HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bonvini, R.F. Articles by Gallino, A. Search for Related Content PubMed PubMed Citation Articles by Bonvini, R.F. Articles by Gallino, A. Related Collections Cardiac - other Coronary disease

Eur J Cardiothorac Surg 2002;22:377-380
© 2002 Elsevier Science NL

Telemedicine for cardiac surgery candidates

^a Division of Cardiology, Ospedale San Giovanni, CH-6500 Bellinzona, Switzerland
^b Department of Cardiac Surgery, University Hospital, Lausanne, Switzerland

Received 13 February 2002; received in revised form 29 May 2002; accepted 6 June 2002.

* Corresponding author. Tel.: +41-91-820-9107; fax: +41-91-820-9169
e-mail: agallino{at}bluewin.ch

Background: Cardiac surgery is generally well or over-represented in many Western countries. Since the southern part of Switzerland relies on 300 km distance centers for cardiac surgery, we started a project of telemedicine for the distant evaluation of cardiac surgery candidates. We report our experience of the results of the diagnosis made by telemedicine and by direct scrutiny of coronary angiograms. Methods: Coronary angiography was performed at the distant hospital by an invasive cardiology team. Teletransmission of images was performed using three Integrated Service Digital Network (ISDN) lines by direct transmission of recent recording. A total of 98 cases were reviewed (87 aorto-coronary bypass candidates, seven valvular and four congenital heart disease). We further performed a prospective blinded comparison of 47 consecutive cases with severe coronary artery disease (CAD) with respect to localization and number of significant coronary lesions, obtained by direct scrutiny of the original angiograms and the evaluation obtained with the teletransmitted images. Results: In 89 cases of the 98 analyzed (91%) correct diagnosis and surgical approach could be established by distant transmission. In nine cases (9%, all aortocoronary bypass candidates) definitive diagnosis and treatment was feasible only by direct scrutiny of the original angiograms. Five critically ill patients were urgently referred to the surgical care center based on the correct distant diagnosis. The blinded comparison of distant diagnosis and direct scrutiny of angiograms in defining 1-2-3 vessel CAD was good: r=0.87, P<0.01. Conclusion: Initial experience using non-sophisticated telemedical transmission of angiograms of cardiac surgery candidates seems to be a promising facility for distantly located centers.

Key Words: Coronary angiogram • Telemedicine • Integrated Service Digital Network (ISDN) line • Cardiac surgery

This article has been cited by other articles:

				L. K. von Segesser, B. Marty, P. Tozzi, and P. Ruchat Impact of endoluminal stenting for aortic surgery Eur. J. Cardiothorac. Surg., December 1, 2004; 26(Suppl_1): S14 - S18. [Abstract] [Full Text] [PDF]

				L. K. von Segesser, P. Tozzi, M. Augstburger, and A. Corno Working heart off-pump cardiac repair (OPCARE) - the next step in robotic surgery? Interactive CardioVascular and Thoracic Surgery, June 1, 2003; 2(2): 120 - 124. [Abstract] [Full Text] [PDF]