title: The utility of live video capture to enhance debriefing following transcatheter aortic valve replacement.
abstract: BACKGROUND
  The surgical and procedural specialties are continually evolving their methods to include more complex and technically difficult cases. These cases can be longer and incorporate multiple teams in a different model of operating room synergy. Patients are frequently older, with comorbidities adding to the complexity of these cases. Recording of this environment has become more feasible recently with advancement in video and audio capture systems often used in the simulation realm.
  
  
  OBJECTIVE
  We began using live capture to record a new procedure shortly after starting these cases in our institution. This has provided continued assessment and evaluation of live procedures. The goal of this was to improve human factors and situational challenges by review and debriefing.
  
  
  METHODS
  B-Line Medical's LiveCapture video system was used to record successive transcatheter aortic valve replacement (TAVR) procedures in our cardiac catheterization/laboratory. An illustrative case is used to discuss analysis and debriefing of the case using this system.
  
  
  CONCLUSIONS
  An illustrative case is presented that resulted in long-term changes to our approach of these cases. The video capture documented rare events during one of our TAVR procedures. Analysis and debriefing led to definitive changes in our practice. While there are hurdles to the use of this technology in every institution, the role for the ongoing use of video capture, analysis, and debriefing may play an important role in the future of patient safety and human factors analysis in the operating environment.
authors.affiliation: Department of Anesthesiology, Mayo Clinic Arizona, AZ 85054, USA.
authors.forename: David P
authors.initials: DP
authors.lastname: Seamans
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic Arizona, AZ 85054, USA.
authors.forename: Boshra F
authors.initials: BF
authors.lastname: Louka
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic Arizona, AZ 85054, USA.
authors.forename: F David
authors.initials: FD
authors.lastname: Fortuin
authors.affiliation: Department of Critical Care, Mayo Clinic Arizona, AZ 85054, USA.
authors.forename: Bhavesh M
authors.initials: BM
authors.lastname: Patel
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic Arizona, AZ 85054, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Sweeney
authors.affiliation: Division of Cardiovascular and Thoracic Surgery, Mayo Clinic Arizona, AZ 85054, USA.
authors.forename: Louis A
authors.initials: LA
authors.lastname: Lanza
authors.affiliation: Division of Cardiovascular and Thoracic Surgery, Mayo Clinic Arizona, AZ 85054, USA.
authors.forename: Patrick A
authors.initials: PA
authors.lastname: DeValeria
authors.affiliation: Department of Catheterization Laboratory, Mayo Clinic Arizona, AZ 85054, USA.
authors.forename: Kim M
authors.initials: KM
authors.lastname: Ezrre
authors.affiliation: Division of Cardiovascular and Thoracic Anesthesiology, Mayo Clinic Arizona, AZ 85054, USA.
authors.forename: Harish
authors.initials: H
authors.lastname: Ramakrishna
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D009873:Operating Rooms; D061214:Patient Safety; D012307:Risk Factors; D013997:Time Factors; D065467:Transcatheter Aortic Valve Replacement / Q000379:methods*; D016896:Treatment Outcome; D014743:Videotape Recording