Decision making of a specialist Aortovascular multidisciplinary team meeting

Background: Patients with major aortic pathology have complex needs, require lifelong surveillance and often multiple interventions. Multidisciplinary teams (MDT) have been shown to improve care in other specialities but there are no such reports related to dedicated Aortovascular MDTs. We aim to review our experience and decision making of an Aortovascular MDT over 5 years period since its beginning. Methods: Cohort retrospective analysis of prospectively collected data for all patients referred to our Aortovascular MDT since its inception. Demographics, diagnosis and outcome of discussions were analysed. Results: From April 2015 to April 2020, 871 discussions took place at the MDT meeting on 649 unique patients. Mean age was 52 [17-84] years, 414 (64%) were male, 209 (32%) had previous cardiac surgery and 85 (13%) had connective tissue disorder. Final decision from the MDT meeting was surgery (220, 33.9%), surveillance (240, 36.9%), not for intervention (42, 6.5%), further investigation (53, 8.2%), assess for surgery (30, 4.6%), endovascular therapy (28, 4.3%), other (36, 5.5%). Of 649 patients discussed, 591 (91%) underwent the management suggested by the meeting. Of the 58 (9%) that were not carried out, the most common reason was patient preference. Conclusions: Patients with major aortic pathology should expect care from a dedicated MDT, not only to benefit from the optimal choice of therapy but also the holistic care delivered by a team with expertise in all aspects of care for complex Aortovascular pathologies. We believe Aortovascular MDTs should become a standard of care in such patients.