Establishing and maintaining a remote vascular surgery aortic program: A single-center 5-year experience at the Veterans Affairs.


Journal

Journal of vascular surgery
ISSN: 1097-6809
Titre abrégé: J Vasc Surg
Pays: United States
ID NLM: 8407742

Informations de publication

Date de publication:
03 2022
Historique:
received: 22 03 2021
accepted: 24 08 2021
pubmed: 26 9 2021
medline: 8 3 2022
entrez: 25 9 2021
Statut: ppublish

Résumé

We sought to detail the process of establishing a surgical aortic telehealth program and report the outcomes of a 5-year experience. A telehealth program was established between two regional Veterans Affairs hospitals, one of which was without a comprehensive aortic surgical program, until such a program was established at the referring institution. A retrospective review was performed of all patients who underwent aortic surgery from 2014 to 2019. The operative data, demographics, perioperative complications, and follow-up data were reviewed. From 2014 to 2019, 109 patients underwent aortic surgery for occlusive and aneurysmal disease. Preoperative evaluation and postoperative follow-up were done remotely via telehealth. The median age of the patients was 68 years, 107 were men (98.2%), 28 (25.7%) underwent open aortic repair, and 81 (74.3%) underwent endovascular repair. Of the 109 patients, 101 (92.7%) had a median follow-up of 24.3 months, 5 (4.6%) were lost to follow-up or were noncompliant, 2 (1.8%) were noncompliant with their follow-up imaging studies but responded to telephone interviews, and 1 (0.9%) moved to another state. At the 30-day follow-up, eight patients (7.3%) required readmission. Four complications were managed locally, and four patients (3.6%) required transfer back to the operative hospital for additional care. Telehealth is a great tool to provide perioperative care and long-term follow-up for patients with aortic pathologies in remote locations. Most postoperative care and complications can be managed remotely, and patient compliance for long-term follow-up is high.

Identifiants

pubmed: 34562570
pii: S0741-5214(21)02135-2
doi: 10.1016/j.jvs.2021.08.083
pmc: PMC8863634
mid: NIHMS1742939
pii:
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

1063-1072

Subventions

Organisme : NCI NIH HHS
ID : T32 CA211034
Pays : United States

Informations de copyright

Published by Elsevier Inc.

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Auteurs

Joshua P Kronenfeld (JP)

Division of Vascular and Endovascular Surgery, Department of Surgery, University of Miami Miller School of Medicine and Miami Veterans Affairs Medical Center, Miami, Fla.

Naixin Kang (N)

Division of Vascular and Endovascular Surgery, Department of Surgery, University of Miami Miller School of Medicine and Miami Veterans Affairs Medical Center, Miami, Fla.

Stefan Kenel-Pierre (S)

Division of Vascular and Endovascular Surgery, Department of Surgery, University of Miami Miller School of Medicine and Miami Veterans Affairs Medical Center, Miami, Fla.

Alberto Lopez (A)

Division of Vascular and Endovascular Surgery, Department of Surgery, University of Miami Miller School of Medicine and Miami Veterans Affairs Medical Center, Miami, Fla.

Jorge Rey (J)

Division of Vascular and Endovascular Surgery, Department of Surgery, University of Miami Miller School of Medicine and Miami Veterans Affairs Medical Center, Miami, Fla.

Frederick Fisher (F)

Division of Vascular Surgery, Orlando Veterans Affairs Medical Center, Orlando, Fla.

John Karwowski (J)

Division of Vascular and Endovascular Surgery, Department of Surgery, University of Miami Miller School of Medicine and Miami Veterans Affairs Medical Center, Miami, Fla.

Arash Bornak (A)

Division of Vascular and Endovascular Surgery, Department of Surgery, University of Miami Miller School of Medicine and Miami Veterans Affairs Medical Center, Miami, Fla. Electronic address: abornak@med.miami.edu.

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