Heart Teams as a New Gold Standard of Cardiac Care
In the last 10 years, with the advent of minimally invasive surgical procedures and percutaneous catheter-based approaches, the treatment of cardiac patients with valve disease has dramatically changed. Novel catheter-based devices were first presented as alternatives to conventional cardiac surgery for patients with limited life expectancy if only treated medically (Leon et al., N Engl J Med 363(17):1597–1607, 2010). Most of these patients were either too old or too sick to undergo open-heart surgery. Only a few years after their initial implementation, transcatheter percutaneous valve replacement or repair is now commonly offered to the lower-risk patient population, as a valid alternative supported by large multicenter clinical trials providing clear evidence of clinical benefit. Consequently, the treatment of aortic stenosis or functional mitral regurgitation is rapidly shifting to transcatheter aortic valve implantation (TAVI) or mitral clipping (Mitraclip, Abbott Inc., USA).
KeywordsInvasive surgical procedures Percutaneous catheter-based approaches Heart teams Percutaneous coronary interventions (PCIs) Coronary artery bypass graft (CABG) Complex coronary artery disease (CAD)
- 3.Patel MR, Calhoon JH, Dehmer GJ, Grantham JA, Maddox TM, Maron DJ, et al. ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2017 appropriate use criteria for coronary revascularization in patients with stable ischemic heart disease: a report of the American College of Cardiology Appropriate use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2017;69(17):2212–41.CrossRefGoogle Scholar
- 4.Windecker S, Kolh P, Alfonso F, Collet JP, Cremer J, Falk V, Filippatos G, et al. 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):2541–619.CrossRefGoogle Scholar