[The heart team in coronary artery disease-perspectives from centers without institutional cardiac surgery].

The management of coronary artery disease (CAD) has become more demanding due to evolving therapeutic options and more complex patient profiles. In this context, the heart team has become established: a structured, interdisciplinary decision-making process that brings together the specialist knowledge from cardiology, cardiac surgery, anesthesia and other specialist fields to enable individual and evidence-based treatment recommendations. While this model is well-established in university medical centers, its implementation in nonuniversity hospitals lacking in-house cardiac surgery presents unique challenges. This article explores practical strategies for successfully establishing heart teams in such institutions, including the formation of a stable organized core team for case coordination, formal cooperation with external cardiac surgery centers (often via telemedicine), integration of experienced cardiac anesthesiologists and the establishment of clear internal processes for communication and documentation. Particular attention is given to the technical infrastructure required to support hybrid or virtual conferencing formats.