When a patient needs both a blocked coronary artery opened and a brain aneurysm secured, the two organs often pull treatment decisions in opposite directions. Blood thinners that protect a stented heart can turn a fragile intracranial vessel into a hemorrhage risk, while the timing of carotid and coronary revascularization remains contested in the surgical literature. A hospital in Beijing has now tested a structural answer to this dilemma: instead of shuttling patients between cardiology and neurosurgery wards, it put the specialties under one roof.
Peking Union Medical College Hospital opened a dedicated Heart–Brain Integrated Ward in July 2026, supported by a joint outpatient clinic, combined cerebro-cardiac imaging, and a hybrid operating room. A team led by Qi Liu, Yang Zhao, and Yuanli Zhao has now published the first two months of experience in the Chinese Neurosurgical Journal as a retrospective descriptive study. The report covers 56 consecutive patients admitted between July 1 and August 21, 2026, and describes who they were, what conditions brought them in, and how a four-specialty team decided to treat them. It is an early operational account, not an outcome trial, and the authors are explicit that the findings are hypothesis-generating.
The cohort was predominantly male, with 42 of 56 patients (75.0%) men, and had a mean age of 62.4 ± 12.2 years, ranging from 19 to 80. Most patients arrived through neurosurgery, which accounted for 31 primary admissions (55.4%), while cardiac surgery admitted 22 (39.3%). Vascular risk factors were common: 41 patients (73.2%) had hypertension, 18 (32.1%) had hyperlipidemia, and 14 (25.0%) had diabetes mellitus. Admission required both a confirmed or suspected neurological condition and a confirmed or suspected cardiac condition; patients admitted only for single-organ evaluation were not included, which means the cohort was selected for complexity rather than representative of the broader comorbidity population.
To organize this complexity, the team developed a six-category classification framework before the ward opened, adapted from existing literature on pan-vascular disease, stroke–heart syndrome, and cardiogenic embolism. The categories run from shared etiologies, through cardiogenic and cerebrogenic disorders, to psychocardiological conditions, therapeutically interactive states, and special perioperative situations. Patients were assigned prospectively during multidisciplinary discussion, and when a patient fit more than one category, the one driving the dominant therapeutic decision was chosen by consensus. The authors stress that this framework is a proposed conceptual structure that has not been externally validated.
The spectrum that emerged was dominated by atherosclerosis. Category I.1, shared atherosclerotic vascular disease, accounted for 29 of 56 patients (51.8%), most often ischemic cerebrovascular disease combined with coronary artery disease (18 patients, 32.1%). Category II, cardiogenic cerebral disorders, included 6 patients (10.7%), and Category I.3, systemic infectious or inflammatory etiologies, included 5 (8.9%). Notably, Category IV, psychocardiological disorders, made up 12 patients (21.4%), typically people with anxiety or stress-related cardiac symptoms in the setting of significant cerebrovascular disease. The authors attribute this high proportion to the ward’s early referral pattern rather than any true prevalence, and they note that standardized psychological assessment was not performed, so the category needs refinement in later cohorts. Category V, therapeutically interactive conditions, included 3 patients (5.4%), and Category VI included 1 (1.8%). Among specific neurological diagnoses, intracranial aneurysm led at 15 patients (26.8%), followed by carotid artery stenosis (12, 21.4%), cerebral infarction (11, 19.6%), and vertebral artery stenosis (10, 17.9%). On the cardiac side, coronary artery disease was most common (15, 26.8%), followed by aortic valve disease (5, 8.9%), atrial fibrillation (4, 7.1%), and aortic arch pathology (3, 5.4%).
Every single patient underwent at least one formal multidisciplinary team discussion attended by attending physicians from neurosurgery, cardiac surgery, cardiology, and neurology, and 55 of 56 (98.2%) required a second. The most frequently debated questions reveal where the clinical friction lies: whether antithrombotic therapy could be safely continued in patients with intracranial vascular pathology who needed coronary stenting; the sequence of carotid and coronary revascularization; and the timing of cardiac surgery in patients with infective endocarditis and cerebral microbleeds. In emergencies, the most senior available attending from the time-critical specialty made the initial call, which was then reviewed at the next team meeting.
