The Cardiac Surgical Team is a highly-specialized group of providers who rely on one another’s specialized disciplines to carry out an efficient and safe surgery on the heart and cardiovascular anatomy. Each person has a dedicated role. Many studies have been done specifically on Cardiac Surgery Teams and most of the research suggests that the ‘continuity of the team’ produces better outcomes. As many who work on these teams will say, great cardiac surgery is “boring cardiac surgery” - the team performs like a synchronized orchestra where little needs to be spoken - instruments are ready before prompted, pumps are initiated at the exact right time, IV meds are infused like clockwork. Many institutions hand-pick team members based on their proven excellence in other surgical services.

With the exception of the Anesthesiologist and Perfusionist, all other members are “Scrubbed-In” - this means that they take part in a surgical scrub before entering the Operating Room and are gowned-and-gloved in a sterile manner. Sterility like in any surgery is essential to minimizing Surgical Site Infections (SSI) and is taken very seriously.

Note those who are heavily involved in performing the surgery (working directly in the operative field where safety glasses with magnifying glasses - there are called “loupes” and vary in magnifying power. Most interviewed indicate they prefer loupes with 3.5x magnification. The main company that makes surgical loupes is Designs for Vision. In most cases, both surgeon and first-assist wear a headlight to further illuminate the operative field. LuxTec used to be the preference of choice but a new company called Ronin Surgical has emerged with a lighter option. The lightness of headgear is paramount to eliminating neck issues especially when surgical team members are scrubbed-in for many hours.

In some institutions and cases, there may be more than one Surgeon involved in a case - these are typically high-risk cases such as “redo’s” that involve high complexity. Additionally, the latest trend at many teaching institutions is for the surgeon to dictate who is the “First Assist” on the case - Cardiothoracic PAs are highly-specialized and build ‘surgical rapport’ with the attending, which is developed over the course of many operations. One surgeon interviewed said, “My PA knows me better than anyone in that room - if there is any question about the complexity of the case, I want her as my First Assist - patient outcomes are more important than teaching to me.”