Establishment of a Multidisciplinary Heart Team in a resource-constrained public safety-net hospital was feasible and sustainable, and may serve as a blueprint to deliver guideline-concordant cardiovascular therapies to underserved populations.
Key Findings
Methods
A Multidisciplinary Heart Team (MHT) established at Los Angeles General Medical Center discussed 494 patients over approximately 2.5 years.
The MHT was established in May 2023 and the study period ran 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.
This represents the first described implementation of a guideline-supported MHT in a public safety-net hospital setting.
Results
The patient cohort was predominantly composed of valvular disease cases, followed by complex coronary disease, endocarditis, and congenital heart disease.
369 patients (74.7%) had any valvular disease.
78 patients (15.8%) had complex coronary disease.
33 patients (6.7%) had endocarditis.
29 patients (5.9%) had congenital heart disease.
Results
The patient population reflected a high prevalence of healthcare disparities across race, insurance status, and substance use.
93.9% of patients reported a race or ethnicity other than non-Hispanic White.
69.0% had Medicaid (publicly funded insurance) and 3.6% were uninsured.
28.1% of patients had frequent substance use disorders.
The hospital is described as serving an underserved population in a resource-constrained setting.
Results
The MHT generated consensus treatment recommendations spanning surgical, transcatheter, percutaneous, and medical management strategies.
149 patients (30.2%) were recommended medical management.
122 patients (24.7%) were recommended transcatheter intervention.
99 patients (20.0%) were recommended cardiac surgery.
30 patients (6.1%) were recommended complex percutaneous coronary intervention.
Results
In-hospital mortality was low among patients who underwent surgical or percutaneous procedures.
9 patients died in-hospital out of those who underwent surgical or percutaneous procedures, representing a mortality rate of 3.6%.
This low mortality rate was achieved in a resource-constrained, safety-net hospital setting.
The low mortality figure supports the feasibility and safety of implementing advanced cardiovascular procedures in this context.
Results
The program demonstrated measurable growth over the study period, including development of new procedural capabilities.
Programmatic growth included development of a transcatheter valve repair program.
There was increased complexity of cardiac surgical case volume over the study period.
These developments occurred within a public safety-net hospital previously without described MHT infrastructure.
Conclusions
The authors conclude that an MHT model in a resource-constrained public safety-net hospital is both feasible and sustainable.
The model is proposed as a potential 'blueprint to deliver guideline-concordant cardiovascular therapies to underserved populations.'
The MHT used a hybrid meeting format and a privacy-compliant centralized platform to enable longitudinal care coordination.
The program successfully integrated complex cardiovascular subspecialties despite resource constraints typical of safety-net institutions.
What This Means
This research describes the creation and operation of a specialized heart care team — called a Multidisciplinary Heart Team (MHT) — at Los Angeles General Medical Center, which is a public hospital serving low-income and underserved communities. Over roughly 2.5 years, this team of cardiovascular specialists met weekly to review and make treatment recommendations for nearly 500 patients with complex heart conditions, including valve disease, severe coronary artery disease, congenital heart defects, and heart valve infections. The vast majority of patients were from racial and ethnic minority groups, most relied on Medicaid or had no insurance, and more than one in four had a substance use disorder — reflecting the significant social and health challenges faced by this patient population.
The team recommended a range of treatments, from medications alone to minimally invasive catheter-based procedures to open-heart surgery, and was able to grow its capabilities over time — including launching a new transcatheter valve repair program. Among patients who underwent procedures, the in-hospital death rate was 3.6%, which is a relatively low figure for this type of complex cardiac care. These outcomes were achieved despite the resource constraints typical of a safety-net hospital, suggesting that high-quality, guideline-based heart care can be delivered to patients who are often left out of advanced medical programs.
This research suggests that a structured, team-based approach to complex heart disease is not only possible but sustainable in underfunded public hospital settings. The authors propose their model as a potential template for other safety-net hospitals seeking to provide equitable access to advanced cardiovascular treatments for disadvantaged communities who historically have had limited access to such specialized care.
Zern E, Rege S, Gorgy I, Tang W, Patel P, Benck K, et al.. (2026). Multidisciplinary Heart Team Model to Deliver Advanced Cardiovascular Care in a Public Safety-Net Hospital.. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.126.051826