title: Patient safety and outcomes from live case demonstrations of interventional cardiology procedures.
abstract: OBJECTIVE
  The goal of this study was to examine the safety and results of interventional procedures performed during the broadcast of live case demonstrations.
  
  
  BACKGROUND
  Professional meetings using live case demonstrations to present cutting-edge technology are considered a valuable educational resource. There is an ongoing discussion on whether patients who are treated during live case demonstrations are exposed to a higher risk.
  
  
  METHODS
  Between 1998 and 2010, 101 patients were treated during live transmissions from a single center in 15 invasive-cardiology conferences. Technical success was defined as the ability to effectively perform the planned procedure without any major complication. The primary endpoint of the study was the composite occurrence of death, myocardial infarction, or stroke.
  
  
  RESULTS
  The interventional procedures included coronary (n=66), carotid (n=15), peripheral (n=1), valvular (n=2), congenital heart disease (n=12), and complex electrophysiological mapping and ablation interventions (n=7). In 4 cases, the intended procedure was not done. The procedure was technically successful in 95%. In 5 cases, the procedure was unsuccessful because of the inability to cross a chronic total occlusion. There were no deaths during the hospital stay, and the composite primary endpoint occurred in 2 patients: a minor stroke following an atrial fibrillation ablation and a rise in serum troponin levels after percutaneous coronary intervention. These results were no different from those of 66 matched controls who underwent procedures performed by the same operators but not as live case demonstrations (relative risk: 0.32; 95% confidence interval: 0.02 to 3.62, p=0.62).
  
  
  CONCLUSIONS
  In this consecutive series of interventional cardiology procedures that were performed by expert operators during live demonstration courses, the procedural and 30-day clinical outcomes were similar to those found in daily practice and to those that have been reported in the contemporary published data. These results suggest that broadcasting live case demonstrations in selected patients from selected centers may be safe.
authors.affiliation: Department of Cardiology, Rambam Medical Center, B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Shiran
authors.initials: S
authors.lastname: Eliyahu
authors.forename: Ariel
authors.initials: A
authors.lastname: Roguin
authors.forename: Arthur
authors.initials: A
authors.lastname: Kerner
authors.forename: Monther
authors.initials: M
authors.lastname: Boulos
authors.forename: Avraham
authors.initials: A
authors.lastname: Lorber
authors.forename: Majdi
authors.initials: M
authors.lastname: Halabi
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Suleiman
authors.forename: Eugenia
authors.initials: E
authors.lastname: Nikolsky
authors.forename: Shmuel
authors.initials: S
authors.lastname: Rispler
authors.forename: Rafael
authors.initials: R
authors.lastname: Beyar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002309:Cardiology / Q000941:ethics* / Q000379:methods; D002318:Cardiovascular Diseases / Q000601:surgery* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D003226:Congresses as Topic / Q000941:ethics; D004502:Education, Medical, Continuing / Q000941:ethics* / Q000379:methods; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D008875:Middle Aged; D005791:Patient Care; D061214:Patient Safety; D012189:Retrospective Studies; D012306:Risk; D018570:Risk Assessment / Q000379:methods; D013663:Teaching; D016896:Treatment Outcome; D055815:Young Adult