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Cardiologist and Heart Surgeries

A cardiologist is a physician who is certified to treat problems of the cardiovascular system—the heart, arteries, and veins. Cardiology is classified as an internal medicine subspecialty. Knowledge of internal medicine and other specialties is required to obtain certification. There are many requirements on the quest to becoming a cardiologist; first, obviously is graduation from an approved medical school. Next is the completion of an ACGME-accredited internal medicine residency program, which is a minimum of 3 years in length.

There must be a minimum of 2 years of meaningful patient contact and responsibility. Of the 2 years, 20 months must occur in in-patient services, ambulatory settings, and in the services of dermatology or neurology. Four months may be taken outside the above areas, subject to program director approval. The level of responsibility for patients must increase with each year of training. After satisfactory completion of graduate education, the physician is allowed to take the Internal Medicine board certification examination food steroids antibiotics sprays .

Once this examination has been passed, the physician receives board certification in internal medicine. This is a prerequisite to becoming certified in cardiology. Knowledge and competence in performing and interpreting tests and procedures of the heart is necessary as well. Once training is satisfactorily completed, the physician is eligible to take the American Board of Internal Medicine cardiology examination. Subspecialties have developed along with new tests and therapeutic interventions.

Sub specialization in these areas usually requires 1 or 2 additional years of highly specialized formal training such as Interventional cardiology, electrophysiology, nuclear physiology, and echocardiography. The designation of Fellow of The American College of Cardiology (FACC) represents recognition of high professional achievement in a cardiovascular subspecialty. FACC candidates must be certified both by a primary specialty board and by a subspecialty board that is a member either of the American Board of Medical Specialties or the Advisory Board for Osteopathic Specialists of the American Osteopathic Association.

Candidates must provide written evidence from their communities showing that they are recognized as specialists and consultants or as scientists. Candidates for FACC must have completed the required subspecialty training 18 months prior to review by the Credentials Committee of the American College of Cardiology. There are many different surgeries for the heart. Cardiac transplantation is a procedure of last resort. This means that there are no other medical or surgical options that will improve your current heart condition.

Heart transplantation involves the placement of a healthy heart from a cadaveric donor into the recipient with end-stage heart disease. Coronary Artery Bypass Grafting (CABG), or bypass surgery, is a surgical operation in which the surgeon uses a section of vein, usually from the patient's leg, or an artery from inside the patient's chest, to create a new route for oxygen-rich blood to reach the heart muscle. The most commonly used vessels are the internal mammary arteries, which are inside the chest wall, or the greater saphenous veins, which are in the leg.

These vessels are "spares. " Blood flow is usually not affected by removing them. Less often, the radial artery in the arm may be used for a graft. Grafts usually last for 10 to 12 years. Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) is a minimally invasive approach to conventional Coronary Artery Bypass Graft (CABG) surgery. MIDCAB is beating heart surgery, which means that stopping the heart (cardioplegia) is not necessary and a heart-lung machine is not required.

Unlike conventional surgery, which requires a 10"-12" incision to separate the sternum (sternotomy) and places the patient on the heart-lung machine, MIDCAB surgery can be performed through a 3"-5" incision placed between the ribs, or may be done with several small incisions. MIDCAB surgery results in a faster recovery, fewer complications, and less pain after surgery. It is indicated for use when bypassing one or two coronary arteries. For bypassing three or more arteries, a conventional CABG is indicated.

Heart valve disease occurs when a valve doesn't work right. A valve may not open all the way. Or, a valve may have problems closing. If this happens, blood doesn't move through the heart's chambers the way it should. During heart valve surgery, one or more valves are repaired or replaced. Repair means that the valve is mended to help it work better. Replacement means your diseased valve is removed and a new valve is inserted in its place. Whether a valve will be repaired or replaced can only be decided once surgery has begun.

Your surgeon will talk with you about his or her plans for surgery and any other procedures you may need. During valve repair, a ring may be sewn around the opening of the valve to tighten it. Other parts of the valve may be cut, shortened, separated, or made stronger to help the valve open and close right. If a valve can't be repaired, it may be replaced with a prosthetic valve. Two kinds of prosthetic heart valves are available: mechanical valves and biological valves.

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