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Student Student

A career in cardiothoracic surgery

BMJ 2019; 367 doi: (Published 16 October 2019) Cite this as: BMJ 2019;367:l5914
  1. Tom A Rayner, fifth year medical student1,
  2. Daniel Fudulu, registrar cardiothoracic surgery2,
  3. Samer Nashef, consultant cardiac surgeon3
  1. 1Bristol Medical School, University of Bristol, UK
  2. 2Department of Cardiac Surgery, Bristol Heart Institute at University Hospital Bristol NHS Foundation Trust, UK
  3. 3Department of Cardiac Surgery, Royal Papworth NHS Foundation Trust, Cambridge, UK
  1. tomrayner25{at}

Cardiothoracic surgery combines working in specialised teams and surgical innovation

Cardiothoracic surgeons are surgical specialists who perform procedures on the structures in the chest, including the heart, great vessels, and lungs. They treat patients throughout their lifespan—from newborns to older adults. Cardiothoracic surgery is an exciting and competitive specialty, with opportunities to subspecialise, perform research, and work with innovative new surgical techniques. In this article, we discuss the day to day life of the cardiothoracic surgeon, the application process and training pathway, and the future of the specialty.

What is cardiothoracic surgery?

Cardiac and thoracic surgeons are mainly distinct from each other—few surgeons practise both cardiac and thoracic surgery. Cardiac surgeons operate on the heart and great vessels—aorta and pulmonary artery, whereas thoracic surgeons operate on the pleural membranes, lungs, and mediastinal structures outside the heart. Boxes 1 and 2 show the range of procedures performed by cardiac and thoracic surgeons, respectively.1

Box 1

Common procedures performed by cardiac surgeons (list not exhaustive)1

Adult cardiac surgery

  • Coronary artery bypass graft

  • Aortic valve replacement

  • Combined valve repair/replacement and coronary artery bypass graft

  • Mitral valve repair or replacement

  • Aortic (root, ascending, and arch) surgery

Congenital cardiac surgery

Transplant surgery

  • Heart transplantation

  • Lung transplantation

  • Heart-lung transplantation

  • Left ventricular assist device insertion

Box 2

Common procedures performed by thoracic surgeons (list not exhaustive)1

  • Video assisted thoracic surgery, robotic or open surgery

  • Pleural space surgery (empyema or pneumothorax surgery)

  • Lung resection (eg, pneumonectomy, lobectomy)

  • Mediastinal surgery (thymectomy)

  • Tracheal surgery

  • Chest wall resection and reconstruction

What does a cardiothoracic surgeon do?

In a normal week, trainee cardiothoracic surgeons perform preoperative …

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