Safety and Efficacy of Implementing a Multidisciplinary Heart Team Approach for Revascularization in Patients With Complex Coronary Artery Disease

Chu, Danny; Anastacio, Melissa M.; Mulukutla, Suresh; Lee, Joon S.; Smith, A.J. Conrad; Marroquin, Oscar C.; Sanchez, Carlos E.; Morell, Victor O.; Cook, Chris C.; Lico, S; Wei, Lawrence M.; Badhwar, Vinay

doi:10.1001/jamasurg.2014.2059

Cited by 43 publications

(38 citation statements)

References 19 publications

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“…The authors compared the outcome of the pilot study with that of historical data and reported that outcomes of patients with complex CAD, undergoing the optimal treatment strategy recommended by the Heart Team, were similar to those of published national standards. Based on this, they concluded that implementation of the Heart Team approach for patients with complex CAD is safe and efficacious [17].…”

Section: Scope Of the Heart Teammentioning

confidence: 99%

Heart Team—the Indian perspective

Sarkar

2018

Indian J Thorac Cardiovasc Surg

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Purpose The European Society of Cardiology and the European Association for Cardio-Thoracic Surgery as well as the American College of Cardiology and the American Heart association have recognized the "Heart Team" as the best option for a patient centric treatment strategy and has granted a class I recommendation for its formation. The aim of this review is to discuss the evolution, scope and composition, the benefits, and problems inherent in its implementation in the Indian scenario. Methods A review of articles on Heart Team from cardiac surgery as well as multidisciplinary meetings from other specialties was performed. Advantages of Heart Team formation and its implementation have been critically evaluated and its applicability to the Indian scenario considered in particular. Results Heart Team formation is associated with many positives. Concern remains about the implementation of Heart Team approach in its true sense. Heart Team-led decisions are definitely patient centric despite multiple challenges in resource-limited environments. Conclusions Despite the challenges, a multidisciplinary team approach in the form of Heart Team is recommended and its implementation possible in India. However, adjustments to the mechanism of implementation are required. Further research needs to focus on creating models for implementation and assessment of these models in terms of cost effectiveness, improved patient outcomes, and patient satisfaction in the process.

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Section: Scope Of the Heart Teammentioning

confidence: 99%

Heart Team—the Indian perspective

Sarkar

2018

Indian J Thorac Cardiovasc Surg

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“…Multidisciplinary team models are an emerging standard of care in CVD management. Multidisciplinary models including various types of cardiologists (e.g., subspecialists in heart failure, electrophysiology, cardiac surgery, interventional cardiology) have demonstrated efficacy in improving clinical outcomes in coronary artery disease patients and adult heart failure patients (Altman et al 2012;Chu et al 2014). Further, the management of congenital heart disease populations ideally includes a multidisciplinary approach involving both cardiology specialists and subspecialists in other fields, including psychiatry, pulmonology (Perry et al 2011) psychology, and social work (Kovacs et al 2005).…”

Section: Introductionmentioning

confidence: 99%

Minding the Genes: a Multidisciplinary Approach towards Genetic Assessment of Cardiovascular Disease

Rhodes

Rosman

Cahill

et al. 2016

Journal of Genetic Counseling

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Genetic assessment for inherited cardiovascular disease (CVD) is increasingly available, due in part to rapid innovations in genetic sequencing technologies. While genetic testing is aimed at reducing uncertainty, it also produces awareness of potential medical conditions and can leave patients feeling uncertain about their risk, especially if there are ambiguous results. This uncertainty can produce psychological distress for patients and their families undergoing the assessment process. Additionally, patients may experience psychological distress related to living with inherited CVD. In order to more effectively manage the psychosocial challenges related to genetic assessment for CVD, a multidisciplinary model expanded to include psychologists and other allied health professionals is outlined. A case study is provided to illustrate how psychological distress can manifest in a patient living with inherited CVD, as well as proposed psychological management of this patient. Finally, a guide for genetic counselors is provided to aid in identifying and managing common psychological reactions to genetic assessment for CVD.

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“… The rate of surgical turndowns that went on to PCI was a steady 1.5–2.5% across 33 hospitals. However, determining the actual turn down rate still is unknown without a true HEART TEAM approach to every nonemergent coronary revascularization . The latter is not readily practical given the ad hoc intervention rate these days.…”

mentioning

confidence: 99%