The Impact of the Heart Team Approach: Learning our Limits in Complex Valvular and Coronary Disease

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About this Research Topic

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Background

Treatment modalities for patients with end-stage coronary artery disease or complex valvular pathologies, especially those presenting with high-risk profile have been always a matter of discussion. As before, advanced age and the presence of comorbidities can lead to a higher risk profile. In the past two decades, the highly and vast development of the different treatment options and strategies for such patients allowed for improved short to mid-term outcomes. These patients require appropriate care that not only concerns the surgical concept, but also involves various non-surgical specialties as an interdisciplinary "Heart Team" management to jointly discuss the best option for each individual patient and to create an appropriate therapy concept (interventional or conventional surgery, valve reconstruction or replacement, minimally invasive access route, type of prosthesis, etc.).

This interdisciplinary teamwork is established to discuss and choose the best possible therapy for patients, especially those presenting with high-risk profile. The cooperation between the cardiology, interventional cardiology, cardiac surgery and the anesthesiology departments would allow for an interdisciplinary treatment approach for the development and implementation of new interventional or surgical techniques and can be carried out with optimal outcomes. Therefore, we sought to discuss the impact of the heart team approach in treatment concept for variety of patients presenting with different cardiac pathologies especially those with complex valvular and coronary diseases. Our goal is to further promote the use of the heart-team approach for the purpose of optimizing the survival and quality of life of the patient.

Complex coronary artery and valvular diseases are the major causes of cardiovascular events such as myocardial infarction and heart failure, causing death of millions of people worldwide annually. The severity of the disease and the risk profile of each individual patient directly impacts on outcomes. The optimal strategy for each patient remains controversial. Some controversies persist, and progress is inevitable. Catheter-based interventions challenge cardiac surgery as the "gold standard" in some cardiac pathologies. However, the long-term results and treatment of complex cardiac pathologies remain controversial. To continue providing patients with the best possible outcomes, the heart-team approach needs to keep evolving, with the goal of continued improvements.

The selected research papers should highlight the improved outcomes and innovative solutions on topics that include:

Coronary artery bypass grafting and intervention

Surgical procedures for complex and end-stage coronary artery disease,

Interventional procedures for complex and end-stage coronary artery diseases,

Aortic, mitral and tricuspid valve surgeries and intervention

Surgical procedures for complex aortic, mitral and tricuspid valve pathologies,

Interventional procedures for complex aortic, mitral and tricuspid valve pathologies,

Hybrid cardiac surgeries, and minimal invasive procedures.

Research Topic Research topic image

Keywords: heart team, coronary artery disease, complex pathology, interventional surgery, interdisciplinary

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