Recommenda- tions that refer to SYNTAX scores use them as surrogates for the extent and complexity of CAD. Revascularization recommendations to improve survival and symptoms are given in the following text and summa- rized in Tables 2 and 3. References to studies comparing revascularization with medical therapy are presented when available for each anatomic subgroup. See Online Data Supplements 8 and 9 for additional data regarding the survival and symptomatic benefits with CABG or PCI for different anatomic subsets. 3.1. Heart Team Approach to Revascularization Decisions: Recommendations Class I 1. A Heart Team approach to revascularization is recommended in patients with unprotected left main or complex CAD.302 304 (Level of Evidence: C) Class IIa 1. Calculation of the STS and SYNTAX scores is reasonable in patients with unprotected left main and complex CAD.301,302,305 310 (Level of Evidence: B) One protocol used in RCTs302 304,311 often involves a multi- disciplinary approach referred to as the Heart Team. Com- posed of an interventional cardiologist and a cardiac surgeon, the Heart Team 1) reviews the patient s medical condition and coronary anatomy, 2) determines that PCI and/or CABG are technically feasible and reasonable, and 3) discusses revascularization options with the patient before a treatment strategy is selected. Support for using a Heart Team approach comes from reports that patients with complex CAD referred specifically for PCI or CABG in concurrent trial registries have lower mortality rates than those randomly assigned to PCI or CABG in controlled trials.303,304 The SIHD, PCI, and CABG guideline writing commit- tees endorse a Heart Team approach in patients with unprotected left main CAD and/or complex CAD in whom the optimal revascularization strategy is not straightfor- ward. 