ABSTRACT
Background: Telemedicine gained popularity during the COVID-19 pandemic. However, virtual consults are mostly utilized in outpatient visits and inpatient curbsides. Virtual consults are underutilized during invasive procedures. Objective: Demonstrate the feasibility of intraoperative virtual consults to facilitate a team-based approach to patient care. Methods: We conducted a retrospective analysis of patients undergoing cardiac procedures in Presidente Perón Hospital, Buenos Aires, Argentina with live virtual clinical support from Mayo Clinic Rochester, MN and technical support from industry sponsor (MediCool Technologies, Inc). All procedures were approved by the institutional review boards. Patients >18 years old undergoing median sternotomy for a cardiac procedure were enrolled in a study to assess the feasibility of terminating atrial fibrillation by placing a cooled device in the oblique sinus. All procedures were performed using videotelephony software (Zoom Video Communications, Inc.) with real-time patient data, visualization of surgical field and device parameters available to Mayo Clinic staff and sponsor. Three-way communication allowed for immediate clinical and technical input given the team’s pre-clinical experience with the novel technology. Results: Three patients met the inclusion criteria and were enrolled in the study. Two patients had aortic and one patient had mitral valve surgeries. All patients had the index surgery without complications. Using remote videotelephony, patient data was available in real-time to Mayo Clinic and sponsor for review and input (Figure 1). Physicians in Argentina operated the novel system successfully and terminated atrial fibrillation in 5/6 applications without any complications, interruptions, delays of care or adverse outcomes. All procedures were recorded and data was available for post procedural analysis. Conclusion: Intraoperative virtual consults are feasible and can facilitate a team approach to patient care. [Formula presented]