Max Hospital, Dehradun is the first hospital in Uttarakhand to adopt “Heart Team Concept” in the management of complex heart diseases. This concept is gaining popularity to provide holistic and ethically correct treatment to patients suffering from various cardiovascular diseases.
For managing patients who are suffering from complex cardiovascular diseases has changed substantially over the last 10 years with the advent of advancements in information technology and an increasing amount of evidence data. As a result, it is necessary to synthesize a large quantity of information so that the care management options that are available are understandable to patients and their families. To facilitate this process of evidence-based care, patient-centric approach, Multidisciplinary teams have become cornerstones.
Presently, this approach is useful in planning Revascularization Strategies to manage complex coronary artery disease with multiple co-morbidities. The heart team in coronary revascularization consists of Interventional Cardiologists, CTVS surgeons and cardiac anesthesiologists, an imaging specialist and a neurologist.
The concept of heart team came into existence after SYNTAX trial results (synergy between PCI and CABG).
The conventional approach to surgical aortic valve implantation in high-risk candidates with co-morbidities has been replaced with the percutaneous approach by interventional cardiologists; hence the heart team works in the management of Severe Aortic valve stenosis.
The Objective of Heart Team Approach is to provide patient-centric care where family and the patients participate in decisions that are taken by the team. The other alternatives to the treatment are discussed in the presence of family and the outcome of each approach is also discussed to understand the expectations. The final treatment will only be given once the family and team take the final decision.
According to the ESC and ACC guidelines, the heart team concept is now being imbibed in the guidelines document as a Class 1 indication regarding coronary revascularization in complex CAD patients.
At present, there are some barriers to this concept of heart team like a conflict of interest between surgeon and cardiologist, the difference in position or hierarchy, busy schedules of one of the people involved in the team. These barriers can be crossed once this concept evolves.