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​The Heart Team at the UPMC Heart and Vascular Institute

A Collaborative Approach to Cardiovascular Care

In 2012, the UPMC Heart and Vascular Institute began our Heart Team Initiative.

The Heart Team draws on the experience of several specialists, including:

The team determines the best treatment plan for our most complex cardiac cases and more challenging heart valve issues.

This Heart Team approach offers truly individualized care by considering each patient's specific circumstances. At daily meetings, the team reviews the medical records and diagnostic images, then fully discusses the treatment options.

Through this review and discussion, we're able to come to a consensus about the most appropriate treatment approach.

We present our conclusions to you, making sure you fully understand:

We have found that the Heart Team approach not only improves medical outcomes, but also increases patient satisfaction and results in patients who are more engaged in their care.

Innovative, Patient-Centered Treatments for Coronary Artery Disease and Heart Valve Conditions

Our first case: coronary artery disease

We first adopted the Heart Team approach to determine the best treatments for complex coronary artery disease (CAD). Research has shown that, in cases of complex CAD, a collaborative approach like this improves outcomes.

The most effective CAD treatments for restoring blood flow to the heart include:

  • Angioplasty — an interventional cardiologist uses x-ray imaging to guide a balloon-tipped catheter to the point at which your coronary artery has narrowed, clearing the blockage from inside the artery. He or she also places a stent to the artery wall to keep the artery open.
  • Bypass surgery — a cardiac surgeon attaches a part of a vein from another part of your body, bypassing the blockage. There are different kinds of bypass surgery based on the way in which the surgeon gains access to the heart and arteries.

There are cases of CAD for which either bypass surgery or angioplasty are the appropriate treatment. There are also cases where it is not as clear which type of procedure is called for, and deciding on the best treatment can be difficult.

Factors that can make treatment decisions more complicated, include:

  • Other medical conditions you may have.
  • How many arteries have become narrowed.
  • Which artery or arteries are narrowed.
  • Where in the artery plaque is located and how much plaque has built up (atherosclerosis, also called hardening of the arteries).

We began using the Heart Team approach at the UPMC Heart and Vascular Institute to ensure we make the most appropriate treatment recommendations to our patients with complex CAD.

Our next case: heart valve conditions

Heart valve conditions also can be complex.

When functioning properly, heart valves open to allow blood to flow in the right direction through the heart, and close to keep blood from traveling in the wrong direction.

Untreated heart valve conditions can lead to other problems, such as:

In addition, surgeons must consider how damaged the valve is and whether it can be repaired or must be replaced.

In recent years, there have been breakthroughs in treating certain types of patients with percutaneous valves — valves that can be implanted without the need for open-heart surgery. The physicians at UPMC have been highly active as these novel therapies have emerged. This has even more highlighted the value of a collaborative Heart Team approach in the care of patients with valvular heart disease.

For more information, or to make an appointment, contact the UPMC Heart and Vascular Institute at 1-855-UPMC-HVI (876-2484) or HeartAndVascular@upmc.edu.