Heart Team Decision-Making Adds Value

Treatment options for valve disease have grown exponentially from the days of simply choosing between tissue or mechanical valves. Now, determining the most appropriate treatment for each patient requires multidisciplinary perspectives.

Clinical Scenarios: The Heart Team

Monday

1:15 p.m. – 5:00 p.m.

Room 30ABCD

Enter the heart team, a collaborative group of clinicians who can offer a wide range of viewpoints on the benefits and risks of rapidly evolving treatment strategies, leading to optimal patient selection and improved outcomes. 

“We are entering into a new patient-centric experience that relies on the cardiac surgeon having a robust communication and interaction with cardiology colleagues,” said Vinod H. Thourani, MD, of MedStar Heart and Vascular Institute in Washington, DC, a moderator for today’s Clinical Scenarios: The Heart Team session.

Vinod H. Thourani, MD

Vinod H. Thourani, MD

Besides cardiac surgeons and interventional cardiologists, the suggested members of a heart team include cardiac anesthesiologists, intensivists, perfusionists, advanced practice providers, and cardiac imaging specialists.

The speakers in this session will draw from the latest research to identify decision-making challenges in mitral valve disease, aortic valve disease, and coronary artery disease. 

A hot discussion topic will be the recently published COAPT trial, which showed that transcatheter mitral valve approximation in combination with guideline-directed medical therapy was superior to guideline-directed medical therapy alone for patients with symptomatic heart failure with grades 3 to 4+ mitral valve regurgitation. These findings have important implications for management decisions in practice.

Speakers also will discuss transcatheter approaches to valve replacement, which have become the first-line treatment in many situations. All-cause mortality and risk of stroke are similar for transcatheter and surgical procedures, but the risks of adverse events are distinct.

In addition, the debate over whether percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) surgery is preferred for coronary revascularization will be highlighted. Several studies have sought to determine the factors affecting mortality and morbidity for each procedure, and recent research has indicated that the type of disease (multivessel or left main), coronary complexity, and diabetes status are important factors to consider in decision-making regarding PCI or CABG. 

Heart team discussions of specific cases related to each of these topics will help attendees gain a greater understanding of the best approaches for their own patients.

“As our patients grow in complexity, it is incumbent that we stay purposeful in our approach to managing their care,” said Dr. Thourani. 

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