Page 11 - Journal of Structural Heart Disease - Volume 1 Issue 1

Original Research Article
Journal of Structural Heart Disease, May 2015,
Volume 1, Issue 1: 5-8
DOI: http://dx.doi.org/10.12945/j.jshd.2015.00010-14
Received: December 3, 2014 Accepted: January 26, 2015 Published online: May 2015
Building a Structural Heart Disease Team
How to Integrate People
John M. Lasala, MD, PhD*, Alejandro Aquino, MD
Barnes Jewish Hospital at Washington University School of Medicine, St. Louis, Missouri, USA
Abstract
Although the field of structural heart disease interven- tion is by no means a nascent one, it has undergone an unprecedented period of growth and organization over the past decade. The long-established stalwarts of aortic and mitral valvuloplasty have been joined by newer techniques including shunt (ASD/PFO) closure, transcatheter aortic valve replacement (TAVR), tran- scatheter pulmonary valve therapy, and mitral valve repair (MitraClip). As this field continues to unify, the expectation is that it will only grow. The prevalence of aortic and mitral valve disease is expected to increase as the population ages. This fact and the inevitable broadened commercial availability of these proce- dures will drive the number of structural procedures upwards. As an illustrative example, it is postulated that by 2015 the number of TAVR procedures will reach 25,000 per year.
Copyright © 2015 Science International Corp.
Key Word Heart Team
Growth of Structural Heart Disease
Although the field of structural heart disease inter- vention is by no means a nascent one, it has under- gone an unprecedented period of growth and orga- nization over the past decade. The long-established stalwarts of aortic and mitral valvuloplasty have been joined by newer techniques including shunt Atrial Septal Defect (ASD) and Patent Foramen Ovale
(PFO) closure, transcatheter aortic valve replacement (TAVR), transcatheter pulmonary valve therapy, and mitral valve repair (MitraClip). As this field continues to unite, the expectation is that it will only grow. The prevalence of aortic and mitral valve disease is ex- pected to increase as the population ages [1]. This fact and the inevitably broadened commercial avail- ability of these procedures will drive the number of structural procedures upwards. As an illustrative ex- ample, it is postulated that by 2015 the number of TAVR procedures will reach 25,000 per year [2].
Building a Multidisciplinary Team Approach
The Importance of Multidisciplinary Team
As our field moves forward, it does so riding the edge of technological innovation but without prior organizational doctrine to guide the construction of a structural heart disease program. The concept of multidisciplinary care has long been utilized in other medical fields, the most conspicuous example being oncology. Trials evaluating forms of revascularization for coronary artery disease (SYNTAX and BARI) [3,4] introduced the concept of multidisciplinary care into cardiovascular medicine in the form of the “heart team.”While there are indications from Neily et al. [5] that a cohesive team approach may improve mortality outcomes, the advantage of a multidisciplinary team (MDT) extends beyond procedural success. When dealing with the complexity of structural heart disease, the MDT is fundamental in the evaluation,
* Corresponding Author:
John L. Lasala
Barnes Jewish Hospital at Washington University School of Medicine 660 South Euclid Ave, Campus Box 8086, St. Louis, Missouri 63110, USA Tel. +1 314 747-4535, E-Mail: jlasala@dom.wustl.edu
Fax +1 203 785 3346
E-Mail: jshd@scienceinternational.org http://structuralheartdisease.org/
© 2015 Journal of Structural Heart Disease Published by Science International Corp. ISSN 2326-4004
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