Because of the depth of knowledge required for a surgeon to successfully complete a variety of procedures, fields of medicine relating to surgery are broken down into categories. Differentiation may be based on patient age but is also based on the part of the body, or organ system, to which a procedure applies. Pediatric cardiothoracic surgery is heart and chest surgery undertaken on infants, children and young adults.

 

Training
    Becoming a cardiothoracic surgeon has many of the same demands required of other doctors, with the addition of special training. All cardiothoracic doctors graduate from college with at least a four-year degree, attend medical school for another four years, then complete a surgical residency followed by a fellowship in cardiothoracic surgery. Pediatric specialists often are required an to have an additional fellowship working in pediatrics. This may total anywhere from six to 10 years of training after medical school. However, if surgeons choose to complete their surgical residencies and fellowships in a pediatric hospital, there may be no need for further specialization. In addition, surgeons must receive board certification to practice medicine in their state.

Pediatric Cardiology
    The field of pediatric cardiology deals with two types of cardiac disease: congenital and acquired heart disease. The overwhelming majority of cases seen by pediatric cardiologists are congenital disorders, which means that patients were born with their abnormalities. Acquired heart disease is more typical of older patients who have damaged their cardiovascular systems by making unhealthy choices during their life. Congenital heart diseases come in many degrees of complexity and severity. Disorders range from undeveloped blood vessels and chambers of the heart to dysfunctional valves to improperly connected components of the cardiovascular system. Some disorders can be managed with medication, but others require invasive procedures to correct.

Surgery
    When a team of cardiologists and surgeons decide surgery is the best option for treatment, there are two general types of surgery that can be undertaken. Depending on the patient's circumstances, surgeons will proceed with either reparative or palliative surgery. The purpose of reparative surgery is correct an abnormality in the cardiovascular system. This may include reconnecting vessels in the normal manner, installing prosthetic valves or vessels or repairing holes in cardiac tissue. Palliative care is the name given to treatment that does not entirely resolve an issue but serves to reduce the amount of discomfort or difficulty a patient must face. Such procedures might, for example, involve increasing or decreasing blood pressure in a certain vessels or altering the amount of work cardiac muscle must do to pump blood.

Surgical Statistics
    According to Cincinnati Children's Hospital Medical Center, about 20,000 pediatric cardiothoracic procedures are carried out in the U.S. every year. Relatively minor procedures, such as those used to close small holes in the heart, have no mortality rate. More complicated procedures' mortality rates vary with the complexity of the case and may range anywhere from less than 5 and up to 30 percent. Considerations such as the patient's age also play a significant role in the likelihood of a positive surgical outcome.

Top Centers for Pediatric Cardiothoracic Surgery
    Rankings made by "US News & World Report" of the best pediatric hospitals for cardiology and cardiothoracic surgery in 2010 hold that the following medical centers are listed in order as the best in the country: Children's Hospital Boston, Children's Hospital of Philadelphia, Texas Children's Hospital, University of Michigan C.S. Mott Children's Hospital and Lucile Packard Children's Hospital at Stanford. Also ranked in the Top 10 are Cincinnati Children's Hospital Medical Center and Children's Hospital Los Angeles.