Key result
Implementing a Multidisciplinary Heart Team in a safety-net hospital is feasible with 3.6% procedural mortality.
Why the study?
Implementation of guideline-supported Multidisciplinary Heart Teams for the management of complex cardiovascular disease has not been described in a public safety-net hospital setting.
Observational (n=494)
No
Implementation of a Multidisciplinary Heart Team in a resource-constrained safety-net hospital is feasible and facilitates the delivery of complex cardiovascular therapies with low procedural mortality.
Supports MHT feasibility in safety-net hospitals; leaves open outcome benefits versus usual care in controlled studies.
BACKGROUND: Implementation of guideline-supported Multidisciplinary Heart Teams (MHT) for the management of complex cardiovascular disease has not been described in a public safety-net hospital setting. In May 2023, an MHT was established at Los Angeles General Medical Center to deliver comprehensive cardiovascular care to an underserved population in a resource-constrained setting. METHODS: We conducted a retrospective review of all cases discussed by a comprehensive MHT at Los Angeles General Medical Center from May 24, 2023 through January 21, 2026. The MHT convenes weekly in a hybrid format, using a privacy-compliant centralized platform for longitudinal care coordination. Referral pathways extend to affiliated safety-net clinics and hospitals. RESULTS: During the study period, the MHT discussed 494 patients, including 369 (74.7%) with any valvular disease, 78 (15.8%) with complex coronary disease, 29 (5.9%) with congenital heart disease, and 33 (6.7%) with endocarditis. The patient cohort reflected a high prevalence of health care disparities, with 93.9% reporting a race or ethnicity other than non-Hispanic White, a high proportion with publicly funded (69.0% Medicaid) or uninsured (3.6%) status, and frequent substance use disorders (28.1%). The MHT generated consensus recommendations including cardiac surgery (99 [20.0%]), transcatheter intervention (122 [24.7%]), complex percutaneous coronary intervention (30 [6.1%]), and medical management (149 [30.2%]). In-hospital mortality was low among patients who underwent surgical or percutaneous procedure (9 [3.6%]). Programmatic growth included development of a transcatheter valve repair program and increased complexity of cardiac surgical case volume. CONCLUSIONS: Establishment of an MHT in a resource-constrained public safety-net hospital was feasible and sustainable. Our model may serve as a blueprint to deliver guideline-concordant cardiovascular therapies to underserved populations.
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Zern et al. (2026) conducted an observational in Complex cardiovascular disease (n=494). Multidisciplinary Heart Team (MHT) model was evaluated on In-hospital mortality among patients who underwent surgical or percutaneous procedure. Implementation of a Multidisciplinary Heart Team in a public safety-net hospital was feasible, with a 3.6% in-hospital mortality rate among patients undergoing surgical or percutaneous procedures.
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