At the beginning of the twenty-first century, cardiothoracic surgery is arguably the most successful of all medical specialties. There are effective treatments including transplantation, for almost all cardiac and thoracic diseases that can be performed with low morbidity and mortality. Cardiothoracic surgeons have mastered technical difficulties through innovation, hard work, planning and skill. Yet in the past decade, the primacy of cardiothoracic surgery has been challenged by new technologies. This paper applies business school theories to examine how cardiothoracic surgeons might best respond to such "disruptive technologies". Otherwise well-managed business and industrial enterprises have had difficulty dealing with disruptive technological change because of well-recognized organizational impediments. Cardiothoracic surgeons must understand the characteristics of disruptive technologies and consider organizational changes that will allow the profession to better adapt to them.