute
UOHI’s cardiac surgeons perform more than 1,400 open-heart procedures annually, and the institute is known for its reconstructive heart-valve surgery program. Dr Marc Ruel is the Chief of Cardiac Surgery. It has among the lowest mortality rates and largest patient volumes in North America, especially for high-risk patients. Surgical specialties include:The Heart Institute is the provincial centre for pulmonary thromboendarterectomy.
Median sternotomy
Median sternotomy is often mistakenly referred to as open heart surgery, in which it is a preliminary step. However, open heart additionally involves incision of the pericardium, and many median sternotomy procedures do not require this. Open heart usually involves the use of a cardiopulmonary bypass, also known as a heart-lung machine.
Heart
Cardiovascular diseases, which include diseases of the heart, are the leading cause of death worldwide. The majority of cardiovascular disease is noncommunicable and related to lifestyle and other factors, becoming more prevalent with ageing. Heart disease is a major cause of death, accounting for an average of 30% of all deaths in 2008, globally. This rate varies from a lower 28% to a high 40% in high-income countries. Doctors that specialise in the heart are called cardiologists. Many other medical professionals are involved in treating diseases of the heart, including doctors such as general practitioners, cardiothoracic surgeons and intensivists, and allied health practitioners including physiotherapists and dieticians.
Bernard Lown
The DC defibrillator provided a new approach for resuscitating patients. It also paved the way for new possibilities in cardiac surgery. The Lown clinical group were the first to use the defibrillator and cardioverter at Peter Bent Brigham Hospital. Donald B. Effler, was the first cardiac surgeon to use the DC defibrillator in 1962 at the Cleveland Clinic. According to Effler, this advance made possible modern cardiac surgery. Indeed, in 1967, Rene Favoloro performed what is regarded as the first coronary artery bypass operation in Effler’s surgical department at Cleveland Clinic. DC defibrillation provided a safe way to restore a normal heart rhythm during the surgical bypass of obstructed coronary arteries.
Perfusionist
Perfusionists can be involved in a number of cardiac surgical procedures, select vascular procedures and a few other surgical procedures in an ancillary role. In the realm of cardiac surgery, perfusionists perform cardiopulmonary bypass in adult and pediatric surgical procedures, which constitute the majority of procedures that perfusionists perform.
Coronary artery bypass surgery
CABG is performed to relieve angina unsatisfactorily controlled by maximum tolerated anti-ischemic medication, prevent or relieve left ventricular dysfunction, and/or reduce the risk of death. CABG does not prevent myocardial infarction (heart attack). This surgery is usually performed with the heart stopped, necessitating the usage of cardiopulmonary bypass. However, two alternative techniques are also available, allowing CABG to be performed on a beating heart either without using the cardiopulmonary bypass, a procedure referred to as "off-pump" surgery, or performing beating surgery using partial assistance of the cardiopulmonary bypass, a procedure referred to as "on-pump beating" surgery. The latter procedure offers the advantages of the on-pump stopped and off-pump while minimizing their respective side-effects.
Hybrid cardiac surgery
For congenital cardiac malformations, even though surgery remains the treatment of choice, interventional cardiology approaches are increasingly being used. However, such percutaneous approaches can be challenging or even impossible because of difficult and complex anatomies (such as double-outlet right ventricle, or transposition of the great arteries, acute turns or kinks in the pulmonary arteries of tetralogy of Fallot patients) and patient characteristics/ complications (low weight, poor vascular access, induced rhythm disturbances, hemodynamic compromise). Nevertheless, surgery has its limitations, so that combining interventions and surgery into a single therapeutic procedure potentially leads to reduction of complexity, cardiopulmonary bypass time, risk, and to improved outcomes.
Another important concept in hybrid procedures is completion angiography, as described above, which in the case of congenital heart disease surgery may detect residual structural lesions, thus reduce postoperative complications. Again, 3D imaging using rotational angiography should be the concept of choice. Completion angiography in a hybrid OR may even induce a reduction of contrast media and ionizing radiation dose applied to the patient, as it reduces the need for post-operative examination. Further dose reduction can be achieved with a combination of intraoperative rotational angiography and intraoperative MRI, when both a fixed C-arm and a MRI system are available in the surgical theatre, and MRI adds functional information.
