Thorac Cardiovasc Surg 2017; 65(07): 519-523
DOI: 10.1055/s-0037-1606356
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Heart Team: Joint Position of the Swiss Society of Cardiology and the Swiss Society of Cardiac Surgery

Giovanni B. Pedrazzini
1   Swiss Society of Cardiology (SSC), Ticino, Switzerland
,
Enrico Ferrari
2   Swiss Society of Cardiac Surgery (SGHC), Zurich, Switzerland
,
Michael Zellweger
1   Swiss Society of Cardiology (SSC), Ticino, Switzerland
,
Michele Genoni
2   Swiss Society of Cardiac Surgery (SGHC), Zurich, Switzerland
› Institutsangaben
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Publikationsverlauf

07. August 2017

07. August 2017

Publikationsdatum:
18. September 2017 (online)

Abstract

The Swiss Society of Cardiology (SSC) and the Swiss Society of Cardiac and Thoracic Vascular Surgery (SSCTVS) have formulated their mutual intent of a close, patient-oriented, and expertise-based collaboration in the Heart Team Paper. The interdisciplinary dialogue between the SSC and SSCTVS reflects an attitude in decision making, which guarantees the best possible therapy for the individual patient. At the same time, it is a cornerstone of optimized process quality, placing individual interests into the background.

Evaluation of the correct indication for a treatment is indeed very challenging and almost impossible to verify retrospectively. Quality in this very important health policy process can therefore only be assured by the use of mutually recognized indications, agreed upon by all involved physicians and medical specialties, whereby the capacity of those involved in the process is not important but rather their competence.

These two medical societies recognize their responsibility and have incorporated international guidelines as well as specified regulations for Switzerland. Former competitors now form an integrative consulting team able to deliver a comprehensive evaluation for patients. Naturally, implementation rests with the individual caregiver. The Heart Team Paperof the SGK and SGHC, has defined guide boards within which the involved specialists maintain sufficient room to maneuver, and patients have certainty of receiving the best possible therapy they require.

 
  • References

  • 1 Windecker S, Kolh P, Alfonso F. , et al; Authors/Task Force members. 2014 ESC/EACTS Guidelines on myocardial revascularization: the task force on myocardial revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J 2014; 35 (37) 2541-2619
  • 2 Kesson EM, Allardice GM, George WD, Burns HJ, Morrison DS. Effects of multidisciplinary team working on breast cancer survival: retrospective, comparative, interventional cohort study of 13 722 women. BMJ 2012; 344: e2718
  • 3 Prospective randomised study of coronary artery bypass surgery in stable angina pectoris. Second interim report by the European Coronary Surgery Study Group. Lancet 1980; 2 (8193): 491-495
  • 4 King III SB, Lembo NJ, Weintraub WS. , et al. A randomized trial comparing coronary angioplasty with coronary bypass surgery. Emory Angioplasty versus Surgery Trial (EAST). N Engl J Med 1994; 331 (16) 1044-1050
  • 5 Bypass Angioplasty Revascularization Investigation (BARI) Investigators. Comparison of coronary bypass surgery with angioplasty in patients with multivessel disease. N Engl J Med 1996; 335 (04) 217-225
  • 6 Windecker S, Stortecky S, Stefanini GG. , et al. Revascularisation versus medical treatment in patients with stable coronary artery disease: network meta-analysis. BMJ 2014; 348: g3859
  • 7 Holmes Jr DR, Rich JB, Zoghbi WA, Mack MJ. The heart team of cardiovascular care. J Am Coll Cardiol 2013; 61 (09) 903-907
  • 8 Shortell SM, Jones RH, Rademaker AW. , et al. Assessing the impact of total quality management and organizational culture on multiple outcomes of care for coronary artery bypass graft surgery patients. Med Care 2000; 38 (02) 207-217
  • 9 Long J, Luckraz H, Thekkudan J, Maher A, Norell M. Heart team discussion in managing patients with coronary artery disease: outcome and reproducibility. Interact Cardiovasc Thorac Surg 2012; 14 (05) 594-598
  • 10 Filardo G, Maggioni AP, Mura G. , et al. The consequences of under-use of coronary revascularization; results of a cohort study in Northern Italy. Eur Heart J 2001; 22 (08) 654-662
  • 11 Yates MT, Soppa GK, Valencia O, Jones S, Firoozi S, Jahangiri M. Impact of European Society of Cardiology and European Association for Cardiothoracic Surgery Guidelines on Myocardial Revascularization on the activity of percutaneous coronary intervention and coronary artery bypass graft surgery for stable coronary artery disease. J Thorac Cardiovasc Surg 2014; 147 (02) 606-610
  • 12 Shahian DM, O'Brien SM, Filardo G. , et al; Society of Thoracic Surgeons Quality Measurement Task Force. The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 3--valve plus coronary artery bypass grafting surgery. Ann Thorac Surg 2009; 88 (1, Suppl) S43-S62
  • 13 Nashef SA, Roques F, Sharples LD. , et al. EuroSCORE II. Eur J Cardiothorac Surg 2012; 41 (04) 734-744 ; discussion, 744–745
  • 14 Mohr FW, Morice MC, Kappetein AP. , et al. Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial. Lancet 2013; 381 (9867): 629-638
  • 15 Head SJ, Kaul S, Mack MJ. , et al. The rationale for Heart Team decision-making for patients with stable, complex coronary artery disease. Eur Heart J 2013; 34 (32) 2510-2518
  • 16 Kapadia SR, Leon MB, Makkar RR. , et al; PARTNER trial investigators. 5-year outcomes of transcatheter aortic valve replacement compared with standard treatment for patients with inoperable aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet 2015; 385 (9986): 2485-2491
  • 17 Mack MJ, Leon MB, Smith CR. , et al; PARTNER 1 trial investigators. 5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet 2015; 385 (9986): 2477-2484
  • 18 Cribier A, Durand E, Eltchaninoff H. Patient selection for TAVI in 2014: is it justified to treat low- or intermediate-risk patients? The cardiologist's view. EuroIntervention 2014; 10 (Suppl U): U16-U21
  • 19 Leon MB, Smith CR, Mack MJ. , et al; PARTNER 2 Investigators. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med 2016; 374 (17) 1609-1620
  • 20 Maisano F, Alfieri O, Banai S. , et al. The future of transcatheter mitral valve interventions: competitive or complementary role of repair vs. replacement?. Eur Heart J 2015; 36 (26) 1651-1659
  • 21 Nishimura RA, Otto CM, Bonow RO. , et al; American College of Cardiology; American College of Cardiology/American Heart Association; American Heart Association. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Thorac Cardiovasc Surg 2014; 148 (01) e1-e132
  • 22 Vahanian A, Alfieri O, Andreotti F. , et al; Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC); European Association for Cardio-Thoracic Surgery (EACTS). Guidelines on the management of valvular heart disease (version 2012). Eur Heart J 2012; 33 (19) 2451-2496