Guidance for cardiac multidisciplinary meetings
The new guidance on cardiac multidisciplinary meetings published in Heart in April 2022 updates the 2015 joint British Societies' recommendations on multidisciplinary meetings (MDMs) to reflect changes in practice. The guidance covers the structure and function of MDMs which should be taking place in every cardiac surgical centre. Out of scope are MDMs that do not require the routine presence of a cardiac surgeon such as electrophysiology MDMs and those which are not provided in every centre, such as complex aortic surgery.
Key messages from the guidance
MDMs are a key part of the patient pathway for myocardial revascularisation, aortic valve disease, mitral and tricuspid valve disease and endocarditis.
MDMs should function as a single, disease-specific, point of access to interventional pathways.
Many patients can be rapidly triaged by the relevant MDM but those where the optimal management is unclear require detailed review.
MDMs should incorporate the principles of patient-centred care and shared decision making.
MDMs should be virtual (or hybrid) by default and accessible to all referring clinicians within a network.
Each surgical centre should convene a daily MDM for consideration and prioritisation of urgent inpatient referrals involving, as a minimum, the on call cardiologist and cardiac surgeon.
MDMs must have a coordinator and a chair and should be job planned for all core attendees.
All MDM discussions must be documented and the decisions made subject to regular audit.