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Updated: Jun 7, 2025

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
The heart team: the multidisciplinary approach to coronary artery disease
Ramon A Riojas1,2, Jennifer S Lawton1, Thomas S Metkus1,3
1Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Insights
The heart team approach, recommended for over a decade for revascularization, has seen limited adoption despite proven benefits. This review examines its history, success factors, and barriers to implementation.
Area of Science:
- Cardiology
- Healthcare Management
Background:
- The heart team approach for guiding revascularization has been recommended for over 10 years.
- Evidence supports improved guideline adherence with this multidisciplinary strategy.
Purpose of the Study:
- To review the historical guidelines and data supporting the heart team approach.
- To identify attributes of successful heart teams and implementation models.
- To explore barriers and future considerations for heart team adoption.
Main Methods:
- Literature review of guidelines and supporting data.
- Analysis of heart team operational models at academic centers.
- Discussion of implementation challenges.
Main Results:
- Despite strong evidence, widespread adoption of the heart team approach remains limited.
- Key attributes for successful heart teams include clear communication and defined roles.
- Barriers include logistical challenges, established practices, and interdisciplinary collaboration issues.
Conclusions:
- The heart team approach is evidence-based but faces adoption hurdles.
- Addressing identified barriers is crucial for optimizing patient care through collaborative decision-making.
Abstract:
The recommendation to employ a heart team to guide revascularization has persisted for over a decade. Despite evidence for improved adherence to guidelines, widespread adoption of the heart team approach has been limited. This review delves into the history of the guidelines endorsing the use of a heart team and the supporting data. Additionally, it outlines some attributes of a successful heart team, and how the heart team has been run at several large academic centers. Finally, it reviews some of the barriers to a heart team and future considerations.
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