Dr. Eugenio Mulero-Portela

It’s a very good question that confuse many people, including health reporters and even the hospital CEO. Although they have common grounds they are trained through totally different programs after medical school. The cardiologists are internal medicine doctors specialists in cardiovascular conditions. They don’t open patients. The cardiothoracic surgeon are surgeons specialists in the heart and other thoracic conditions. The surgeons are the only physicians trained and certified to open the patients’ chests. Some surgeons are also trained in minimally invasive procedures, endoscopic procedures, and catheter related procedures. The cardiologists and other sub-specialists of internal medicine are trained for diagnosis and treatments with “no-surgical” options and some are trained in interventions with devices placed with catheters or endoscopes. For example, a coronary stent is placed by a cardiologist with a catheter intervention, that is not a surgery. The coronary bypasses, the heart valves replacements, and a removal of a lung tumor are done by the cardiothoracic surgeons.
I hope this help.

Eugenio Mulero-Portela, M.D., FACS

Not necessarily connected. After a bypass surgery you should be using only aspirin, unless you are allergic. Other anticoagulants may cause bleeding problems and offer no additional benefits. If you are using other anticoagulants you should check with your cardiologist. If you are only on aspirin I suggest to visit your Ob/Gyn.

Yes, you can. Heart rate abnormalities and coronary artery disease are sometimes related, it’s called arrhythmia. Not all the heart attacks will have arrhythmia.

It’s the same. People call a heart attack an episode of severe chest pain caused by a blockage of the coronary arteries that is causing a myocardial infarction.

Major complications are not common nowadays as it was in the past. Today’s rates for major complications and death are around 2% for most of the patients in experienced hands. Actually there’s more risks with medical therapy and no therapy at all than with the surgery itself. Minor complications are also much less than in the past. The incisional pain is still a variable issue depending on patient’s tolerance, and usually responds well to oral analgesics and sometimes require anti inflammatory meds; swelling of the legs are common if there is poor compliance with the stockings and ambulation. Cardiac arrhythmias are common after heart surgery but are self limited and responds very well to medications. Other complications may be related to other medical conditions and/or organs dysfunction already present, that should be discussed clearly with your cardiac surgeon. If you are having an “open” heart surgery, you may have a valve repair/replacement and you should be in potent anticoagulants for a while. The best way to prevent complications with anticoagulants is to have frequent monitoring of your anticoagulation levels and a good communication with your surgeon. People call any surgery of the heart an “open heart surgery” but if you are getting a coronary bypass surgery your heart is not going to be opened and the only medication after surgery you should take for your bypasses is aspirin; simple, low risk, and effective. Remember that every patient is different and every case should be individualized by your doctors.