Implementation and consistency of Heart Team decision-making in complex coronary revascularisation

International Journal of Cardiology
Antonis N PavlidisSimon R Redwood

Abstract

A multidisciplinary team (MDT) approach for decision-making in patients with complex coronary artery disease (CAD) is now a class IC recommendation in the European and American guidelines for myocardial revascularisation. The aim of this study was to evaluate the implementation and consistency of Heart Team HT decision-making in complex coronary revascularisation. We prospectively evaluated the data of 399 patients derived from 51 consecutive MDT meetings held in a tertiary cardiac centre. A subset of cases was randomly selected and re-presented with the same clinical data to a panel blinded to the initial outcome, at least 6 months after the initial discussion, in order to evaluate the reproducibility of decision-making. The most common decisions included continued medical management (30%), coronary artery bypass grafting (CABG) (26%) and percutaneous coronary intervention (PCI) (17%). Other decisions, such as further assessment of symptoms or evaluation with further invasive or non-invasive tests were made in 25% of the cases. Decisions were implemented in 93% of the cases. On re-discussion of the same data (n=40) within a median period of 9 months 80% of the initial HT recommendations were successfully reproduced. The Heart ...Continue Reading

References

Jan 16, 2009·The New England Journal of Medicine·Pim A L ToninoUNKNOWN FAME Study Investigators
Feb 21, 2009·The New England Journal of Medicine·Patrick W SerruysUNKNOWN SYNTAX Investigators
Mar 29, 2011·Annals of Surgical Oncology·Benjamin W LambNick Sevdalis
May 31, 2011·Lancet·Stuart J HeadA Pieter Kappetein
Jul 7, 2011·JAMA : the Journal of the American Medical Association·Paul S ChanJohn A Spertus
Aug 9, 2011·Annals of Oncology : Official Journal of the European Society for Medical Oncology·K S SainiE de Azambuja
Nov 15, 2011·International Journal of Cardiology·Davide Capodanno, Corrado Tamburino
Feb 2, 2012·Interactive Cardiovascular and Thoracic Surgery·Jenny LongMichael Norell
May 19, 2012·Journal of the American College of Cardiology·Edward L HannanSpencer B King
Feb 22, 2013·European Heart Journal·Stuart J HeadA Pieter Kappetein
Mar 2, 2013·Journal of the American College of Cardiology·David R HolmesMichael J Mack
Jul 1, 2011·World Journal for Pediatric & Congenital Heart Surgery·James PerryAnthony C Chang
Sep 3, 2013·The American Journal of Cardiology·Uri RosenscheinAmnon Rofe
Sep 12, 2013·Circulation. Cardiovascular Quality and Outcomes·Carlos E SanchezSuresh R Mulukutla
Dec 11, 2013·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Josep M BorrasRobin Wilson
Jan 10, 2014·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Ashish PershadWilliam Lombardi
Apr 29, 2014·International Journal of Cardiology·Refai ShowkathaliJonathan Byrne
Jul 19, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Sheharyar S BaigDavid P Taggart
Mar 13, 2015·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Heyman LuckrazGraham Cooper
Apr 11, 2015·Journal of the American College of Cardiology·Megan CoylewrightPatrick T O'Gara

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Citations

Apr 5, 2019·Journal of the American Heart Association·Tiffany PattersonAntonis N Pavlidis
Jul 11, 2019·Future Cardiology·Ran Kornowski, Guy Witberg
Aug 11, 2017·Current Opinion in Cardiology·Bobby YanagawaSubodh Verma
Apr 21, 2020·Journal of the American Heart Association·Michael N YoungFarouc A Jaffer
May 15, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Robert F RileyFarouc A Jaffer
Aug 31, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Miguel Sousa-UvaUNKNOWN ESC Scientific Document Group
Jan 23, 2019·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Franz-Josef NeumannMichael O Zembala
Aug 31, 2018·European Heart Journal·Franz-Josef NeumannUNKNOWN ESC Scientific Document Group
Jan 24, 2020·Cardiovascular Therapeutics·Alexandru BurlacuGrigore Tinica
Aug 14, 2018·Interactive Cardiovascular and Thoracic Surgery·Carina T DominguesStuart J Head
Nov 24, 2020·The Thoracic and Cardiovascular Surgeon·Luciana Oliveira Cascaes DouradoLuis Henrique W Gowdak
Dec 10, 2020·European Cardiology·Marjan JahangiriJustin Nowell

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