Mitral valve heart team can be ‘vehicle’ for coordination, care

SAN FRANCISCO — The development of an integrated, multispecialty team must be a concept “embedded” in the approach to care for patients with mitral valve disease, according to a presentation on the creation of a mitral valve heart team at annual TCT Scientific Symposium.

“Fundamentally, we believe that cardiology and surgery [have] to get together,” said David L. Brown, MD, FACC, FACP, FSCAI, founder of The Heart Hospital Baylor Plano and president and chairman of the medical staff. “You’ve got to do it as co-champions — you’ve got to get buy in from both sides. You’ve got to use the stakeholders. The subspecialization in the practice is what has helped us build a very in-the-trenches heart team.”

Brown began with an overview of mitral valve disease, the goals of treatment and the intricacies of transcatheter aortic valve replacement vs. transcatheter mitral valve repair. Institutions can begin building a mitral valve heart team by building on experience with their TAVR team, according to Brown, who also is director of interventional cardiology and structural heart and co-director for cardiovascular research for The Heart Hospital Baylor Plano.

“You’ve got to bring everybody to the game,” he said. “The surgeons have learned to come out of the operating room … and participate in all the weekly conferences and reviews. Certainly, travel to meetings together like this and bring your colleagues, both on the intervention side as well as imaging and other things.”

Brown discussed the steps involved in building and maintaining the mitral valve team, including preparing for patients’ visits, performing echocardiography and CT, marketing the program and conducting routine reviews to improve patient care. He also emphasized the need to be aware of issues related to reimbursement and cost.

The mitral valve heart team can be “a vehicle to provide coordination and collaboration among multidisciplinary practitioners and support staff,” Brown said. “The concept must be embedded. We think that all [CVD] states are going to need this as we go along in the future.” – by Julia Ernst, MS

Reference:

Brown DL. Session 1. Mitral Regurgitation: The Big Picture. Presented at: TCT 2015; Oct. 11-15, 2015; San Francisco.

Disclosure: Brown reports that he or his spouse/partner receives investigational grants, consulting fees and/or honoraria from Edwards Life Science, holds major stock shares/equity in CVT and receives investigational grants from Medtronic, St. Jude and Direct Flow.