Abstract Introduction Cardiovascular Multidisciplinary Heart Teams (MDHTs) are integral for patient management, but persistent challenges, including limited subspecialty expertise and time constraints, necessitate innovative approaches. This study explores the viability of conducting international Meta-Heart Team sessions utilizing virtual reality (VR) within the metaverse, aiming to address these challenges. Methods The Meta-Heart Team, comprising participants from diverse medical specialties and countries, engaged in VR sessions facilitated by VR headsets and web browsers. The immersive Aimedis metaverse platform recreated a three-dimensional hospital setting, complete with a dedicated Meta-Heart Team room featuring large screens displaying patient data such as coronary angiograms and echocardiograms. A 0-10 scale questionnaire evaluated participant experiences, covering technical quality, immersion, willingness to participate again, and overall satisfaction. Results The virtual environment effectively facilitated discussions on valvular heart disease cases among 10 participants, dedicating 15 minutes to each case. Technical stability was robust (90%), with only one participant experiencing internet disconnection. Positive participant feedback highlighted high ratings for technical quality (8.0±1.8) and engagement, a good immersive experience (8.0±1.3), willingness to participate again (9.2±0.8), and confidence in treatment decisions (80%). Despite a sense of digital fatigue reported by a few participants, the majority expressed that the VR session saved time compared to traditional meetings. Privacy concerns were acknowledged by 80% of participants. Discussion The virtual environment demonstrated potential in augmenting MDHT collaboration, providing advantages in global accessibility, multidimensional analysis, and adaptability. Participants recognized limitations in non-verbal communication and interpersonal connections but underscored the adaptability and effectiveness of the virtual setting. Technical challenges, including a single internet disconnection, emphasized the importance of a robust technical infrastructure. Privacy issues, digital fatigue, and potential exclusions were highlighted, prompting consideration of ethical guidelines and ongoing technological advancements. Conclusion Leveraging VR in the metaverse for MDHT sessions is feasible and offers substantial benefits. Despite challenges such as technical issues and privacy concerns, the Meta-Heart Team complements traditional interactions, ushering in a new era in collaborative decision-making while demanding ongoing attention to technological and ethical considerations.Two presenters explaining the processThe Metaverse-based Heart Team room