Heart valve diseases are dealt with by many different medical specialties at the same time. Until today, each specialty did its work individually. The patient made several separate appointments while transferring his tests himself from doctor to doctor. With the specialized heart valve center things change radically in the interest of the patient. There is faster service and harmonized coordination between doctors of different specialties. International guidelines now recommend this organization for specialized heart valve centers.

The role of the Cardiac Surgeon

The Cardiac Surgeon now knows what the patient wants – an excellent outcome for their heart condition with the least invasive method. Most valve procedures will be done either thoracoscopically (with a camera and a very small incision in the chest), or completely percutaneously (with a catheter like a simple coronary angiogram is done) avoiding a sternotomy. Examples of procedures performed without a sternotomy are mitral valve repair, aortic valve replacement, tricuspid valve repair, coronary bypass, and complex aneurysm repair. The pre-operative check in coordination with the other doctors of the team will provide the data for the appropriate planning of the operation.

The role of the Interventional Cardiologist

An Interventional Cardiologist is a specialist in treating heart disease using catheters inserted from an artery or vein in the arm and leg. In collaboration with the Cardiac Surgeon, they perform hybrid and percutaneous valve operations. Collaboration on different techniques brings better postoperative results. The usual place for these operations is the hybrid operating room – a specially designed room equipped with the latest technology that allows all the functions of the classic operating room with those of the hemodynamic laboratory.

The role of the cardiac anesthetist

The Cardiac Anesthesiologist has a special role in heart surgery and heart valve centers, helping to screen the patient before the operation to ensure the smooth flow of the operation. He will also collaborate with the Cardiac Surgeon and Interventional Cardiologist during the operation to provide important information about the patient’s heart condition and adjust the patient’s perioperative medication. The Anesthesiologist contributes significantly to the management and elimination of the patient’s pain, which is important for his quick mobilization and the reduction of his days of stay in the hospital.

The role of the Imaging Cardiologist – specialist in Triplex Cardiac Ultrasound

The Cardiologist with expertise in ultrasound plays an important role pre-operatively, during the operation and post-operatively. Before the operation, he gives the team details about the heart valves, the general function of the heart and the possible changes in the structure of the heart that have been caused by valvular disease. His relationship with the patient will continue within the operating room. There, the same doctor will complete the transesophageal ultrasound to provide images and conclusions about the heart’s function immediately before the operation and at the end of the operation will do a “quality check” checking that the operation has been completed successfully.

The role of the Clinical Cardiologist

The Clinical Cardiologist is one of the most important members of the team because he is responsible for the chronic monitoring of the patient. He knows the patient’s history and ailments better and contributes significantly to the smooth cooperation of all specialties. His knowledge of the diagnosis and treatment of heart valves makes him a valuable member of the team.

The role of the Radiologist

The Radiologist offers valuable imaging data of the patient’s whole body. For minimally invasive methods, he will create the “mapping” of the patient’s body, showing the anatomical relationship of the arteries, the heart valves, the structure of the chest, as well as the function and position of other organs that may affect the operation. The most common techniques are CT and MRI but also angiography and ultrasound and PET will contribute significantly in specific cases. The 3D reconstruction technique can create digital “models” on which the operation can be simulated to optimize the pre-operative planning.

The role of the Intensivist

In the internationally recognized heart valve centers there are appropriate intensivists who staff the Intensive Care Unit. These physicians are trained in the immediate postoperative monitoring and management of the patient.

There are many medical specialties that will coordinate for the good of the patient and each specialty will offer something important to ensure the best end result for the patient. This multidisciplinary collaboration is the secret to the success of heart valve specialist centers.