Virtual Heart Team

Complex revascularization — left main, multivessel, frailty — sits in genuine equipoise. Guidelines mandate a Heart Team, yet 20–24% of recommendations flip on re-discussion, and the specialty of whoever is in the room shifts CABG rates. Most centers have no Heart Team at all. Virtual Heart Team convenes four Claude agents — interventional cardiologist, cardiac surgeon, clinical cardiologist, non-voting methodologist — over two deliberation rounds, grounded in a 30-citation evidence base built with Claude Science, every DOI verified and auditable from the UI. Sonnet runs the agents; Opus runs intake and synthesis. Each proceduralist runs in advocate and neutral framings, N=5 samples each, and drift is computed deterministically in code — no model produces the number. Drift came out near zero. So we pointed Claude Code at our own headline metric and asked it to find the flaw. It did: the advocate prompt's CONCEDE clause bounds advocacy by construction. We ablated it. Removing the guardrail widens advocate-versus-neutral divergence from 0.20 to 0.80 (−3..+3 scale, N=5); re-running on Opus widens it to 1.20. Our finding is not that specialists are biased — we induced that bias ourselves. It is that the guardrail measurably contains it, and you can see it happen in one click, on the same patient.