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Review
. 2022 Apr 28;12(5):705.
doi: 10.3390/jpm12050705.

An Individualized Approach of Multidisciplinary Heart Team for Myocardial Revascularization and Valvular Heart Disease-State of Art

Szymon Jonik  1 , Michał Marchel  1 , Zenon Huczek  1 , Janusz Kochman  1 , Radosław Wilimski  2 , Mariusz Kuśmierczyk  2 , Marcin Grabowski  1 , Grzegorz Opolski  1 , Tomasz Mazurek  1
Affiliations
Review

An Individualized Approach of Multidisciplinary Heart Team for Myocardial Revascularization and Valvular Heart Disease-State of Art

Szymon Jonik et al. J Pers Med. .

Abstract

The multidisciplinary Heart Team (HT) remains the standard of care for highly-burdened patients with coronary artery disease (CAD) and valvular heart disease (VHD) and is widely adopted in the medical community and supported by European and American guidelines. An approach of highly-experienced specialists, taking into account numerous clinical factors, risk assessment, long-term prognosis and patients preferences seems to be the most rational option for individuals with. Some studies suggest that HT management may positively impact adherence to current recommendations and encourage the incorporation of patient preferences through the use of shared-decision making. Evidence from randomized-controlled trials are scarce and we still have to satisfy with observational studies. Furthermore, we still do not know how HT should cooperate, what goals are desired and most importantly, how HT decisions affect long-term outcomes and patient's satisfaction. This review aimed to comprehensively discuss the available evidence establishing the role of HT for providing optimal care for patients with CAD and VHD. We believe that the need for research to recognize the HT definition and range of its functioning is an important issue for further exploration. Improved techniques of interventional cardiology, minimally-invasive surgeries and new drugs determine future perspectives of HT conceptualization, but also add new issues to the complexity of HT cooperation. Regardless of which direction HT has evolved, its concept should be continued and refined to improve healthcare standards.

Keywords: aortic stenosis; coronary artery disease; decision-making; heart team; interventions; mitral regurgitation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The variables associated with Heart Team decision-making process. NYHA—New York Heart Association, CCS—Canadian Cardiovascular Society, OMT—optimal medical therapy, EuroSCORE II—European System for Cardiac Operative Risk Evaluation, STS—Society of Thoracic Surgeons, SYNTAX—Synergy Between PCI with Taxus and Cardiac Surgery.
Figure 2
Figure 2
The HT specialists cooperation.
See this image and copyright information in PMC

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