The Multidisciplinary Heart Team in Cardiovascular Medicine: Current Role and Future Challenges

Wayne B Batchelor¹, Saif Anwaruddin², Dee Dee Wang³, Elizabeth M Perpetua⁴, Ashok Krishnaswami⁵, Poonam Velagapudi⁶, Janet F Wyman⁷, David Fullerton⁸, Patricia Keegan⁹, Alistair Phillips¹⁰, Laura Ross¹¹, Brij Maini¹², Gwen Bernacki¹³, Gurusher S Panjrath¹⁴, James Lee³, Jeffrey B Geske¹⁵, Fred Welt¹⁶, Prashanth D Thakker¹⁷, Anita Deswal¹⁸, Ki Park¹⁹, Michael J Mack²⁰, Martin Leon²¹, Sandra Lewis²², David Holmes²³

Affiliations

¹ ACC Interventional Cardiology Section Leadership Council, Inova Heart and Vascular Institute, Falls Church, Virginia, USA. Electronic address: Wayne.Batchelor@inova.org.
² Division of Cardiology, ACC Interventional Section Leadership Council, St. Vincent Hospital, Worcester, Massachusetts, USA.
³ ACC Cardiovascular Imaging Section Leadership Council, Center for Structural Heart Disease, Henry Ford Hospital, Detroit, Michigan, USA.
⁴ ACC Cardiovascular Team Section Leadership Council, Empath Health Services, Seattle, Washington, USA; Seattle Pacific University, School of Health Sciences and School of Nursing, Seattle, Washington, USA.
⁵ Division of Cardiology, ACC Geriatric Cardiology Section Leadership Council, Kaiser Permanente San Jose Medical Center, San Jose, California, USA; Division of Geriatrics, Stanford University School of Medicine, Stanford, California, USA.
⁶ Division of Cardiology, ACC Early Career Professionals Section Leadership Council, University of Nebraska Medical Center, Omaha, Nebraska, USA.
⁷ ACC Cardiovascular Team Section Leadership Council, Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan, USA.
⁸ Division of Cardiothoracic Surgery, Department of Surgery, ACC Cardiac Surgery Team Section Leadership Council, University of Colorado School of Medicine, Aurora, Colorado, USA.
⁹ Division of Cardiology, ACC Cardiovascular Team Section Leadership Council, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, Atlanta, Georgia, USA.
¹⁰ ACC Cardiac Surgery Team Section Leadership Council, The Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
¹¹ ACC Interventional Cardiology Section Leadership Council, Park Nicollet Heart and Vascular Center, St. Louis Park, Massachusetts, USA.
¹² Charles E. Schmidt College of Medicine, Florida Atlantic University, Delray Medical Center, Delray Beach, Florida, USA.
¹³ Cardiovascular Division, Department of Medicine, ACC Geriatric Section Leadership Council, Cambia Palliative Care Center of Excellence, University of Washington, Seattle, Washington, USA; Veterans Administration of Puget Sound, University of Washington School of Medicine, Seattle, Washington, USA.
¹⁴ ACC Heart Failure and Transplant Section Leadership Council, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
¹⁵ Department of Cardiovascular Medicine, ACC Cardiovascular Imaging Section Leadership Council, Mayo Clinic, Rochester, Minnesota, USA.
¹⁶ Division of Cardiovascular Medicine, ACC Interventional Cardiology Leadership Council, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
¹⁷ Cardiovascular Division, Department of Medicine, ACC Fellows in Training Section Leadership Council, Washington University, Saint Louis, Missouri, USA.
¹⁸ Division of Internal Medicine, Department of Cardiology, ACC Cardio-Oncology Leadership Council, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
¹⁹ Division of Cardiovascular Medicine, ACC Interventional Cardiology Section Leadership Council, University of Florida College of Medicine, Malcom Randall VA Medical Center, Gainesville, Florida, USA.
²⁰ Division of Cardiothoracic Surgery, Department of Surgery, ACC Cardiac Surgery Team Section Leadership Council, Baylor Scott and White Health, Dallas, Texas, USA.
²¹ Division of Cardiology, Department of Medicine, ACC Leon Center Leadership Council, Columbia University Irving Medical Center, New York, New York, USA.
²² ACC Section Steering Committee, Legacy Medical Group Cardiology, Portland, Oregon, USA.
²³ Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.

