TEAM APPROACH TO STRUCTURAL HEART DISEASE
The field of cardiovascular medicine is being challenged by the need to treat increasingly older patients and patients who are complex because they have multiple conditions. Many of these patients are high risk for conventional treatments such as open heart surgery.
Traditionally, Australian heart patients are referred to a single practitioner who tries to provide a solution to that patient’s problems. However, because medicine is advancing so rapidly, it is increasingly beyond the scope of one individual in a single discipline to be across all aspects of a patient’s condition and to embrace all treatments (established and new) available.
To best serve the interests of all patients, the Sydney Heart Team brings together doctors from different specialties who work in an integrated manner to provide a comprehensive array of solutions, using all the available technologies.
We comprehensively assess the entire spectrum of a patient’s health condition and decide treatment options as an interdisciplinary team, involving cardiologists and cardiothoracic surgeons as well as imaging specialists, geriatricians, anaesthetists, intensivists and clinical nurse consultants.
This interdisciplinary team approach benefits all patients with heart disease. If they’re not suitable for corrective open surgery we can take advantage of minimally invasive or trans-catheter techniques (like trans-catheter aortic valve implantation) that have lower mortality and faster recover rates than traditional open heart surgery. By working collaboratively across disciplines such as interventional cardiology and cardiac surgery, we can offer a patient the best solution to their problem.
PATIENT CARE: PRE-, DURING, AND POST-OPERATION
A key advantage of the Sydney Heart Team is that patients are assessed by the cardiologist and the surgeon, in one place and during the one visit. This allows for a comprehensive integrated assessment of heart problems in a single place.
This reduces time and stress, which is particularly important for elderly or very sick patients, as well as the friends and relatives who are supporting and assisting them.
However, this gives patients more than just convenience. We take account of their whole health profile from their nutritional state to how they manage the first five stairs up to the front door to how they do things like shopping, showering and banking.
We look at their family and social support network as well as their heart and lung disease, to work out how to help patients comprehensively.
After the patient has undergone a number of investigations targeted at trying to characterise their problem, we discuss the patient’s case within the heart team.
The team incorporates non-procedural cardiologists, interventional cardiologists, heart surgeons, radiologists, cardiac anaesthetists, geriatricians and clinical nurse consultants. We’re really about trying to create a solution that’s tailor-made for the patient.
During the operation, we also take a team approach, because multiple heads and hands on the problem, are critical in achieving outstanding results in complex surgery. For instance, we may use trans-catheter technology with an operating heart surgeon and an operating interventional cardiologist. Or with a more complex open heart procedure we’ll have two operating heart surgeons at the same time.
Post-operation, there are a number of things that need to be reviewed before you can return home. The full cognitive and functional testing undertaken by our clinical nurse before the operation, is essential in helping you transition successfully home, post-operation.