Cardioplegia
The word "cardioplegia" combines the Greek "cardio" meaning the "heart", and "plegia" "paralysis". Technically, this means arresting or stopping the heart so that surgical procedures can be done in a still and bloodless field. Most commonly, however, the word "cardioplegia" refers to the solution used to bring about asystole of the heart, or heart paralysis. One of the first physicians to use the term cardioplegia was Dr. Lam in 1957. However his work on the myocardial protection was preceded serendipitously by Sidney Ringer in the late 1800s. At that time Ringer and colleagues noticed that tap water had the ability to increase contractility of the heart, likely due its high calcium content. Sidney Ringer also commented on the importance of potassium ion concentration on depressing intrinsic heart rhythm. Through a series of experiments performed on frog and canine hearts, reversible arrest was achieved with potassium ions with the consequence of ventricular fibrillation and observed myocardial necrosis. These early experiments started nearly 50 years of work that has led to variety of perfusion strategies available today.
Cardiac surgery
In order to assess the performance of surgical units and individual surgeons, a popular risk model has been created called the EuroSCORE. It takes a number of health factors from a patient and, using precalculated logistic regression coefficients, attempts to quantify the probability that they will survive to discharge. Within the United Kingdom, the EuroSCORE was used to give a breakdown of all cardiothoracic surgery centres and to indicate whether the units and their individuals surgeons performed within an acceptable range. The results are available on the Care Quality Commission website.
Perfusionist
In New Zealand there are only Clinical Perfusionists who perform perfusion in heart surgery. A Clinical Perfusionist must have at least a science degree(usually Clinical/Health Sciences) as an entry requirement, before training. Further didactic training is in a practical/clinical format, at a hospital, whilst doing a three-year course via correspondence with the Australian and New Zealand College of Perfusionists. Final examination for a Clinical Perfusionists, is administered by the ANZCP over two days. This involves a three hour written, two hour multiple choice and four half hour viva voce questions.
William B. Kouwenhoven
The news of Kouwenhoven's finding began altering the approach to cardiac care. Despite the high risks of the procedure, it was used by doctors at Case Western School of Medicine. In 1947, Claude Beck, M.D., became the first surgeon ever to place electrodes directly on a heart that was in ventricular fibrillation during a surgery. Kouwenhoven's studies also influenced the Division of Anesthesiology at Johns Hopkins School of Medicine. In the 1940s, researchers James Elam and Peter Safir perfected the emergency mouth-to-mouth method of lung ventilation, which is essential for oxygenating the blood when the heart is no longer functioning.
In 1950, Kouwenhoven began his research on a closed-chest defibrillator. Alfred Blalock, the Chief of Surgery at the time, was dubious at first regarding Kouwenhoven's ideas. However, he soon agreed to provide laboratory space and equipment for Kouwenhoven's studies. At first, Kouwenhoven and his team monitored the effect of electrodes on the opposite sides of the chest. They noted that a brief AC current of 20 amperes was able to jolt a heart from ventricular fibrillation back into a normal sinus rhythm. Samuel Talbot, a surgeon who was studying heart arrhythmias in dogs at the time, asked Kouwenhoven to merge his research on a defibrillator with Talbot's studies. Afterwards, Kouwenhoven observed that the current flowed best vertically instead of horizontally when passed through a dog's heart. By noticing this, he was able to decrease the shock's intensity by 50 percent.
Lawrence H. Cohn
Having performed over 11,000 cardiac surgical operations, Cohn is an expert in the field of heart valve repair and replacement surgery and minimally invasive heart valve surgery. He has published over 440 original scientific articles, 105 book chapters and 12 books, including "Cardiac Surgery in the Adult", the most referenced text book in adult cardiac surgery today. He has given more than 750 lectures worldwide. He has held or holds office in the American Board of Thoracic Surgery (ABTS), the American College of Cardiology, and the American Association for Thoracic Surgery of which he was President. In 1999, he presented pioneering cardiac surgeon Dr. Michael E. DeBakey with the Scientific Achievement Award of The American Association for Thoracic Surgery.He has also been the President of the American College of Chest Physicians and Chairman of the Board of the National Library of Medicine in Bethesda, Maryland. He is Past-President of the Thoracic Surgery Foundation for Research and Education. He is a member of 20 other professional organizations, and holds honorary membership in 4 international organizations. He has served on the Editorial Board of 14 medical journals. He is currently the editor of the "Journal of Thoracic and Cardiovascular Surgery", the most referenced journal in the field of cardiothoracic surgery. .
