Cardiologists and cardiac surgeons are two different groups of doctors who treat heart diseases. Cardiac surgeons treat heart diseases through surgery. Cardiologists, on the other hand, do not perform surgery; they apply non-surgical methods. Cardiologists are divided into four subspecialties based on their fields of interest:
- Interventional cardiologists: Cardiologists who perform interventions that cardiac surgeons would normally do with surgery, using non-surgical (percutaneous) methods.
- Imaging specialists: Cardiologists who specialize in diagnosis using imaging devices, primarily echocardiography (heart ultrasound).
- Arrhythmia specialists (Electrophysiologists): Cardiologists involved in the diagnosis and treatment of heart rhythm disorders. Their main tasks include recording ECGs from within the heart for diagnostic purposes (electrophysiological study-EPS), ablation (destroying the focus of the rhythm disorder using cold or heat), and the implantation of pacemakers and defibrillators (ICDs).
- Clinicians: Cardiologists who focus solely on patient follow-up, diagnosis, and treatment planning.
In procedures performed by interventional cardiologists, unlike heart surgeries, the heart is not stopped; procedures are carried out while the heart continues to beat. No incision is made in the chest or the heart. Devices (such as stents and heart valves) placed inside flexible, thin, and long tubes (catheters) are delivered to the heart remotely through the vascular system via a small entry point in the wrist (arm) or groin (leg). Therefore, the work performed is not called “surgery” but an “intervention” or “interventional procedure.” Consequently, the cardiologist who performs these is called an “interventional cardiologist.”
Interventional cardiology has advanced significantly in recent years thanks to evolving technology. Consequently, heart problems that could previously only be resolved through open-heart surgery can now be treated using non-surgical methods. Examples of these interventional procedures—all performed non-surgically and representing my (Prof. Şükrü Akyüz, MD) areas of expertise—include:
- Coronary artery blockages can be opened with a stent without the need for bypass surgery.
- Heart valves can be replaced without opening the rib cage.
- Stenosis (narrowing) of a heart valve can be dilated with a balloon.
- Heart valve leakage can be repaired with a clip.
- Holes in the heart can be closed with an umbrella-like device.
- The pouch where blood clots form in the heart can be closed with a plug.
- Thickening of the heart wall can be thinned using alcohol injected into the tissue.
- In addition to these, numerous other procedures can be performed non-surgically.
In most cases, the benefit provided to the heart by non-surgical methods is as effective as surgery; in fact, in some cases, it is even superior. In rare instances, surgery remains the better option. This choice varies depending on the patient’s characteristics and the specifics of the disease.
Whether you have consulted a cardiologist or a cardiac surgeon, it is vital to seek a second opinion from a physician in the other specialty. Gathering information about both surgical and non-surgical options will make it easier for you to determine the best decision for your health.
