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EACVI survey on the role, structure, and implementation of heart teams in current cardiology practice
Vlatka Reskovic Luksic1, Riitta Paakkanen2, Tomaz Podlesnikar3,4
1School of Medicine and University Hospital Center Zagreb, University of Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia.
Insights
The Heart Team (HT) approach is vital for complex cardiac cases, but practical implementation faces challenges. This survey highlights areas for improving HT structure, leadership, and efficiency in clinical practice.
Area of Science:
- Cardiology
- Healthcare Management
Background:
- The Heart Team (HT) concept is emphasized in clinical guidelines but faces practical application challenges.
- Contemporary Heart Teams are crucial for managing complex cardiovascular cases.
Purpose of the Study:
- To explore the structure and dynamics of current Heart Teams in real-world clinical practice.
- To identify perceived benefits and barriers associated with Heart Team collaboration.
Main Methods:
- A 24-question online survey was distributed to cardiologists and specialists involved in Heart Team meetings.
- 233 responses were collected from 48 countries, with a majority from Europe.
- The survey identified HT configurations, core members, and discussion focus.
Main Results:
- Twelve distinct HT configurations were identified, with core members including cardiologists, cardiac surgeons, and imaging specialists.
- Leadership within HTs is inconsistent, and regular audits are lacking in over half of centers.
- Key benefits include structured decision-making and optimized management of complex cases, while barriers include scheduling and communication issues.
Conclusions:
- Multidisciplinary Heart Teams play a significant role in modern cardiology but require improvements in efficiency and structure.
- Addressing identified challenges can enhance HT practices and patient care for complex cases across cardiology subspecialties.
Aims:
The Heart Team (HT) concept is underscored in multiple guidelines, but the practical application is still challenging.
Objective:
This survey, endorsed by the European Association of Cardiovascular Imaging (EACVI) Scientific Initiatives Committee and conducted by the EACVI Leaders of Tomorrow, aimed to explore the structure and dynamics of contemporary HTs in real-life clinical practice.
Methods And Results:
The Survey comprised 24 questions, including single-choice, multiple-choice, and open-labeled formats. It addressed all cardiologists and associated specialists involved in the HT meetings via online platform. A total of 233 responses were collected from 48 countries, 203 (87%) from Europe. Most respondents were imaging specialists (38%) and general cardiologists (29%), with 85% actively engaged in HT meetings. Twelve distinct HT configurations were identified. Core HT members included general and interventional cardiologists, cardiac surgeons, and imaging specialists. Complex cases are usually discussed at HT meetings, and ESC guidelines serve as a guiding framework (87%). Leadership within HTs is inconsistent and regular HT audits are lacking in 53% of centers. The Heart Team predominantly focus on treatment planning (97%) rather than outcome review (45%) or education (36%). Key perceived benefits include structured decision-making (74%), optimized management of complex cases (69%), and reduced specialty bias (67%). Recognized barriers included scheduling constraints, resource limitations, and communication inefficiencies.
Conclusion:
This survey shows the important role of multidisciplinary HTs in contemporary clinical practice but reveals several areas of potential improvement. Addressing common challenges could result in more efficient HT practices and improve the care of complex patient cases in various cardiology subspecialty areas.
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