What is a Thoracic Surgeon?

What is a Thoracic Surgeon?
A thoracic surgeon is a medical doctor who performs operations on the heart, lungs, esophagus, and other organs in the chest. This also includes surgeons who can be called cardiothoracic surgeons, cardiovascular surgeons, general thoracic surgeons, and congenital heart surgeons.

The above video features STS members Vinod H. Thourani, MD, Douglas E. Wood, MD, Lauren C. Kane, MD, and Robert S.D. Higgins, MD.

What kind of training is required to become a Thoracic Surgeon?
Thoracic surgeons have to graduate from medical school and most commonly will go on to complete a five-year general surgery residency. After this they must successfully matriculate through an approved cardiothoracic surgery residency program for either two or three years. Some thoracic surgeons choose to do additional training in a sub-specialized area but this training is largely optional, except for congenital heart surgery.

What does it mean to be a board certified Thoracic Surgeon?
The American Board of Thoracic Surgery (ABTS) maintains standards for the practice of thoracic surgery in the public interest. Thoracic surgeons who have completed approved residency training, hold a full and unrestricted license to practice medicine in the United States, and maintain an ethical standing in the profession are eligible for board certification. Candidates must then pass both a written examination that is designed to test a broad range of knowledge in all areas of thoracic surgery. Upon successful completion of the written examination, candidates are eligible for and must pass an oral examination that tests knowledge, judgment and the integration of these skills in clinical practice. Once successful in these pursuits, a thoracic surgeon is “board certified”. In order to keep this certification, the maintenance of certification process is required to demonstrate lifelong learning throughout the thoracic surgeons’ career. There is a separate subspecialty certificate for congenital heart surgery.

Are there different kinds of Thoracic Surgeons?  What is the difference between a Thoracic and Cardiothoracic Surgeon?
All thoracic surgeons have the same general training and are certified by the same specialty board, except for congenital heart surgeons who have a sub-specialty certificate in addition to the ABTS certification. Some surgeons choose to focus their clinical practice in certain areas of thoracic surgery and can be referred to differently. A cardiac or cardiovascular surgeon will focus on the heart and great vessels. General thoracic surgeons treat diseases of the lungs, esophagus, chest wall, and mediastinum. Congenital heart surgeons operate on infants and children with heart disease. Cardiothoracic surgeon is the most inclusive term used to describe the specialty, irrespective of a particular surgeon’s area of focus and expertise, and can be used interchangeably with the term thoracic surgeon.

What diseases does a Thoracic Surgeon treat?
Thoracic surgeons operate on diseases that occur in the organs inside the chest, and in the bony structures and tissues that form the chest cavity. Coronary artery disease is one of the most common diseases treated by cardiac and cardiovascular surgeons. General thoracic surgeons treat a lot of lung cancer and diseases of the esophagus. Congenital heart surgeons care for babies and children with holes between the heart chambers or abnormal connections within the heart. Listed below are some examples of diseases treated by thoracic surgeons.

A cardiac or cardiovascular surgeon could treat:
- Coronary artery disease or blockages of the arteries in the heart
- Blockages in one of the heart valve(s)
- Leaking heart valve(s)
- Abnormal enlargement or aneurysms of the large arteries in the chest
- Heart failure
- Atrial fibrillation

A general thoracic surgeon could treat:
- Lung cancer
- Severe emphysema
- Cancer of the esophagus
- Gastroesophageal reflux disease
- Hiatal hernias
- Swallowing disorders such as achalasia
- Excess sweating, usually of the upper extremity called hyperhydrosis

A congenital heart surgeon could treat:
- Atrial septal defects
- Ventricular septal defects
- Coarctation of the aorta
- Hypoplastic left or right heart syndrome
- Transposition of the great arteries

What kind of operations does a Thoracic Surgeon do?

  • A cardiac or cardiovascular surgeon could perform:
    - Coronary artery bypass surgery
    - Valve repair or replacement
    - Repair of thoracic aneurysms
    - Minimal access cardiac surgery
    - Ventricular remodeling
    - Heart transplant
    - Maze procedure
  • A general thoracic surgeon could perform:
    - Removal of portion(s) of the lung containing cancer, eg, lobectomy, pneumonectomy
    - Thoracoscopy or VATS
    - Removal of a portion of the esophagus containing cancer and reconstruction of the gastrointestinal tract or esophagogastrectomy
    - Laparoscopic Nissen fundoplication
    - Laparoscopic Heller myotomy
    - Thoracoscopic sympathectomy
    - Lung transplant
  • A congenital heart surgeon could perform:
    - Atrial septal defect repair
    - Ventricular septal defect repair
    - Repair of coartcation of the aorta
    - Arterial switch operation
    - Norwood operation
    - Creation of shunt to the pulmonary artery, e.g., modified Blalock-Taussig shunt, bidirectional Glenn shunt

The below video provides additional insight into what cardiothoracic surgeons do and how they treat patients. 

The above video features STS members Todd K. Rosengart, MD, Ram Kumar Subramanyan, MD, PhD, Leah M. Backus, MD, Jeffrey B. Rich, MD, Robbin G. Cohen, MD, MMM, and Jeffrey P. Jacobs, MD.

Do Thoracic Surgeons do procedures other than open operations? 

Yes. Some cardiac surgeons also perform percutaneous (through punctures in the groin) interventions to treat aneurysms of the large vessels in the chest. Most general thoracic surgeons also perform bronchoscopy and/or esophagoscopy, drain fluid from the chest with needles, or place catheters or tubes into the chest to drain fluid or air.

How is a Thoracic Surgeon different from a cardiologist or pulmonologist?
A cardiologist will primarily diagnose disorders of the heart and treat them with medication.  Cardiologists also perform interventions on the arteries in the heart working through puncture wounds in the groin, but they do not do open surgery.
A pulmonologist will diagnose disorders of the lung and treat them with medication.  Some pulmonologists will perform interventions through the airway such as bronchoscopy to diagnose some disorders but again, they do not perform open surgery. 

When should I see a Thoracic Surgeon?
Your primary care physician, cardiologist, pulmonologist, or gastroenterologist may send you to a thoracic surgeon if he/she feels that you could benefit from an operation to treat a condition involving the heart, lungs, esophagus, mediastinum, or chest wall.

How can I find a Thoracic Surgeon?
The physician sending you to a thoracic surgeon may recommend a particular surgeon. You can also search for a thoracic surgeon by clicking here.

What can I expect on my first visit? 
You will be interviewed and examined by the thoracic surgeon, and if you have had any tests, echocardiograms, X-rays or CT scans done, your thoracic surgeon will review the images and reports. Then, he/she will make a recommendation for the next step in your evaluation and treatment. This includes possible surgery, additional testing, or observing your condition over time.

What is The Society of Thoracic Surgeons?
The Society of Thoracic Surgeons is a not-for-profit organization representing more than 7,100 surgeons, researchers, and allied health professionals worldwide who are dedicated to ensuring the best possible heart, lung, esophageal, and other surgical procedures for the chest. Founded in 1964, the mission of STS is to enhance the ability of cardiothoracic surgeons to provide the highest quality patient care through education, research, and advocacy.