Treatment followed a predominantly cautious, staged pattern. Of the 56 patients, 41 (73.2%) underwent surgical or endovascular intervention, while 15 (26.8%) received medical management or remained under evaluation. Among the treated group, 24 (42.9% of the total cohort) had single-system interventions, 13 (23.2%) completed staged procedures for both systems within the same admission, and only 4 (7.1%) received synchronous dual-system procedures in a single anesthesia session. Fourteen patients (25.0%) ultimately required intervention for both organ systems; of these, 10 were managed with staged procedures and 4 synchronously. The synchronous cases were two combined cerebral–coronary diagnostic angiographies, one session combining carotid stenting with aortic debranching and thoracic endovascular aortic repair, and one combining coronary dilation with intracranial aneurysm embolization. The authors note these were selected for technical convenience or because acute lesions in both systems could not be safely staged.
The early safety signal is encouraging but heavily qualified. By the data cutoff on August 21, 2026, 38 patients (67.9%) had been discharged and 18 (32.1%) remained hospitalized. Among the discharged patients, no in-hospital mortality and no major procedure-related complications were observed, where major complications were predefined as in-hospital stroke lasting more than 24 hours, myocardial infarction, major bleeding requiring transfusion or reoperation, dialysis-requiring acute kidney injury, wound infection, or death. Among the 18 patients still hospitalized, no deaths had occurred by the cutoff, but complication surveillance was ongoing. The authors warn directly that the absence of observed complications among discharged patients should not be extrapolated to the full cohort, and that the four synchronous cases are far too small a sample to draw any conclusions about safety or generalizability.
Beyond the clinical numbers, the report offers organizational lessons for anyone attempting similar models. Clear admission criteria proved essential: the ward was appropriate when both organ systems had active or high-risk conditions requiring coordinated management, or when a comorbidity materially altered the risk–benefit balance of a planned procedure, while patients with only incidental, low-risk comorbidities were better served in conventional specialty wards. Nursing staff needed orientation to dual-system monitoring of both neurological and cardiac parameters. The hybrid operating room functioned as a diagnostic–therapeutic bridge, with several patients undergoing combined cerebral–coronary angiography there, allowing the team to adjust treatment plans immediately in light of the findings. Coordinating multidisciplinary schedules remained a persistent challenge.
The authors are candid about the study’s limits. It is a single-center, retrospective descriptive analysis with a small sample and short follow-up; it does not compare outcomes against conventional care and cannot establish clinical effectiveness. Length-of-stay and cost data were not systematically collected. The proposed classification awaits external validation. What the study does establish is operational feasibility: a dedicated heart–brain ward can admit a complex comorbid population, achieve universal multidisciplinary review, and deliver both staged and selectively synchronous dual-system procedures without observed major early events among discharged patients. The authors suggest that a Plan–Do–Study–Act cycle could compare operational metrics such as consultation response time and procedure cancellation rates before and after implementation, and they call for prospective multicenter registries with longer follow-up to validate the classification and compare synchronous against staged strategies. Whether this integrated model genuinely improves outcomes over conventional consultation-based care remains an open question that only controlled comparison can answer.
Subject of Research: Early clinical experience of a dedicated heart–brain integrated ward for patients with combined neurological and cardiac conditions at a Chinese tertiary hospital
Article Title: Early experience of a dedicated heart–brain integrated ward at Peking Union Medical College Hospital: a retrospective descriptive study
Article References: Liu, Q., Zhao, Y., Zhao, Y., Yang, S., Zheng, J., & Zhao, Y. (2026). Early experience of a dedicated heart–brain integrated ward at Peking Union Medical College Hospital: a retrospective descriptive study. Chinese Neurosurgical Journal, 12(1), Article 32. https://doi.org/10.1186/s41016-026-00451-9
Image Credits: AI Generated
DOI: 10.1186/s41016-026-00451-9
Keywords: heart–brain comorbidity, integrated ward, multidisciplinary team, pan-vascular disease, Peking Union Medical College Hospital, retrospective descriptive study, synchronous dual-system procedures, staged revascularization, psychocardiological disorders, multidisciplinary care, cerebrovascular disease, coronary artery disease
News Source: Cassandra Pierce. (October 27, 2026). Dedicated Heart–Brain Ward Treats First 56 Complex Patients in China. Scienmag.