Cardiac surgery
A major concern with cardiac surgery is neurological damage. Stroke occurs in 2–3% of all people undergoing cardiac surgery, and the rate is higher in patients with other risk factors for stroke. A more subtle complication attributed to cardiopulmonary bypass is postperfusion syndrome, sometimes called "pumphead". The neurocognitive symptoms of postperfusion syndrome were initially thought to be permanent, but turned out to be transient, with no permanent neurological impairment.
Athletic heart syndrome
No treatment is required for people with athletic heart syndrome; it does not pose any physical threats to the athlete, and despite some theoretical concerns that the ventricular remodeling might conceivably predispose for serious arrhythmias, no evidence has been found of any increased risk of long-term events. Athletes should see a physician and receive a clearance to be sure their symptoms are due to athlete's heart and not another heart disease, such as cardiomyopathy. If the athlete is uncomfortable with having athlete's heart or if a differential diagnosis is difficult, deconditioning from exercise for a period of three months allows the heart to return to its regular size. However, one long-term study of elite-trained athletes found that dilation of the left ventricle was only partially reversible after a long period of deconditioning. This deconditioning is often met with resistance to the accompanying lifestyle changes. The real risk attached to athlete's heart is if athletes or nonathletes simply assume they have the condition, instead of making sure they do not have a life-threatening heart illness.
Cardiothoracic surgery
Cardiac surgery training in the United States is combined with general thoracic surgery and called cardiothoracic surgery or thoracic surgery. A cardiothoracic surgeon in the U.S. is a physician (D.O. or M.D.) who first completes a general surgery residency (typically 5–7 years), followed by a cardiothoracic surgery fellowship (typically 2–3 years). The cardiothoracic surgery fellowship typically spans two or three years, but certification is based on the number of surgeries performed as the operating surgeon, not the time spent in the program, in addition to passing rigorous board certification tests. Recently, however, options for an integrated 6-year cardiothoracic residency (in place of the general surgery residency plus cardiothoracic residency) have been established at many programs (over 20). Applicants match into these I-6 programs directly out of medical school, and the application process has been extremely competitive for these positions as there were approximately 160 applicants for 10 spots in the U.S. in 2010. As of May 2013, there are now 20 approved programs, which include the following:
European Association for Cardio-Thoracic Surgery
The European Association for Cardio-Thoracic Surgery (EACTS) is a membership organisation devoted to the practice of cardiothoracic surgery. The mission statement of the association is to advance education in the field of cardiac, thoracic and vascular interventions; and promote research into cardiovascular and thoracic physiology, pathology and therapy, with the aim to correlate and disseminate the results for the public benefit. Within the EACTS there is a large number of committees working on various issues in order to improve cardio-thoracic surgery.
Cardiothoracic surgery
A cardiac surgery residency typically comprises anywhere from 4 to 6 years (or longer) of training to become a fully qualified surgeon. Cardiac surgery training may be combined with thoracic surgery and / or vascular surgery and called cardiovascular (CV) / cardiothoracic (CT) / cardiovascular thoracic (CVT) surgery. Cardiac surgeons may enter a cardiac surgery residency directly from medical school, or first complete a general surgery residency followed by a fellowship. Cardiac surgeons may further sub-specialize cardiac surgery by doing a fellowship in a variety of topics including: pediatric cardiac surgery, cardiac transplantation, adult acquired heart disease, weak heart issues, and many more problems in the heart.
Potassium chloride (medical use)
Some cardiac surgery procedures cannot be carried out on the beating heart. For these procedures, the surgical team will bypass the heart with a heart-lung machine and inject potassium chloride into the heart muscle to stop the heartbeat.
Benigno Aquino Jr.
His request was granted and Ninoy was allowed to go to the US for surgery, together with his entire family. This was arranged after a secret hospital visit by Imelda Marcos. This "emergency leave" was set when Ninoy supposedly agreed to the First Lady's 2 conditions: that if he leaves, he will return; and while in America, he should not speak out against the Marcos regime. Ninoy was operated in Dallas, Texas by Rolando M. Solis, a Filipino American, and the longest practicing cardiologist in Dallas currently. After the Surgery, Ninoy made a quick recovery. After which, he decided to renounce the agreement saying, "a pact with the devil is no pact at all".
