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

Joshua P. Kronenfeld, Naixin Kang, Stefan Kenel-Pierre, Alberto Lopez, Jorge Rey, Frederick Fisher, John Karwowski, Arash Bornak

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: We sought to detail the process of establishing a surgical aortic telehealth program and report the outcomes of a 5-year experience. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish (US)
JournalJournal of vascular surgery
DOIs
StateAccepted/In press - 2021

Keywords

  • Aorta
  • Aortic surgery
  • EVAR
  • Telehealth
  • Telemedicine
  • Videoconference

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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