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Updated: Sep 10, 2025
Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
[The heart team in coronary artery disease-perspectives from centers without institutional cardiac surgery]
M Winhard1,2, M Krane3,4, S Hakmi5
1Medizinische Klinik I, Kardiologie, Pneumologie, internistische Intensivmedizin, Lakumed Krankenhaus Landshut Achdorf, Achdorfer Weg 3, 84036, Landshut, Deutschland.
Insights
Establishing a heart team in hospitals without cardiac surgery requires a coordinated core team, external partnerships, and clear communication protocols. This interdisciplinary approach ensures evidence-based treatment for complex coronary artery disease (CAD) patients.
Area of Science:
- Cardiology
- Cardiac Surgery
- Healthcare Management
Context:
- Coronary artery disease (CAD) management is increasingly complex.
- The heart team model is standard in university centers but challenging in non-university hospitals.
- Lack of in-house cardiac surgery poses implementation hurdles for heart teams.
Purpose:
- To outline practical strategies for establishing heart teams in non-university hospitals.
- To address the unique challenges faced by institutions without in-house cardiac surgery.
- To provide guidance on interdisciplinary decision-making for CAD management.
Summary:
- This article details how non-university hospitals can form effective heart teams.
- Key strategies include a core team, external cardiac surgery partnerships (telemedicine), and integrated anesthesiology.
- Emphasis is placed on robust communication, documentation, and necessary technical infrastructure for virtual collaboration.
Impact:
- Facilitates evidence-based, individualized treatment for complex CAD patients in diverse healthcare settings.
- Enhances collaboration between cardiology and cardiac surgery, improving patient care outcomes.
- Promotes the adoption of the heart team model beyond major academic medical centers.
Abstract:
The management of coronary artery disease (CAD) has become more demanding due to evolving therapeutic options and more complex patient profiles. In this context, the heart team has become established: a structured, interdisciplinary decision-making process that brings together the specialist knowledge from cardiology, cardiac surgery, anesthesia and other specialist fields to enable individual and evidence-based treatment recommendations. While this model is well-established in university medical centers, its implementation in nonuniversity hospitals lacking in-house cardiac surgery presents unique challenges. This article explores practical strategies for successfully establishing heart teams in such institutions, including the formation of a stable organized core team for case coordination, formal cooperation with external cardiac surgery centers (often via telemedicine), integration of experienced cardiac anesthesiologists and the establishment of clear internal processes for communication and documentation. Particular attention is given to the technical infrastructure required to support hybrid or virtual conferencing formats.
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