Page 205 - Read Online

Riojas et al. Vessel Plus 2024;8:6 Vessel Plus
DOI: 10.20517/2574-1209.2023.122

Review Open Access

The heart team: the multidisciplinary approach to

coronary artery disease

1
1,2
Ramon A. Riojas , Jennifer S. Lawton , Thomas S. Metkus Jr. 1,3
1
Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
2
Malcolm Grow Medical Clinics and Surgery Center, Joint Base-Andrews, MD 20762, USA.
3
Divison of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Correspondence to: Dr Thomas S. Metkus Jr., Division of Cardiology, Department of Medicine, Johns Hopkins University School
of Medicine, Blalock 524, C, 600 North Wolfe Street, Baltimore, MD 21287, USA. E-mail: tmetkus1@jhmi.edu
How to cite this article: Riojas RA, Lawton JS, Metkus Jr. TS. The heart team: the multidisciplinary approach to coronary artery
disease. Vessel Plus 2024;8:6. https://dx.doi.org/10.20517/2574-1209.2023.122
Received: 4 Sep 2023 First Decision: 27 Nov 2023 Revised: 21 Dec 2023 Accepted: 16 Jan 2024 Published: 25 Jan 2024

Academic Editors: Carlos A. Mestres, Alistair Royse Copy Editor: Fangyuan Liu Production Editor: Fangyuan Liu

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.

Keywords: Multidisciplinary team, heart team, complex coronary artery disease, PCI, CABG

INTRODUCTION
Many medical fields have adopted team-based approaches to decision making due to rapidly evolving and
complex treatment algorithms. Guidelines are produced by major societies, and new algorithms are
published almost annually . Risk score calculators are generated to help with decision making. As such,
[1]
navigating the decision-making process by a single physician or healthcare provider is ever challenging. In
the field of cardiovascular disease, many institutions have developed multidisciplinary teams of physicians
and providers to help with the decision-making process . For example, cardiologists and surgeons meet
[2-5]
with a variety of other health providers to determine whether patients with end-stage heart failure are

© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

www.oaepublish.com/vp