Cardiology
Clinical cardiac electrophysiology is a branch of the medical specialty of cardiology and is concerned with the study and treatment of rhythm disorders of the heart. Cardiologists with expertise in this area are usually referred to as electrophysiologists. Electrophysiologists are trained in the mechanism, function, and performance of the electrical activities of the heart. Electrophysiologists work closely with other cardiologists and cardiac surgeons to assist or guide therapy for heart rhythm disturbances (arrhythmias). They are trained to perform interventional and surgical procedures to treat cardiac arrhythmia.
Cardiac surgery
In robot-assisted heart surgery, a machine controlled by a cardiac surgeon is used to perform a procedure. The main advantage to this is the size of the incision required: three small holes instead of an incision big enough for the surgeon's hands.
Coronary artery bypass surgery
Coronary artery bypass surgery, also known as coronary artery bypass graft (CABG, pronounced "cabbage") surgery, and colloquially heart bypass or bypass surgery, is a surgical procedure to restore normal blood flow to an obstructed coronary artery. A normal coronary artery transports blood to and from the heart muscle itself, not through the main circulatory system.
Hypoplastic left heart syndrome
Surgical operations to assist with hypoplastic left heart are complex and need to be individualized for each patient. A cardiologist must assess all medical and surgical options on a case-by-case basis.
Heart arrhythmia
Some cardiologists further sub-specialize into electrophysiology. In specialized catheter laboratories, they use fine probes inserted through the blood vessels to map electrical activity from within the heart. This allows abnormal areas of conduction to be located very accurately and subsequently destroyed by heat, cold, electrical, or laser probes in a process called catheter ablation.
Cardiothoracic surgery
Cardiac surgery programs in Canada:In the United Kingdom, you have to train for an MBBS (or MBChB), typically for 5 years. You may intercalate a BSc degree for a total 6 years undergraduate education, but this is not required. After you apply for a specialty place, or core surgical training (which is less competitive than going straight into the speciality). If you go for the core surgical training, you can then apply on the third year for cardiothoracic surgery, which at that point is much less competitive. Once you're training for the speciality, you may choose to subspecialise in perhaps: aortic surgery; adult cardiac surgery; thoracic surgery; paediatric cardiothoracic surgery; adult congenital surgery. 
This is a rewarding and technically challenging speciality, similar to interventional cardiology in some aspects.
Cardiac surgery
Surgery on the great vessels (e.g., aortic coarctation repair, Blalock–Thomas–Taussig shunt creation, closure of patent ductus arteriosus) became common after the turn of the century. However, operations on the heart valves were unknown until, in 1925, Henry Souttar operated successfully on a young woman with mitral valve stenosis. He made an opening in the appendage of the left atrium and inserted a finger in order to palpate and explore the damaged mitral valve. The patient survived for several years, but Souttar's colleagues considered the procedure unjustified, and he could not continue.
Transplant surgeon
A transplant surgeon is a surgeon who performs organ transplants. Among the many organs that can be transplanted are: kidneys. livers, hearts, lungs, the pancreas, the intestine (especially the small intestine), and recently, faces, tracheal (windpipe) tissue, and penises. At the present time, some organs, notably the brain and its constituent lobes and subdivisions, cannot be transplanted, and even if possible (recently, research has been done into the subject), would be very controversial for many. However, more extensive research into the transplantation of individual neurons and supportive brain tissue, or groups thereof (including glia, astrocytes, other neural connective tissue, and the surrounding meninges) has been done, and may be more practical and somewhat less controversial.
Deep hypothermic circulatory arrest
The advent of cardiopulmonary bypass in the United States during the 1950s allowed the heart to be stopped for surgery without having to stop circulation to the rest of the body. Cooling more than a few degrees was no longer needed for heart surgery. Thereafter, the only surgeries that required stopping blood circulation to the whole body ("total circulatory arrest") were surgeries involving blood supply to the brain. The only heart surgeries that continued to require total circulatory arrest were repairs to the aortic arch.
Cardiothoracic surgery
The American Board of Thoracic Surgery offers a special pathway certificate in congenital heart surgery which typically requires an additional year of fellowship. This formal certificate is unique because pediatric cardiac surgeons in other countries do not have formal evaluation and recognition of pediatric training by a licensing body.
