If treating your blockages requires bypass surgery, your cardiologist will refer you to a cardiac surgeon, or cardiothoracic surgeon. These surgeons specialize in treatment of the heart, lungs, esophagus, and chest.
Before, during, and after your procedure, your cardiac surgeon will be assisted by other care team members, including the following:
An anesthesiologist. An anesthesiologist is a medical doctor trained to administer the drugs that will take you "under" and block any feeling of pain or unpleasant sensations. Your anesthesiologist is involved in your care before, during, and after your surgery. He or she may do a medical evaluation before your surgery to determine an anesthesia plan tailored for you. During surgery, the anesthesiologist oversees life support and pain control. And after the surgery, he or she also provides life support, including intensive care management if needed. If time allows before surgery, you should discuss the anesthetic plan, as well as alternatives, risks, and benefits of the chosen anesthetic techniques, with the anesthesiologist.
A perfusionist. A perfusionist operates the heart-lung bypass machine, the machine that takes over the responsibilities of the heart (to pump blood to the body) and lungs (to exchange carbon dioxide in the blood for oxygen) during bypass surgery. (During the surgery, the heart is stopped while the surgeon grafts a vessel to the clogged artery to create a bypass around a blockage.) The perfusionist may be a specially trained nurse or technician who has been certified by the American Board of Cardiovascular Perfusion. Those who are not certified should have at least two years of supervised experience working in an operating room during open heart surgeries.
Operating room nurses and technicians. Operating room nurses and technicians support the cardiac surgeon as he or she performs the procedure. They also monitor your condition and work to make you as comfortable as possible.
An intensivist. An intensivist (or ICU doctor) is a medical doctor who specializes in the care of critically ill patients, usually in an intensive care unit (ICU). An intensivist may be trained in internal medicine, anesthesiology, or another medical specialty. In addition, the ICU doctor will have completed a fellowship or one or more years' duration in critical care medicine. Depending on your hospital, you may be under the care of an intensivist while in the ICU or the cardiac surgery ICU.
Intensive care nurses. If you are moved into the hospital's intensive care unit following bypass surgery, you will be cared for by intensive care (or critical care) nurses. These nurses have special training in caring for patients facing life-threatening problems, including cardiac and respiratory emergencies.
Cardiac care nurses. Cardiac care nurses are specially trained to work with heart disease patients and their families. They may have an additional specialty-that of critical care nurse-that prepares them to work with patients in the hospital. Otherwise, you may be visited by a cardiac care nurse in your home following bypass surgery or angioplasty.
Physical therapists/occupational therapists/rehab nurses. Both while you are in the hospital and after you are discharged, these medical professionals work with you to help you build up your strength, restore function and regain your ability to move.
Cardiac rehabilitation team. A team of health care professionals, including nurses, exercise physiologists, physical therapists, occupational therapists, dieticians and nutritionists, counselors and others, will provide education and coaching to speed your rehabilitation. During cardiac rehab, the team will support you as you learn and adopt heart-healthy behaviors, such as eating a healthy diet, exercising regularly, and managing stress.
Your cardiologist continues to be closely involved with your case while you are under the care of the cardiac surgeon. He or she, in turn, should also provide reports and updates to your primary care physician in order to ensure your continued coordinated care.