PMID: 38939019
PMCID: PMC11198656
DOI: 10.1016/j.jacadv.2022.100160

Review

The Multidisciplinary Heart Team in Cardiovascular Medicine: Current Role and Future Challenges

Wayne B Batchelor et al. JACC Adv. 2023.

. 2023 Jan 11;2(1):100160.

doi: 10.1016/j.jacadv.2022.100160. eCollection 2023 Jan.

Authors

Affiliations

¹ ACC Interventional Cardiology Section Leadership Council, Inova Heart and Vascular Institute, Falls Church, Virginia, USA. Electronic address: Wayne.Batchelor@inova.org.
² Division of Cardiology, ACC Interventional Section Leadership Council, St. Vincent Hospital, Worcester, Massachusetts, USA.
³ ACC Cardiovascular Imaging Section Leadership Council, Center for Structural Heart Disease, Henry Ford Hospital, Detroit, Michigan, USA.
⁴ ACC Cardiovascular Team Section Leadership Council, Empath Health Services, Seattle, Washington, USA; Seattle Pacific University, School of Health Sciences and School of Nursing, Seattle, Washington, USA.
⁵ Division of Cardiology, ACC Geriatric Cardiology Section Leadership Council, Kaiser Permanente San Jose Medical Center, San Jose, California, USA; Division of Geriatrics, Stanford University School of Medicine, Stanford, California, USA.
⁶ Division of Cardiology, ACC Early Career Professionals Section Leadership Council, University of Nebraska Medical Center, Omaha, Nebraska, USA.
⁷ ACC Cardiovascular Team Section Leadership Council, Center for Structural Heart Disease, Henry Ford Health System, Detroit, Michigan, USA.
⁸ Division of Cardiothoracic Surgery, Department of Surgery, ACC Cardiac Surgery Team Section Leadership Council, University of Colorado School of Medicine, Aurora, Colorado, USA.
⁹ Division of Cardiology, ACC Cardiovascular Team Section Leadership Council, Emory Structural Heart and Valve Center, Emory University Hospital Midtown, Atlanta, Georgia, USA.
¹⁰ ACC Cardiac Surgery Team Section Leadership Council, The Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.
¹¹ ACC Interventional Cardiology Section Leadership Council, Park Nicollet Heart and Vascular Center, St. Louis Park, Massachusetts, USA.
¹² Charles E. Schmidt College of Medicine, Florida Atlantic University, Delray Medical Center, Delray Beach, Florida, USA.
¹³ Cardiovascular Division, Department of Medicine, ACC Geriatric Section Leadership Council, Cambia Palliative Care Center of Excellence, University of Washington, Seattle, Washington, USA; Veterans Administration of Puget Sound, University of Washington School of Medicine, Seattle, Washington, USA.
¹⁴ ACC Heart Failure and Transplant Section Leadership Council, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
¹⁵ Department of Cardiovascular Medicine, ACC Cardiovascular Imaging Section Leadership Council, Mayo Clinic, Rochester, Minnesota, USA.
¹⁶ Division of Cardiovascular Medicine, ACC Interventional Cardiology Leadership Council, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
¹⁷ Cardiovascular Division, Department of Medicine, ACC Fellows in Training Section Leadership Council, Washington University, Saint Louis, Missouri, USA.
¹⁸ Division of Internal Medicine, Department of Cardiology, ACC Cardio-Oncology Leadership Council, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
¹⁹ Division of Cardiovascular Medicine, ACC Interventional Cardiology Section Leadership Council, University of Florida College of Medicine, Malcom Randall VA Medical Center, Gainesville, Florida, USA.
²⁰ Division of Cardiothoracic Surgery, Department of Surgery, ACC Cardiac Surgery Team Section Leadership Council, Baylor Scott and White Health, Dallas, Texas, USA.
²¹ Division of Cardiology, Department of Medicine, ACC Leon Center Leadership Council, Columbia University Irving Medical Center, New York, New York, USA.
²² ACC Section Steering Committee, Legacy Medical Group Cardiology, Portland, Oregon, USA.
²³ Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.

