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Page 12 of 16 Riojas et al. Vessel Plus 2024;8:6 https://dx.doi.org/10.20517/2574-1209.2023.122

Figure 4. Coronary angiogram of a 71-year-old male with a history of AVR and MVr complicated by sternal wound infection and closure
with titanium plates and screws and pectoralis muscle flaps who presented with severe AS, severe MS, and CAD and was discussed by
a Heart Team (Patient #3). A representative image demonstrates significant stenosis in the proximal RCA (yellow arrow), contrast in
the ascending aorta, sternal plates and screws, and bioprosthetic aortic valve. AVR: Aortic valve replacement; MVr: mitral valve repair;
AS: aortic stenosis; MS: mitral stenosis; CAD: coronary artery disease; RCA: right coronary artery.

OTHER EXAMPLES OF HEART TEAM CONFERENCES
At Johns Hopkins, there are several other heart teams including a structural heart team, a heart transplant
team, an extracorporeal membrane oxygen/cardiogenic shock (ECMO) team, and a pulmonary embolus
response team (PERT). The structural heart team and the heart transplant team follow a very structured
weekly meeting where every patient being considered for intervention is reviewed prior to surgery or
medical management. The ECMO and PERT teams serve to address acutely decompensating patients.
Providers contact the central call center, which then emergently contacts multiple providers on one call.
Team members include a cardiologist, intensivist, surgeon, and other interventionalists as needed. The
referring provider gives a quick patient synopsis and review of current data. Then, the team decides on the
best course of action while on one call.

At the University of Pittsburgh Medical Center, PA, a daily heart team meeting discusses referred patients
with unprotected left main CAD, multivessel CAD, proximal LAD disease in diabetic patients or other
patients with complex CAD that could potentially benefit from either PCI or CAD. The patient clinical
presentation includes a brief summary of the clinical presentation, comorbid conditions, calculated
SYNTAX and STS scores, measurement of left ventricular function, and subjective commentary on the
patients’ overall functional status and frailty. The information is collected on a data sheet, and the Heart
team discusses different approaches and optimal treatment strategies . Notably, this team met multiple
[18]
times per week to discuss patients. The authors noted increased collaboration between cardiologists and
surgeons, and an unmeasurable educational benefit for those involved in the meetings.