Heart Team at Soroka University Medical Center: From Concept to Practice

Background: The choice of treatment for myocardial revascularization, coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI), occasionally remains a matter of debate. Multidisciplinary decision-making by a Heart -eam consisting of non-invasive cardiologist, interventional cardiologist and cardiac-surgeon may enhance this process and establish the optimal treatment-strategy furthermore -this concept is highly recommended in the American and European guidelines.

Methods: An institutional revascularization protocol was formed in accordance with the European guidelines for revascularization based on Angiographic SYNTAX and Society of Thoracic Surgeons (STS) risk scores. Patients were respectively categorized as low (0-21), Intermediate (22-32) or high (>32) SYNTAX score, and low (<4%), Intermediate (4-8%) or high (>8%) STS mortality risk score.

Excluded from the Heart-Team were patients with complex or, reciprocally, mild non-debated coronary artery disease (CAD); these patients were referred directly to CABG or PCI, respectively.

Results: From October 22 to December 14, 2015, 14 Heart-Team meetings were convened to discuss 22 patients with non-emergent CAD. Mean time from angiogram was 22 ± 19 hours and meetings were set by grouping of the Heart-Team members with aid of what`s up application. Syntax and STS score were calculated independently by cardiologists and surgeons prior to the meeting. Ten patients were referred to CABG and 12 to PCI.

Conclusions: Formal multidisciplinary institutional revascularization Heart-Team is feasible and reproducible. This approach improves communication, enhances a uniform non-debated decision and provides a tailored-approach to the patient.