Journal of the American Heart Association · 2026
Multidisciplinary Heart Team Model to Deliver Advanced Cardiovascular Care in a Public Safety-Net Hospital.
СтатьяНазвание и аннотация: Перевод в очереди
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Zern Emily K, Rege Soham, Gorgy Isaac, Tang Wilson, Patel Parth P, Benck Kelley, Lucas Eric D, Shen Adriana, Steyer Henry, Sanousi Imam, Ge Brandon B, Lin Ben A, Gordon Samuel S, Justino Christopher, Do Diane, Zamora Nicole C, Stachel Maxine, Patel Sanjeet, Nikolic Ivana, Govea Alayn, Van Herle Helga, Kobsa Serge, Baden Rachel, Spellberg Brad, Mehra Anilkumar, Wiley Brandon M
Аннотация
BACKGROUND: Implementation of guideline-supported Multidisciplinary Heart Teams (MHT) for the management of complex cardiovascular disease has not been described in a public safety-net hospital setting. In May 2023, an MHT was established at Los Angeles General Medical Center to deliver comprehensive cardiovascular care to an underserved population in a resource-constrained setting.
METHODS: We conducted a retrospective review of all cases discussed by a comprehensive MHT at Los Angeles General Medical Center from May 24, 2023 through January 21, 2026. The MHT convenes weekly in a hybrid format, using a privacy-compliant centralized platform for longitudinal care coordination. Referral pathways extend to affiliated safety-net clinics and hospitals.
RESULTS: During the study period, the MHT discussed 494 patients, including 369 (74.7%) with any valvular disease, 78 (15.8%) with complex coronary disease, 29 (5.9%) with congenital heart disease, and 33 (6.7%) with endocarditis. The patient cohort reflected a high prevalence of health care disparities, with 93.9% reporting a race or ethnicity other than non-Hispanic White, a high proportion with publicly funded (69.0% Medicaid) or uninsured (3.6%) status, and frequent substance use disorders (28.1%). The MHT generated consensus recommendations including cardiac surgery (99 [20.0%]), transcatheter intervention (122 [24.7%]), complex percutaneous coronary intervention (30 [6.1%]), and medical management (149 [30.2%]). In-hospital mortality was low among patients who underwent surgical or percutaneous procedure (9 [3.6%]). Programmatic growth included development of a transcatheter valve repair program and increased complexity of cardiac surgical case volume.
CONCLUSIONS: Establishment of an MHT in a resource-constrained public safety-net hospital was feasible and sustainable. Our model may serve as a blueprint to deliver guideline-concordant cardiovascular therapies to underserved populations.
METHODS: We conducted a retrospective review of all cases discussed by a comprehensive MHT at Los Angeles General Medical Center from May 24, 2023 through January 21, 2026. The MHT convenes weekly in a hybrid format, using a privacy-compliant centralized platform for longitudinal care coordination. Referral pathways extend to affiliated safety-net clinics and hospitals.
RESULTS: During the study period, the MHT discussed 494 patients, including 369 (74.7%) with any valvular disease, 78 (15.8%) with complex coronary disease, 29 (5.9%) with congenital heart disease, and 33 (6.7%) with endocarditis. The patient cohort reflected a high prevalence of health care disparities, with 93.9% reporting a race or ethnicity other than non-Hispanic White, a high proportion with publicly funded (69.0% Medicaid) or uninsured (3.6%) status, and frequent substance use disorders (28.1%). The MHT generated consensus recommendations including cardiac surgery (99 [20.0%]), transcatheter intervention (122 [24.7%]), complex percutaneous coronary intervention (30 [6.1%]), and medical management (149 [30.2%]). In-hospital mortality was low among patients who underwent surgical or percutaneous procedure (9 [3.6%]). Programmatic growth included development of a transcatheter valve repair program and increased complexity of cardiac surgical case volume.
CONCLUSIONS: Establishment of an MHT in a resource-constrained public safety-net hospital was feasible and sustainable. Our model may serve as a blueprint to deliver guideline-concordant cardiovascular therapies to underserved populations.