Iván González Cancel
In 1993 after completing his training in mainland United States he returned to Puerto Rico to practice as a Cardiovascular and Heart Transplant Surgeon. It 
is in 1999 when he makes history by conducting the first heart transplant surgery in Puerto Rico. In June 27, 1999, Dr.Ivan Gonzalez Cancel along with a group of healthcare professionals performed the surgery which took 3 hours and 17 minutes at the 
Cardiovascular Center of Puerto Rico and the Caribbean. Among the group of physicians that participated in the successful surgery were: Dr. Héctor Banchs Pieretti, Dr. Cid Quintana, Dr. Rolando Colón, Dr. Héctor Delgado Osorio and Dr. Efraín Defendini.
St. Francis Hospital (Columbus, Georgia)
The Patrick Heart Institute of St. Francis is a source for diagnosis, treatment and rehabilitation of patients with heart problems. Cardiologists and surgeons provide total cardiac care, from the most advanced diagnostic procedures and the area's only open heart surgery program to cardiac catheterizations, balloon angioplasty and an innovative rehabilitation program.
St Francis was the first hospital in the area to perform open heart surgery, balloon angioplasty and automatic defibrillator tissue implants.
Cardiovascular technologist
Those who assist physicians in the diagnosis of disorders affecting the circulation are known as vascular technologists, vascular specialists or vascular sonographers. They obtain a medical history, evaluate pulses and assess blood flow in arteries and veins by listening to the vascular flow sounds for abnormalities. Then they perform a noninvasive procedure using ultrasound instrumentation to record vascular information such as vascular blood flow, blood pressure, changes in limb volume, oxygen saturation, cerebral circulation, peripheral circulation, and abdominal circulation. Many of these tests are performed during or immediately after surgery.
General surgery
General surgeons can perform vascular surgery if they receive special training and certification in vascular surgery. Otherwise, these procedures are performed by vascular surgery specialists. However, general surgeons are capable of treating minor vascular disorders.
Vascular surgery
Vascular surgery is a surgical subspecialty in which diseases of the vascular system, or arteries, veins and lymphatic circulation, are managed by medical therapy, minimally-invasive catheter procedures, and surgical reconstruction. The specialty evolved from general and cardiac surgery as well as minimally invasive techniques pioneered by interventional radiology. The vascular surgeon is trained in the diagnosis and management of diseases affecting all parts of the vascular system except those of the heart and brain. Cardiothoracic surgeons and interventional cardiologists treat diseases of the heart vessels. Vascular surgeons treat extracranial cerebrovascular disease while Neurosurgeons and interventional neuroradiologists treat diseases of the vessels in the brain (e.g., intracranial aneurysms).
Defibrillation
As devices that can quickly produce dramatic improvements in patient health, defibrillators are often depicted in movies, television, video games and other fictional media. Their function, however, is often exaggerated, with the defibrillator inducing a sudden, violent jerk or convulsion by the patient; in reality, although the muscles may contract, such dramatic patient presentation is rare. Similarly, medical providers are often depicted defibrillating patients with a "flat-line" ECG rhythm (also known as asystole). This is not normal medical practice, as the heart cannot be restarted by the defibrillator itself. Only the cardiac arrest rhythms ventricular fibrillation and pulseless ventricular tachycardia are normally defibrillated. The purpose of defibrillation is to depolarize the entire heart all at once so that it is synchronized, in the hope that it will resume beating normally. Someone who is already in asystole cannot be helped by electrical means, and usually needs urgent CPR and intravenous medication. There are also several heart rhythms that can be "shocked" when the patient is not in cardiac arrest, such as supraventricular tachycardia and ventricular tachycardia that produces a pulse; this more-complicated procedure is known as cardioversion, not defibrillation.
Cardiac surgery
As an alternative to open-heart surgery, which involves a five- to eight-inch incision in the chest wall, a surgeon may perform an endoscopic procedure by making very small incisions through which a camera and specialized tools are inserted.
Thrombolysis
Thrombolysis is performed by many types of medical specialists, including interventional radiologists, vascular surgeons, cardiologists, interventional neuroradiologists, and neurosurgeons. In some countries such as the United States of America, emergency medical technicians may administer thrombolytics for heart attacks in prehospital settings, by on-line medical direction. In countries with more extensive and independent qualifications, prehospital thrombolysis (fibrinolysis) may be initiated by the emergency care practitioner (ECP). Other countries which employ ECP's include, South Africa, the United Kingdom, and New Zealand. Prehospital thrombolysis is always the result of a risk-benefit calculation of the heart attack, thrombolysis risks, and primary percutaneous coronary intervention (pPCI) availability.
