Interventional Cardiologist vs. Cardiac Surgeon: What's the Difference?

By Indeed Editorial Team

July 22, 2021

Heart procedures are the work of specialized doctors like interventional cardiologists and cardiac surgeons, who train for years to perform procedures like transplants and angioplasties. This vital work helps improve life for many people impacted by heart issues, whether they are congenital or develop throughout life. If you're interested in the medical field, researching these roles can help you decide whether one might be the right choice for you. In this article, we discuss some differences between an interventional cardiologist and a cardiac surgeon and explore tips to keep in mind when considering career options.

What's the difference between interventional cardiologists and cardiac surgeons?

The difference between an interventional cardiologist and a cardiac surgeon is how they perform procedures to improve a patient's heart health. An interventional cardiologist performs catheter-based treatments, and a cardiac surgeon performs open surgeries like coronary artery bypass surgeries. Both professions are more specialized than a general cardiologist, who may order diagnostic tests and perform long-term patient care but does not perform procedures.

Related: Guide To Becoming a Cardiologist

What is an interventional cardiologist?

An interventional cardiologist is a subspecialist heart doctor who performs non-surgical procedures to promote circulatory health. They typically use flexible tubes called catheters to enter a patient's heart or arteries, and they may repair valves, place or repair devices like pacemakers or clean arteries to improve blood flow. They have training in general medicine rather than surgery, and they might work alongside cardiac surgeons to perform some procedures.

Related: What Is a Cardiologist?

What is a cardiac surgeon?

A cardiac surgeon is a surgically trained subspecialist in circulatory health who performs invasive procedures. They usually work on surgical teams with nurses and other heart doctors to cut cleanly into a patient's body, then they perform the procedure, whether it's repairing a valve, cleaning an artery or transplanting a heart, and close the patient's wound. Some cardiac surgeons perform procedures on other parts of the upper chest as well, like the esophagus and the lungs, but they are more typically called cardiothoracic surgeons.

Interventional cardiologist vs. cardiac surgeon

Here are some specific differences and similarities between cardiac surgeons and interventional cardiologists:

Type of procedure performed

A cardiac surgeon performs surgical procedures that involve incisions. Here are some specific procedures a cardiac surgeon may perform:

  • Coronary artery bypass grafting surgery to treat coronary artery disease

  • Heart valve repairs and replacements to fix diseased valves

  • Atrial fibrillation ablation to treat irregular heartbeat

  • Carotid endarterectomy to restore blood flow

  • Heart transplants, often as a later resort after other surgeries

Interventional cardiologists train in and perform treatments for heart disease that involve catheters, flexible tubes inserted into the body. These procedures may involve placing devices to help the heart function, repairing holes in the heart or repairing devices placed earlier. Here are some procedures an interventional cardiologist may perform:

  • Angioplasty to insert a stent and restore blood flow

  • Cardiac catheterization to determine whether a heart's valves, muscles and arteries are working properly

  • Exercise stress test to evaluate heart health

  • Percutaneous valve repair to fix diseased valves

  • Ventricular septal defect repair to fix holes in the heart present at birth

There are some procedures that either a cardiac surgeon or an interventional cardiologist may perform, like implanting pacemakers, and some surgeries which involve both a surgeon and a cardiologist working together.

Performing surgery

A cardiac surgeon performs surgeries, which are operations that involve cutting into a patient's tissues. The procedures an interventional cardiologist completes aren't surgeries, since they insert a catheter without making any incisions into the patient. A general cardiologist also doesn't perform surgeries. In many cases, cardiologists attempt other procedures before referring a patient to a cardiac surgeon because of the risks and recovery time involved with heart surgery.

Related: How To Become a Cardiothoracic Surgeon (With FAQs)

Education

As medical doctors and subspecialists, both interventional cardiologists and cardiac surgeons go through extensive education. Both professions require getting an undergraduate degree, attending medical school and completing up to 10 years of additional education. After medical school, an interventional cardiologist trains in internal medicine, completes a cardiology fellowship and spends several years training in interventional cardiology.

A student on their way to being a cardiac surgeon enters a surgical residency after medical school. This residency may take five to seven years and provides a background in general surgery. Next, the potential cardiac surgeon spends two to four years learning specifically about cardiothoracic surgery, procedures involving the chest. They may specialize in heart procedures after this. Some states require surgeons and cardiologists to take final exams to become licensed.

Read more: Applying To Medical School: Tips and Requirements

Area of focus

An interventional cardiologist usually focuses entirely on the heart and circulatory system around it. A cardiac surgeon usually trains as a cardiothoracic surgeon, learning not only about the heart but also about procedures dealing with the lungs and esophagus. Each surgeon's focus depends on their training and the environment where they work, since surgeons in more remote areas may perform a wider variety of procedures.

Role in the healthcare system

Both interventional cardiologists and cardiac surgeons are occasional or one-time healthcare providers, and they rarely provide ongoing healthcare to patients. They are both subspecialists, since their areas of expertise are within the field of cardiology. For ongoing heart healthcare, a patient sees a general cardiologist, who may refer them to an interventional cardiologist or cardiac surgeon for a specific procedure, but who performs regular care and any follow-up procedures.

Work environment

Both interventional cardiologists and cardiac surgeons work in hospital, university or teaching hospital settings. Work hazards can include exposure to diseases and bodily fluids, as well as the risks involved with handling sharp technical tools. During procedures, cardiologists and surgeons may spend significant time on their feet. Both roles involve working closely with nurses and other doctors during procedures, as well as communicating with general cardiologists, patients and other healthcare providers.

Salary

The salary of cardiac surgeons and interventional cardiologists depends on where they work and what they specialize in. The national average salary for cardiac physicians like interventional cardiologists is $291,543 per year. In comparison, surgeons like cardiac surgeons make slightly more, with a national average salary of $297,948 per year.

Further specializations

Some heart doctors may specialize by narrowing their practice or pursing additional fellowships after their cardiac training. An interventional cardiologist may further specialize to perform procedures on children and become a pediatric interventional cardiologist. A congenital heart surgeon specializes in heart procedures for infants and children that treat heart problems and birth defects. Cardiac surgeons may also specialize in transplant procedures or procedures on the aorta and other arteries.

Tips for choosing between interventional cardiology and cardiac surgery

Here are some tips to consider when you're making career goals and educational choices about providing heart care:

  • Consider what you want to learn. Medical training for both occupations involves many years of study, so you might consider whether you'd like to do a general surgery residency or a cardiology fellowship after you complete medical school.

  • Consider how long you'd like to be in school. It generally takes more years of study to become a cardiac surgeon than an interventional cardiologist.

  • Decide how much technology you want to work with. Some developments in heart procedures involve heavy use of technology, particularly interventional cardiologist work. A few more recently developed procedures involve techniques from both fields, so you may work closely with new technology in either field.

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