What Is Cardiac Surgery?

Cardiac surgery is a surgery on the heart and/or great vessels performed by a cardiac surgeon. Frequently, it is done to treat complications of ischemic heart disease (for example, coronary artery bypass grafting), correct congenital heart disease, or treat valvular heart disease caused by various causes including endocarditis. It also includes heart transplantation.

The earliest operations on the pericardium (the sac that surrounds the heart) took place in the 19th century and were performed by, Francisco Romero^[1] Dominique Jean Larrey, Henry Dalton, and Daniel Hale Williams. The first surgery on the heart itself was performed by Norwegian surgeon Axel Cappelen on the 4th of September 1895 at Rikshospitalet in Kristiania, now Oslo. He ligated a bleeding coronary artery in a 24 year old man who had been stabbed in the left axillae and was in deep shock upon arrival. Access was through a left thoracotomy. The patient awoke and seemed fine for 24hrs, but became ill with increasing temperature and he ultimately died from what the post mortem proved to be mediastinitis on the 3rd postoperative day. 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.

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.