title: A call for an evidence-based approach to the Heart Team for patients with severe aortic stenosis.
abstract: Application of a Heart Team approach is now a central concept in the care of patients with severe aortic stenosis. It has Class I recommendations from American and European professional societies and is required for reimbursement for transcatheter aortic valve replacement in the United States. The rationale for changing traditional practice models is to improve patient selection, procedural planning, and management of patients at high or prohibitive surgical risk, thus improving outcomes. Although the concept is intuitive, a clear definition of the Heart Team, and data supporting its effectiveness, are lacking. Other specialties, including oncology, provide a precedent for investigation of the use of a multidisciplinary team and its impact on patient care. We highlight the need for clear definitions and shared metrics to advance our understanding of an optimal Heart Team approach, focusing on patient, clinician, and health system outcomes.
authors: Section of Cardiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
authors: Megan
authors: M
authors: Coylewright
authors: Department of Cardiovascular Disease, Baylor Scott & White Health, Heart Hospital Baylor Plano, Dallas, Texas.
authors: Michael J
authors: MJ
authors: Mack
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota.
authors: David R
authors: DR
authors: Holmes
authors: Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: pogara@partners.org.
authors: Patrick T
authors: PT
authors: O'Gara
mesh_terms: D001024:Aortic Valve Stenosis / Q000175:diagnosis* / Q000601:surgery*; D006328:Cardiac Catheterization / Q000379:methods; D019317:Evidence-Based Medicine / Q000379:methods*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D010348:Patient Care Team; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: aortic valve stenosis; multidisciplinary; outcome and process assessment (health care); patient-centered care; quality of health care; transcatheter aortic valve replacement