Heart transplantation
Approximately 3,500 heart transplants are performed every year in the world, more than half of which occur in the US. Post-operation survival periods average 15 years. Heart transplantation is not considered to be a cure for heart disease but a life-saving treatment intended to improve the quality of life for recipients.
One of the first mentions of the possibility of heart transplantation was by American medical researcher Simon Flexner, who declared in a reading of his paper on "Tendencies in Pathology" in the University of Chicago in 1907 that it would be possible in the then-future for diseased human organs substitution for healthy ones by surgery — including arteries, stomach, kidneys and heart.
Cardiovascular technologist
Technologists who use ultrasound to examine the heart chambers, valves, and vessels are referred to as cardiac sonographers. They use ultrasound instrumentation to create images called echocardiograms. An echocardiogram may be performed while the patient is either resting or physically active. Technologists may administer medication to physically active patients to assess their heart function. Cardiac sonographers also may assist physicians who perform transesophageal echocardiography, which involves placing a tube in the patient’s esophagus to obtain ultrasound images.
Perfusionist
In the United States, there are only Certified Clinical Perfusionists who perform all perfusion, for cardiac Surgery. A bachelor's degree with concentrations in biology, chemistry, anatomy and physiology is the prerequisite to be admitted to a perfusion program. As of 2005, there are 18 perfusion training programs in the United States, most offering a master's degree in perfusion sciences or circulatory sciences. Training typically consists of two years of academic and clinical education. Although the structure and training philosophies of perfusion programs differ, typically a perfusion student will begin his or her training in a didactic fashion in which the student will closely follow instructions from a "certified clinical perfusionist" in the confines of a cardiac surgery procedure. Academic coursework may be concurrent or precede this clinical instruction and is equally vital for their training. Early in their clinical training, the perfusion student may have little involvement outside of an observational role. However, as time progresses, more tasks may be incrementally delegated to them with the ultimate goal of producing a capable and competent perfusionist. Once a student graduates from a perfusion program, he or she must begin the certification process. In the interim, the perfusion graduate is typically referred to as board-eligible, which is sufficient for employment in cardiac surgery with the understanding that achieving certified status is required for long-term employment. Most employers have stipulations on the duration of board-eligible status.
Perfusionist
In the United Kingdom and Ireland there are only Clinical Perfusion Scientists who perform all perfusion, for cardiac Surgery. A bachelor's degree in a science subject (usually life or clinical sciences) is a pre-requisite to enrolment on the two-year perfusion training course. Employment as a trainee perfusionist is also required. Trainees must complete a two-year academic and practical course. They complete academic assessments (essays and exams), while in the workplace moving from a purely observational role to one in which they are capable of managing the patient while they are on cardiopulmonary system with minimal supervision. Once a trainee has been the primary perfusionist in 150 clinical procedures, they must undertake a practical exam. For this exam, the candidate is observed by two external examiners whilst building and priming a cardiopulmonary circuit, then using it during a surgical operation. After the practical exam, trainees must complete a 40-minute "viva voce" exam, which tests their academic knowledge. After this is successfully completed, they are awarded a postgraduate diploma and the status of qualified clinical perfusion scientist. They must maintain this by performing a minimum of 40 clinical procedures per year.
Multan Institute of Cardiology
The institute has a record of having prominent names in its faculty. Prof Haider Zaman, Prof Rana Altaf Ahmed, Prof Ijaz Ahmed are respectable names among the academia of cardiac surgery and cardiology. As a result of the tireless efforts of its faculty, the institute was accredited by the College of Physicians & Surgeons soon after its establishment. It has trained several cardiologists and cardiac surgeons. The academic activities are a regular feature of the institute. Cath. Meetings, Audit Meetings, and GP training programs are on the regular academic calendar of the institute. The institute has hosted several national meetings including the annual meetings of Pakistan Society of Cardiovascular and Thoracic Surgeons as well as Pakistan Hypertension League.
