Cardiovascular disease; Heart team; Multidisciplinary team; Cardiology and Cardiovascular Medicine; Pulmonary and Respiratory Medicine; Surgery
Abstract :
[en] [en] OBJECTIVES: Multidisciplinary approach is well established in various disciplines, with evidence highlighting improved patient outcomes. The objective of this survey was to determine the real-world practice of heart teams across Europe.
METHODS: The survey was drafted after a consensus opinion from the authors. The survey was sent to cardiac surgeons and cardiologists identified through electronic search. The survey link and the information sheet were sent through email followed by survey completion reminders. The survey responses were cumulated and analysed.
RESULTS: Among 2188 invited clinicians, 220 clinicians from 26 countries took part in the survey (response rate 10%). The completion rate for the survey questions was 85%. A total of 140 (64%) were cardiac surgeons and 80 (36%) were cardiologists. The heart team meeting frequency was weekly according to 104 (55%) respondents. This was conducted face to face according to 139 (73%) of the responses. Eighty-seven (56%) of the respondents reported 10-20% of patients undergoing percutaneous coronary intervention were discussed at the heart team meeting. Seventy-nine (47%) respondents had ad hoc percutaneous coronary intervention institutional guidelines. Fifty-four (32%) respondents reported an audit process for the heart team decisions.
CONCLUSIONS: This survey suggests that there is marked variability in the infra-structure and execution of heart teams in different institutions. The results of the survey suggest a need to formulate guidelines on the composition and execution of heart teams which may result in an increase in transparency of decision-making within different institutions in reporting and comparing outcomes.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Imran Hamid, Umar ; Department of Cardiothoracic Surgery, Maastricht University Medical Centre, Maastricht, Netherlands ; Department of Cardiac Surgery, Nottingham University Hospital NHS Trust, Nottingham, UK
Modine, Thomas; Department of Cardiac Surgery, Lille University Hospital, Lille, France
Maessen, Jos; Department of Cardiothoracic Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
van 't Hof, Arnoud; Department of Cardiology, Maastricht University Medical Centre, Maastricht, Netherlands
Sondergaard, Lars; Department of Cardiology, Copenhagen University Hospital, Copenhagen, Denmark
Bleiziffer, Sabine ; Department of Cardiac Surgery, Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
Lancellotti, Patrizio ; Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation
Siepe, Matthias ; Department of Cardiac Surgery, Cardiovascular Centre, Inselspital, University of Bern, Switzerland
Sardari Nia, Peyman ; Department of Cardiothoracic Surgery, Maastricht University Medical Centre, Maastricht, Netherlands
Language :
English
Title :
Structure of multidisciplinary heart teams, a survey-based heart team study.
Publication date :
03 August 2023
Journal title :
Interdisciplinary Cardiovascular and Thoracic Surgery
Forrest LM, McMillan DC, McArdle CS, Dunlop DJ. An evaluation of the impact of a multidisciplinary team, in a single centre, on treatment and survival in patients with inoperable non-small-cell lung cancer. Br J Cancer 2005;93:977-8.
Kesson EM, Allardice GM, George WD, Burns HJ, Morrison DS. Effects of multidisciplinary team working on breast cancer survival: retrospective, comparative, interventional cohort study of 13 722 women. BMJ 2012; 344:e2718.
Archbold A, Akowuah E, Banning AP, Baumbach A, Braidley P, Cooper G et al. Getting the best from the Heart Team: guidance for cardiac multidisciplinary meetings. Heart 2022;108:e2.
Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM et al. 2021 ACC/AHA/SCAI guideline for coronary artery revascularization: executive summary: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2022;145:e4-e17.
Sardari Nia P, Olsthoorn JR, Heuts S, van Kuijk SMJ, Vainer J, Streukens S et al. Effect of a dedicated mitral heart team compared to a general heart team on survival: A retrospective, comparative, non-randomized interventional cohort study based on prospectively registered data. Eur J Cardiothorac Surg 2021;60:263-73.
Coylewright M, Mack MJ, Holmes DR Jr, O'Gara PT. A call for an evidence-based approach to the Heart Team for patients with severe aortic stenosis. J Am Coll Cardiol 2015;65:1472-80.
Beyersdorf F, Vahanian A, Praz F, Milojevic M, Baldus S, Bauersachs J et al.; ESC/EACTS Scientific Document Group. 2021 ESC/EACTS Guidelines for the management of valvular heart disease. Eur J Cardiothorac Surg 2021;60:727-800.
Starck CT, Bracke F, Delnoy PP, Freedman RA, Kutarski A, Gallagher M et al. ILEEM-survey on the Heart Team approach and team training for lead extraction procedures. Cardiol J 2022;29:481-8.
Luckraz H, Norell M, Buch M, James R, Cooper G. Structure and functioning of a multidisciplinary 'Heart Team' for patients with coronary artery disease: rationale and recommendations from a joint BCS/BCIS/ SCTS working group. Eur J Cardiothorac Surg 2015;48:524-9.
