BACKGROUND: Revascularization decisions can profoundly impact patient survival, quality of life, and procedural risk.Although use of Heart Teams to make revascularization decisions is growing, data on their implementation in the real-world are limited.Our objective was to ORG BERRY GREENS assess the prevalence of Heart Teams and their association with collaboration in routine practice.METHODS: A survey of cardiologists and cardiac surgeons at 31 hospitals in Michigan was performed in May, 2011--prior to the recommendation for using Heart Teams in national guidelines.
This survey included all percutaneous coronary intervention-performing hospitals in Michigan participating in the Blue Cross/Blue Shield of Michigan Cardiovascular Consortium and Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative.It targeted both the use of Heart Teams and multidisciplinary Case Conferences.RESULTS: There were 53 physician survey respondents from 27 hospitals with 4 hospitals not responding.Among respondents, 11 (40.
7%) hospitals reported no Heart Teams or Case Conferences while 7 (25.9%) hospitals reported either a Heart Team or Case Conference.However, there was disagreement about the presence of a Heart Team at seven hospitals, and about Case Conferences at nine hospitals.Hospitals with definite Heart Teams reported Defrost Fuse significantly greater levels of collaboration between cardiologists and cardiac surgeons.
CONCLUSION: The overall presence of Heart Teams prior to their recommendation in national guidelines was limited.Even among hospitals with a potential Heart Team, there was substantial disagreement between respondents about their presence.Further refinement of the definition of a Heart Team and measures of successful implementation are needed.