The institute has the honor of establishing a Department of Academic Affairs which is first of its kind in institutes of Cardiology in Pakistan. Prof Anjum Jalal was appointed its first chairman. His academic achievements have been recognized in national and international circles. Being an accomplished author, researcher, medical editor and trainer he had all the skills necessary for the position. He did his best to inspire the interest for research and publications in the young trainees of the institute. Dr. Anjum Jalal left the Institute in April 2013 and now he is the Executive Director of Faisalabad Institute of Cardiology Faisalabad.
Cardiothoracic surgery
Surgery in great vessels (aortic coarctation repair, Blalock-Taussig shunt creation, closure of patent ductus arteriosus) became common after the turn of the century and falls in the domain of cardiac surgery, but technically cannot be considered heart surgery. One of the more commonly known cardiac surgery procedures is the coronary artery bypass graft (CABG), also known as "bypass surgery." In this procedure, vessels from elsewhere in the patient's body are harvested, and grafted to the coronary arteries to bypass blockages and improve the blood supply to the heart muscle.
Cardiac catheterization
Coronary angiography allows for direct intervention in cases of coronary artery occlusion. This technique is also used to assess the amount of occlusion (or blockage) in a coronary artery, often described as a percentage of occlusion. A thin, flexible wire is inserted into either the femoral artery or the radial artery and threaded toward the heart until it is in the ascending aorta. Radial access is not associated with an increased risk of stroke over femoral access. At this point, a catheter is guided over the wire into the ascending aorta, where it can be maneuvered into the coronary arteries through the coronary ostia. In this position, the interventional cardiologist can inject contrast and visualize the flow through the vessel. If necessary, the physician can utilize percutaneous coronary intervention techniques, including the use of a stent (either bare-metal or drug-eluting) to open the blocked vessel and restore appropriate blood flow. In general, occlusions greater than 70% of the width of the vessel lumen are thought to require intervention. However, in cases where multiple vessels are blocked (so-called "three-vessel disease"), the interventional cardiologist may opt instead to refer the patient to a cardiothoracic surgeon for coronary artery bypass graft (CABG; see Coronary artery bypass surgery) surgery.
Borys Todurov
Borys Todurov believes that Ukrainian cardiac surgeons are indebted to their patients. At the national need of 140 thousand cardiac surgeries per year, the Ukrainian facilities perform slightly more than 15%. At the need of 200 thousand angiographic procedures and stentings, it is performed about 15%.
Dwight D. Eisenhower Army Medical Center
EAMC’s Cardiothoracic Surgery Clinic does more heart surgeries than any medical facility in the DoD. A wide range of cardiac, thoracic, vascular services, and minimally invasive techniques are used to address cardiothoracic issues.
Journal of Cardiothoracic Surgery
The Journal of Cardiothoracic Surgery is an open access, peer-reviewed online journal that encompasses all aspects of research in cardiothoracic surgery. Cardiothoracic Surgery is the surgical approach to the treatment of Cardiac and Thoracic (Lung and Throat) conditions. Common pathologies include Coronary Artery Disease, Cardiac Valve Regurgitation \ Stenosis and Respiratory Adenocarcinoma. In many countries, this specialty is divided into two areas, Cardiac and Thoracic, Surgery.
Hybrid cardiac surgery
A hybrid cardiac surgical procedure in a narrow sense is defined as a procedure that combines a conventional surgical part (including a skin incision) with an interventional part, using some sort of catheter-based procedure guided by fluoroscopy (or other, e.g. CT or MRI) imaging in a hybrid OR without interruption. A wider definition includes a clinically connected succession of a catheter intervention and a surgical procedure with a time gap.
Daniel Hale Williams
In the 1890s several attempts were made to improve cardiac surgery. On September 6, 1891 the first successful pericardial sac repair operation in the United States of America was performed by Henry C. Dalton of Saint Louis, Missouri. The first successful surgery on the heart itself was performed by Norwegian surgeon Axel Cappelen on September 4, 1895 at Rikshospitalet in Kristiania, now Oslo. The first successful surgery of the heart, performed without any complications, was by Dr. Ludwig Rehn of Frankfurt, Germany, who repaired a stab wound to the right ventricle on September 7, 1896. Despite these improvements, heart-related surgery was not widely accepted in the field of medical science until during World War II. Surgeons were forced to improve their methods of surgery in order to repair severe war wounds. Although they did not receive early recognition for their pioneering work, Dalton and Williams were later recognised for their roles in cardiac surgery.