PMID: 38939019
PMCID: PMC11198656
DOI: 10.1016/j.jacadv.2022.100160

Abstract

Cardiovascular multidisciplinary heart teams (MDHTs) have evolved significantly over the past decade. These teams play a central role in the treatment of a wide array of cardiovascular diseases affecting interventional cardiology, cardiac surgery, interventional imaging, advanced heart failure, adult congenital heart disease, cardio-oncology, and cardio-obstetrics. To meet the specific needs of both patients and heart programs, the composition and function of cardiovascular MDHTs have had to adapt and evolve. Although lessons have been learned from multidisciplinary cancer care, best practices for the operation of cardiovascular MDHTs have yet to be defined, and the evidence base supporting their effectiveness is limited. This expert panel review discusses the history and evolution of cardiovascular MDHTs, their composition and role in treating patients across a broad spectrum of disciplines, basic tenets for successful operation, and the future challenges facing them.

Keywords: multidisciplinary heart team; structural heart disease; team-based care.

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Conflict of interest statement

Dr Batchelor has received institutional research grant support from Abbott and Boston Scientific; and is a consultant for Abbott, Medtronic, Edwards, V-Wave Medical, and Boston Scientific. Dr Anwaruddin is a consultant/proctor/advisory board member at Medtronic; proctor at Edwards; on the steering committee of Boston Scientific; on the advisory board of OpSens; and has equity in East End Medical. Dr Wang is a consultant at Edwards Lifesciences, Boston Scientific, Abbott, and Neochord; and has received institutional research grant support from Boston scientific. Dr Velugapudi is on the Speakers Bureau of Abiomed and Opsens; and is on the advisory board of Women’s Health Initiative. Ms Wyman is a consultant at Edwards Lifesciences and Boston Scientific. Ms Perpetua is a consultant at Abbott and Edwards; and is on the advisory board of Abbott. Dr Maini has equity in East End Medical; is on the advisory board of Boston Scientific, Abbott, and Medtronic; is on the Speakers Bureau of Boston Scientific, Abbott, and Medtronic; and has received proctorship honoraria from Boston Scientific, Abbott, and Medtronic. Dr Mack is a co-principal investigator/study chair (no renumeration) for Abbott, Edwards Lifesciences, and Medtronic. Dr Leon is on the advisory board (no renumeration) of Abbott, BSC, MDT, Edwards, Gore, and Venus Medtech. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

**Central Illustration**
**Conceptual Framework for the MDHT** The figure depicts the relationships between the key entities involved in the multidisciplinary care of patients with complex cardiovascular disease. Typical members of the core and extended teams and responsibilities of hospital administration are shown. The **arrows** highlight the relationships and communication that exist between these entities. Tier 2 program multidisciplinary heart teams (MDHTs) may share the same internal components as a tier 1 program. The Central Illustration was completed through a collaboration of Devon Stuart (Devon Medical Art) and Mary Kate Wright (MK Illustrations).

**Figure 1**
**Key Principles for the Effective Operation of the MDHT and its Core Responsibilities** MDHT = multidisciplinary heart team; QI = quality improvement.

See this image and copyright information in PMC

References

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The Multidisciplinary Heart Team in Cardiovascular Medicine: Current Role and Future Challenges

Affiliations

The Multidisciplinary Heart Team in Cardiovascular Medicine: Current Role and Future Challenges

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

LinkOut - more resources

Full Text Sources

Miscellaneous