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[Discuss Many to Benefit More - Five-Year Analysis of a Multidisciplinary Aortic Board]

Katrin Meisenbacher1, Uwe Geis1, Hans-Ulrich Kauczor2

  • 1Klinik für Gefäßchirurgie und Endovaskuläre Chirurgie, Universitätsklinikum Heidelberg, Deutschland.

Zentralblatt Fur Chirurgie
|March 25, 2020
PubMed

Insights

Multidisciplinary aortic boards (mAB) effectively filter patients towards conservative treatment, but many patients recommended for surgery do not receive it. Improving mAB performance requires a central management office and registry for better aortic disease management.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Medical Decision Making

Background:

  • Multidisciplinary aortic boards (mAB) are crucial for managing complex aortic pathologies.
  • Evaluating mAB performance is essential for optimizing patient care pathways.

Purpose of the Study:

  • To assess the patient volume and discipline-specific contributions to a maximum care hospital's mAB.
  • To review treatment indications and patient allocation decisions made by the mAB.
  • To identify areas for improvement in mAB function and patient management.

Main Methods:

  • Retrospective analysis of patients discussed in the mAB from 01/2014 to 12/2018.
  • Inclusion of data from Heidelberg University Hospital's Vascular and Endovascular Surgery, Cardiac Surgery, and Radiology departments.
  • Review of patient demographics, treatment indications (conservative vs. surgical), and actual therapies received.

Main Results:

  • 344 patients were discussed over five years (median 71/year), predominantly from Vascular Surgery (76%).
  • Surgical treatment was indicated in 45% of cases, with a nearly equal distribution between Vascular and Cardiac Surgery referrals.
  • A significant proportion (39%) of patients indicated for surgery did not receive the recommended treatment.

Conclusions:

  • The mAB plays a key role in directing patients towards conservative management.
  • The high volume from outpatient sectors highlights the mAB's reliance on external referrals.
  • A central management office and registry are recommended to enhance mAB effectiveness and ensure adherence to surgical recommendations.
Abstract

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