Proceedings (Baylor University. Medical Center) · 2025
Insights from a multidisciplinary heart team for highest-risk valve disease.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Pickering Taylor, Eisenga John, McCullough Kyle, Dorton Cody, Kluis Austin, Moubarak Ghadi, Squiers John J, Shih Emily, Klutts Garrett, Sawhney Rahul, Hocking Jennie, Cohen Meidan Talia, Potluri Srini, Al-Azizi Karim, Moore David, Brinkman William, Hafen Lee, Harrington Katherine, George Timothy, Schaffer Justin, Ejiofor Julius, Smith Robert L, Ryan William, DiMaio J Michael, Szerlip Molly, Hutcheson Kelley
Аннотация
BACKGROUND: Multidisciplinary heart team (MHT) evaluation is a class I recommendation for coronary and structural heart disease, yet limited outcomes data exist for high-risk and complex valvular heart disease (VHD) patients referred for surgery.
METHODS: From June 2021 to August 2022, our institutional MHT-comprising cardiac surgeons, interventional cardiologists, heart failure specialists, advanced imaging specialists, intensivists, and palliative care specialists-evaluated the highest-risk or complex VHD patients. Patient demographics, Society of Thoracic Surgeons Predicted Risk of Mortality scores, initial treatment plans, final team recommendations, and outcomes, including adherence to recommendations, 30-day readmission, and mortality at 30 days, 1 year, and 2 years were analyzed.
RESULTS: Among 121 patients, the MHT recommended surgery for 67%, transcatheter intervention for 14%, a hybrid approach for 3%, and medical management (MM) for 17%. Overall adherence to MHT recommendations was 89%. Thirty-day mortality was 7/81 (9%) for surgical patients, 3/17 (18%) for transcatheter, 0/3 for hybrid, and 4/20 (20%) for MM. By 2 years, mortality rose to 17/81 (21%) for surgery, 9/17 (53%) for transcatheter, 1/3 (33%) for hybrid, and 11/20 (55%) for MM.
CONCLUSION: MHT evaluation facilitates individualized treatment strategies by distinguishing patients who may benefit from intervention despite high procedural risk, while sparing those unlikely to benefit.
METHODS: From June 2021 to August 2022, our institutional MHT-comprising cardiac surgeons, interventional cardiologists, heart failure specialists, advanced imaging specialists, intensivists, and palliative care specialists-evaluated the highest-risk or complex VHD patients. Patient demographics, Society of Thoracic Surgeons Predicted Risk of Mortality scores, initial treatment plans, final team recommendations, and outcomes, including adherence to recommendations, 30-day readmission, and mortality at 30 days, 1 year, and 2 years were analyzed.
RESULTS: Among 121 patients, the MHT recommended surgery for 67%, transcatheter intervention for 14%, a hybrid approach for 3%, and medical management (MM) for 17%. Overall adherence to MHT recommendations was 89%. Thirty-day mortality was 7/81 (9%) for surgical patients, 3/17 (18%) for transcatheter, 0/3 for hybrid, and 4/20 (20%) for MM. By 2 years, mortality rose to 17/81 (21%) for surgery, 9/17 (53%) for transcatheter, 1/3 (33%) for hybrid, and 11/20 (55%) for MM.
CONCLUSION: MHT evaluation facilitates individualized treatment strategies by distinguishing patients who may benefit from intervention despite high procedural risk, while sparing those unlikely to benefit.