Structural Heart | 2021
The Heart Team 2021: Beta Version or General Release?
Abstract
Medicine in general and cardiology, in particular, have undergone revolutionary advances in the past 40 years. The advent of interventional cardiology, first with percutaneous transcatheter coronary angioplasty, and more recently with the burgeoning field of structural heart disease, has required many scientific, technological, and clinical advances. While patients are increasingly benefitting from these advances, the process of clinical decision and associated regulatory and reimbursement issues are playing catch-up. Coupled with other seismic forces affecting the delivery of health care, the resulting medical eco-system has become dizzyingly complex – how to ensure the best outcomes for patients and to ensure that they are sufficiently, let alone fully, informed and empowered to make the best decision for themselves remains a challenge. It is in the context of this environment that the concept of the Heart Team has emerged as a key, if not the key, junction point and gate in the patient’s journey through the medical system for treatment of both coronary disease and valvular heart disease. Endorsed by guidelines, embraced by regulators, payors, professional societies, and other key stakeholders, the Heart Team’s potential importance cannot be overstated. Given its ascendant importance, both the concept and its implementation deserve critical examination. Several key questions need to be addressed: