Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Multidisciplinary heart team (MHT) evaluation is a class I recommendation for coronary and structural heart disease, yet limited outcomes data exist for high-risk and complex valvular heart disease (VHD) patients referred for surgery. Methods: From June 2021 to August 2022, our institutional MHT-comprising cardiac surgeons, interventional cardiologists, heart failure specialists, advanced imaging specialists, intensivists, and palliative care specialists-evaluated the highest-risk or complex VHD patients. Patient demographics, Society of Thoracic Surgeons Predicted Risk of Mortality scores, initial treatment plans, final team recommendations, and outcomes, including adherence to recommendations, 30-day readmission, and mortality at 30 days, 1 year, and 2 years were analyzed. Results: Among 121 patients, the MHT recommended surgery for 67%, transcatheter intervention for 14%, a hybrid approach for 3%, and medical management (MM) for 17%. Overall adherence to MHT recommendations was 89%. Thirty-day mortality was 7/81 (9%) for surgical patients, 3/17 (18%) for transcatheter, 0/3 for hybrid, and 4/20 (20%) for MM. By 2 years, mortality rose to 17/81 (21%) for surgery, 9/17 (53%) for transcatheter, 1/3 (33%) for hybrid, and 11/20 (55%) for MM. Conclusion: MHT evaluation facilitates individualized treatment strategies by distinguishing patients who may benefit from intervention despite high procedural risk, while sparing those unlikely to benefit.
Authors: Taylor Pickering, John Eisenga, Kyle McCullough, Cody Dorton, Austin Kluis, Ghadi Moubarak, John J. Squiers, Emily Shih, Garrett Klutts, Rahul Sawhney, Jennie Hocking, Talia Cohen Meidan, Srini Potluri, Karim Al-Azizi, David Moore, William Brinkman, Lee Hafen, Katherine Harrington, Timothy George, Justin Schaffer, Julius Ejiofor, Robert L. Smith, William Ryan, J. Michael DiMaio, Molly Szerlip, Kelley Hutcheson
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4417128992