Teleproctoring for Training in Structural Heart Interventions: Initial Real-World Experience During the COVID-19 Pandemic

Background Proctoring represents a cornerstone in the acquisition of state-of-the-art cardiovascular interventions. Yet, travel restrictions and containment measures during the COVID-19 pandemic limited on-site proctoring for training and expert support in interventional cardiology. Methods and Resu...

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Bibliographic Details
Published in:Journal of the American Heart Association 2022-02, Vol.11 (4), p.e023757-e023757
Main Authors: Beyhoff, Niklas, Zhu, Miry, Zanders, Lukas, Leistner, David M, Nobles, Anthony, Schroeder, Mark, Barbieri, Fabian, Landmesser, Ulf, Reinthaler, Markus
Format: Article
Language:English
Subjects:
Brief Communication
Cardiac Surgical Procedures - education
COVID-19
Foramen Ovale, Patent - surgery
Humans
Pandemics
patent foramen ovale
PFO closure
remote proctoring
Telemedicine
teleproctoring
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Summary:Background Proctoring represents a cornerstone in the acquisition of state-of-the-art cardiovascular interventions. Yet, travel restrictions and containment measures during the COVID-19 pandemic limited on-site proctoring for training and expert support in interventional cardiology. Methods and Results We established a teleproctoring setup for training in a novel patent foramen ovale closure device system (NobleStitch EL, HeartStitch Inc, Fountain Valley, CA) at our institution using web-based real-time bidirectional audiovisual communication. A total of 6 patients with prior paradoxical embolic stroke and a right-to-left shunt of grade 2 or 3 were treated under remote proctorship after 3 cases were performed successfully under on-site proctorship. No major device/procedure-related adverse events occurred, and none of the patients had a residual right-to-left shunt of grade 1 or higher after the procedure. Additionally, we sought to provide an overview of current evidence available for teleproctoring in interventional cardiology. Literature review was performed identifying 6 previous reports on teleproctoring for cardiovascular interventions, most of which were related to the current COVID-19 pandemic. In all reports, teleproctoring was carried out in similar settings with comparable setups; no major adverse events were reported. Conclusions Teleproctoring may represent a feasible and safe tool for location-independent and cost-effective training in a novel patent foramen ovale closure device system. Future prospective trials comparing teleproctoring with traditional on-site proctoring are warranted.
ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.121.023757