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Are we providing the best treatment options for patients? The "heart team" should function for this purpose.

Recent medical innovation brought numerous new treatment options to everyday clinical practice. It is not unusual that several options are available when a patient arrives at the hospital. The issue of whether we are selecting the best therapy among several alternatives is becoming increasingly important. Especially in the field of cardiovascular disease, intravascular therapies such as aortic stents, coronary stents and/or angioplasties, have emerged. It became more and more important to evaluate and compare pros and cons of intravascular therapy versus open surgical approach. From the point of view of patients, they solely rely on the judgment of physician who takes care of them. In the current era, however, it is very difficult to request a physician to understand every aspect of numerous treatment options, and to make a perfect decision. A team approach is definitely needed. The question is whether we have developed a strategy to establish a team functioning for its purpose. Endovascular aortic repair (EVAR) for abdominal aortic aneurysm has been performed worldwide, and its short term and long term results have been reported.1� Endovascular approach has been extended to the thoracic aorta, as well.2� The players involved in endovascular repair of aortic disease are mainly cardiovascular surgeons who can perform open surgery. Occasionally, radiologists are involved, but their role is becoming limited. In these situations, surgeons or a surgical team can weigh the benefits and disadvantages of open versus endovascular approaches. Selection bias, thus,