Consultation by a Heart Team (HT) is a class I recommendation by the American College
of Cardiology, American Heart Association, and the European Society of Cardiology
for the management of patients with complex cardiac disease. Despite the class I recommendation,
there is a paucity of data to support the role of an HT with only level C quality
of evidence. This study was performed to follow patients who were referred for HT
consultation and long-term outcomes in relation to whether the recommendation of the
HT was followed or not. We performed a prospective analysis of our cohort of patients
who underwent consultation by the HT. A total of 342 cases have been followed. Patient
characteristics, referring physicians’ favored treatment, and key outcomes were followed.
A total of 336 patients were reviewed; 70.4% were male patients with a median age
of 66.3 years and an average EuroSCORE II score of 7.2%. A total of 79.9% of the discussions
resulted in a unanimous decision. The recommendations made by the HT differed from
those documented by the referring physician in 54% of cases. In conclusion, recommendations
made by the HT were followed in 269 cases (83.8%). There was a significant reduction
in cardiac death (6.3% vs 15.3%, p = 0.042), composite cardiac outcome (23.4% vs 51.9%,
p ≤0.001), and hospital admissions (10.4% vs 36.5%, p ≤0.001) when recommendations
were followed. There was no statistical difference between the 2 groups when looking
at noncardiac death, stroke, ST-segment elevation myocardial infarction, non–ST-segment
elevation myocardial infarction, dialysis, or an emergency room visit.
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Article Info
Publication History
Published online: February 12, 2022
Received in revised form:
December 29,
2021
Received:
October 17,
2021
Identification
Copyright
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