Richard A. Silva MD, FACS in Baltimore: Cardiothoracic Surgery and Interventional Cardiology

Richard A. Silva MD, FACS operates as a surgical cardiologist in Baltimore, combining cardiothoracic surgery certification with interventional capabilities to treat coronary artery disease, valvular heart disease, and other conditions requiring either surgical or catheter-based intervention. His FACS credential (Fellow of the American College of Surgeons) indicates board certification in surgery; his practice bridges the gap between interventional cardiologists who work exclusively through catheters and cardiac surgeons who perform open operations, meaning patients can access both approaches without referral elsewhere if their condition permits either.

What a Cardiothoracic Surgeon Actually Does

Cardiothoracic surgeons perform open-heart operations: coronary artery bypass grafts (CABG) for blocked vessels, valve repairs or replacements, and repairs of aneurysms or structural defects. Some, including those with interventional training like Silva, also perform catheter-based procedures such as stent placement, which reduces the need for surgery in select cases. The distinction matters for timing: an interventional approach may be possible on an outpatient basis or with minimal hospital stay, while surgery requires hospital admission and recovery measured in weeks. Silva's dual training means he can evaluate whether your blockage or valve problem is better handled with a catheter or a scalpel, rather than defaulting to one approach.

Services and When Referral or Surgery Is Typical

Cardiothoracic surgeons do not manage high blood pressure or heart failure medication in the primary care sense; they see patients after diagnosis, usually by referral from a cardiologist. Common reasons for a first consultation include significant coronary blockages not safely managed by stent, valves that are leaking or narrowed, or aortic disease. An initial appointment typically involves review of imaging (angiograms, CT, or echocardiograms), a history focused on cardiac risk factors and functional limitations, and discussion of whether surgery or catheter intervention is appropriate. If surgery is planned, pre-operative testing (bloodwork, EKG, sometimes stress testing) follows. The cost structure depends on insurance and the procedure type; major cardiac surgery at a hospital facility where Silva has privileges runs into five figures after hospital and anesthesia fees, though your out-of-pocket cost depends on your plan's deductible and coinsurance.

How Silva Compares to Other Cardiac Surgeons in the Baltimore Area

Baltimore hosts multiple cardiac surgery programs: Johns Hopkins (with multiple surgeons across its cardiac surgery division), University of Maryland Medical Center, Sinai Hospital, and private practitioners. Johns Hopkins maintains the region's highest surgical volume and research profile, which correlates with better survival statistics for high-risk patients in published data, though outcome differences are modest for routine cases. University of Maryland and Sinai also perform substantial cardiac surgery. A private surgeon like Silva may offer more direct access and a relationship less mediated by large institutional bureaucracies, but less backup if an emergency arises intraoperatively. Choose Johns Hopkins or University of Maryland if you have multiple comorbidities or very high-risk anatomy; choose a private surgeon or Sinai if you value personal continuity and your condition is straightforward.

Who This Practice Suits and Who It Does Not

Silva's practice suits patients with significant coronary disease or valve pathology who have been evaluated by a cardiologist and need surgical opinion, and who prefer a single surgeon with both surgical and catheter skills rather than a team. It does not suit patients seeking preventive cardiology, medication management, or stress testing; a general cardiologist is the right first step for those. It is also not the setting for acute emergencies: if you have chest pain or shortness of breath, you need the emergency department at a hospital where Silva has admitting privileges (you can verify this with the office), not a phone call to his clinic.

First Visit and Pre-Operative Process

Your first appointment begins with paperwork and vital signs. Expect 20 to 45 minutes of face-to-face time. Bring any recent test results, a list of current medications, and insurance information. Silva will review your history, examine you, and review imaging on a monitor with you. If surgery is the plan, he will explain the specific operation, risks, and recovery timeline. You will then be scheduled for pre-operative testing, typically completed within two to four weeks of surgery. On the day of surgery, you will arrive at the hospital two hours before the scheduled start, sign final consent forms, and meet the anesthesia team. The operation usually takes two to four hours depending on complexity. Recovery in the intensive care unit is typically one to two days, followed by a standard hospital floor stay of three to five days before discharge home.

Hours, Location, and Logistics

Verify the specific office address and hours with Silva's office directly, as surgical practices often shift locations or consolidate with hospital facilities. Most cardiac surgeons in Baltimore practice with hospital privileges at one or more major medical centers, which means your surgery itself occurs at that hospital, not in an office. Parking at a hospital facility is available but may require validation; ask about this when you schedule. Allow 30 to 60 minutes for your first visit, including check-in.

Richard A. Silva's combination of surgical training and interventional capability gives Baltimore patients a single provider who can evaluate complex cardiac disease and choose the least invasive appropriate treatment, reducing the need for multiple consultations and referrals.