{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T09:13:23Z","timestamp":1769073203861,"version":"3.49.0"},"reference-count":19,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,8,17]],"date-time":"2024-08-17T00:00:00Z","timestamp":1723852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Despite its wide diffusion in surgical procedures, very few experiences are reported so far about the possible applications of remote proctoring (RP) in structural heart interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>Our aim was to demonstrate the feasibility, safety, and efficacy of RP during transcatheter edge\u2010to\u2010edge repair using a mixed reality\u2010based head\u2010mounted display (HMD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two users (a doctor and a proctor), wearing HMDs, were connected through a 5G network, allowing them to share audio and video signals. During the procedure, the proctor was located in a contiguous room, without any direct connection with the operator. The primary endpoint was noninferiority of HMD\u2010mediated interaction if compared with direct in\u2010person interaction. It was assessed using an operator\u2212proctor interaction test based on six questions asked by the doctor to the proctor on six key procedural steps.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between September 2021 and April 2022, nine\u00a0patients were enrolled in the study (15 clips delivered). The primary endpoint was reached in 9\/15 clips implanted (60%). The first three\u00a0failures were due to a chat software problem, and the others were linked with a 5G network malfunction. However, the HMD and its mixed reality tools were well tolerated by the operators, and no interference with the procedure was registered in any of the cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In our experience, RP during structural heart interventions is feasible and efficacious. Wearing the HMD is comfortable and does not affect safety and effectiveness of interventional procedures. However, especially if considering\u00a0a wide geographic use of this tool, a stable internet connection is imperative.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.31187","type":"journal-article","created":{"date-parts":[[2024,8,17]],"date-time":"2024-08-17T11:28:54Z","timestamp":1723894134000},"page":"1037-1043","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Remote proctoring during structural heart procedures: Toward\u00a0a widespread diffusion of knowledge using mixed reality"],"prefix":"10.1002","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7727-0573","authenticated-orcid":false,"given":"Guido","family":"Ascione","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Heart Valve Center, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Rossini","sequence":"additional","affiliation":[{"name":"Artiness srl Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Schiavi","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Heart Valve Center, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University Milan Italy"},{"name":"Alfieri Heart Foundation Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicol\u00f2","family":"Azzola Guicciardi","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Heart Valve Center, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Saccocci","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Heart Valve Center, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7713-3739","authenticated-orcid":false,"given":"Nicola","family":"Buzzatti","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Heart Valve Center, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cosmo","family":"Godino","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Heart Valve Center, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ottavio","family":"Alfieri","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Heart Valve Center, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University Milan Italy"},{"name":"Alfieri Heart Foundation Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eustachio","family":"Agricola","sequence":"additional","affiliation":[{"name":"Echocardiography Laboratory, Heart Valve Center, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Maisano","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Heart Valve Center, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University Milan Italy"},{"name":"Alfieri Heart Foundation Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Denti","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Heart Valve Center, IRCCS San Raffaele Scientific Institute Vita\u2010Salute San Raffaele University Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,8,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/1553350618813250"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.4084\/MJHID.2022.012"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.29504"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.5603\/CJ.a2021.0100"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.023757"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.07.058"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2024.100839"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2023.05.013"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.28421"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2020.01.018"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2020.04.013"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-021-01890-3"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2021.3604"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/15910199211035304"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sopen.2022.06.004"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2021.657901"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7066"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2023.10.029"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2023.09.029"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.31187","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T04:55:53Z","timestamp":1746420953000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.31187"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,17]]},"references-count":19,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1002\/ccd.31187"],"URL":"https:\/\/doi.org\/10.1002\/ccd.31187","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,17]]},"assertion":[{"value":"2024-02-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}