Related Experiment Video
Updated: Apr 24, 2026
Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
Safety and efficacy of implementing a multidisciplinary heart team approach for revascularization in patients with
Danny Chu1, Melissa M Anastacio1, Suresh R Mulukutla2
1Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania2Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Insights
The multidisciplinary heart team (MHT) approach is safe and effective for managing complex coronary artery disease (CAD). This pilot study shows outcomes comparable to national standards for patients receiving MHT-recommended treatments.
Area of Science:
- Cardiology
- Cardiac Surgery
- Interventional Cardiology
Background:
- The multidisciplinary heart team (MHT) approach is standard for transcatheter aortic valve replacement.
- Its impact on patients with complex coronary artery disease (CAD) is not well understood.
Purpose of the Study:
- To evaluate the safety and efficacy of the MHT approach for patients with complex CAD.
- To assess the MHT's role in guiding evidence-based management strategies for CAD.
Main Methods:
- An observational pilot study of 180 patients with complex CAD.
- MHT meetings reviewed cases within 72 hours of angiography.
- Consensus decisions guided treatment strategies, with outcomes tracked.
Main Results:
- Low 30-day periprocedural mortality rates across PCI (8%) and CABG (1%) groups.
- Major adverse cardiac event rates at 12.1 months were 23% for PCI and 14% for CABG.
- Most patients received percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).
Conclusions:
- The MHT approach is safe and effective for complex CAD.
- Outcomes align with national standards for patients managed by MHT.
- MHT facilitates optimal, evidence-based treatment strategies for complex CAD.
Importance:
Since the advent of transcatheter aortic valve replacement, the multidisciplinary heart team (MHT) approach has rapidly become the standard of care for patients undergoing the procedure. However, little is known about the potential effect of MHT on patients with coronary artery disease (CAD).
Objective:
To determine the safety and efficacy of implementing the MHT approach for patients with complex CAD.
Design, Setting, And Participants:
Observational cohort pilot study of 180 patients with CAD involving more than 1 vessel in a single major academic tertiary/quaternary medical center. From May 1, 2012, through May 31, 2013, MHT meetings were convened to discuss evidence-based management of CAD. All cases were reviewed by a team of interventional cardiologists and cardiac surgeons within 72 hours of angiography. All clinical data were reviewed by the team to adjudicate optimal treatment strategies. Final recommendations were based on a consensus decision. Outcome measures were tracked for all patients to determine the safety and efficacy profile of this pilot program.
Exposures:
Multidisciplinary heart team meeting.
Main Outcomes And Measures:
Thirty-day periprocedural mortality and rate of major adverse cardiac events.
Results:
Most of the patients underwent percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG); a small percentage of patients underwent a hybrid procedure or medical management. Incidence of 30-day periprocedural mortality was low across all groups of patients (PCI group, 5 of 64 [8%]; CABG group, 1 of 87 [1%]). The rate of major adverse cardiac events during a median follow-up of 12.1 months ranged from 12 of 87 patients (14%) in the CABG group to 15 of 64 (23%) in the PCI group.
Conclusions And Relevance:
Outcomes of patients with complex CAD undergoing the optimal treatment strategy recommended by the MHT were similar to those of published national standards. Implementation of the MHT approach for patients with complex CAD is safe and efficacious.
Related Concept Videos
01:27Coronary Artery Disease V: Interprofessional Care
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:26Acute Coronary Syndrome V: Nursing Management
01:27Peripheral Artery Disease III: Interprofessional Care
01:30Acute Coronary Syndrome III: Diagnostic Studies