{"id":"73c10eb16e67","type":"article","url":"https://hartvaat.nl/2026/02/20/virtuele-afdeling-met-thuismonitoring-is-veilig-voor-patienten-die-wachten-op-sp/","title":"Virtuele afdeling met thuismonitoring is veilig voor patiënten die wachten op spoed-bypasschirurgie","title_en":"Feasibility, safety and outcomes of a virtual ward with remote monitoring for patients awaiting urgent coronary artery bypass graft surgery","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"Open Heart","doi":"http://openheart.bmj.com/cgi/content/short/13/1/e003568?rss=1","source_url":"https://doi.org/http://openheart.bmj.com/cgi/content/short/13/1/e003568?rss=1","authors":["Kirupananthavel","A.","Woldman","S.","Jones","D. A.","Ferguson","G.","Knight","C.","Ozkor","M.","Edmondson","S.","Archbold","A.","Radley","J.","Niblock","C.","Johnson","A.","Theisinger","J.","Rossi","A.","AlJaaly","E.","Kelshiker","M.","Peters","N. S.","Lall","K.","Das","D.","Yates","M. T."],"significance":5,"published":"2026-02-20","source_date":"2026-02-20","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/cabg-bypasschirurgie/","https://hartvaat.nl/kennis/vasculair/vaatchirurgie-perioperatief-cardiologisch-beleid/"],"congress":"","summary_en":"Waiting times for urgent coronary artery bypass grafting (CABG) are rising in the UK, with long preoperative admissions occupying beds and burdening patients. A 'virtual ward' with home monitoring could let clinically stable patients go home safely earlier. In this prospective multicentre study (128 patients, three UK cardiac centres), patients were discharged home with daily symptom reporting via a digital platform and structured review. No preoperative major adverse cardiac events occurred (0%) and 30-day mortality was 0%; resternotomy occurred in 2.3%, comparable to national rates. Median time from discharge to surgery was 10 days, with an estimated saving of 1,152 inpatient bed-days. Patients were positive (95% felt safe at home). A virtual ward with home monitoring is thus safe and feasible for selected patients awaiting urgent CABG, with major gains in bed capacity.","created":"2026-07-03T10:32:25Z","updated":"2026-07-03T13:31:22Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"De wachttijden voor spoed-coronaire bypasschirurgie (CABG) lopen in het VK op, met lange preoperatieve opnames die bedden bezetten en patiënten belasten. Een 'virtuele afdeling' met thuismonitoring zou klinisch stabiele patiënten veilig eerder naar huis kunnen laten gaan. In deze prospectieve multicentrische studie (128 patiënten, drie Britse hartcentra) werden patiënten met dagelijkse symptoomrapportage via een digitaal platform en gestructureerde controle naar huis ontslagen. Er traden géén preoperatieve majeure cardiale events op (0%) en de 30-daagse sterfte was 0%; resternotomie kwam voor bij 2,3%, vergelijkbaar met landelijke cijfers. De mediane tijd van ontslag tot operatie was 10 dagen, met een geschatte besparing van 1.152 opnamedagen. Patiënten waren positief (95% voelde zich veilig thuis). Een virtuele afdeling met thuismonitoring is dus veilig en haalbaar voor geselecteerde patiënten die op spoed-CABG wachten, met forse winst in bedcapaciteit.","abstract_original":"Background\n

Delays in performing urgent coronary artery bypass graft (CABG) surgery are increasing across the UK, with national wait times now exceeding guideline targets. Prolonged preoperative admissions contribute to hospital bed pressures, increased costs and negative psychosocial effects for patients. Virtual wards using remote patient monitoring (RPM) may enable safe early discharge for clinically stable patients awaiting surgery.

\n\nObjectives\n

To evaluate the feasibility, safety and outcomes of a virtual ward pathway using RPM for patients awaiting urgent CABG surgery.

\n\nMethods\n

A prospective, multicentre, single-arm study was conducted across three UK cardiac centres (December 2022–May 2025). Eligible patients were discharged home with daily symptom reporting via a digital platform and structured clinician review. The primary outcome was preoperative major adverse cardiovascular events (MACE). Secondary outcomes included 30-day mortality, resternotomy, time to surgery, postoperative stay, readmissions and patient experience.

\n\nResults\n

128 patients were enrolled (mean age 61 years; 87% male). No preoperative MACE occurred (0%; 95% CI 0.0% to 2.3%). 30-day mortality was 0% (95% CI 0.0% to 2.9%), and resternotomy occurred in 2.3%, comparable to national rates. Median time from discharge to surgery was 10 days, saving an estimated 1152 inpatient bed-days. Postoperative length of stay was 7.0 days compared with a national average of 8.0 (p=0.084). Patient experience was favourable: 95% felt safe at home, and 89% found the platform easy to use.

\n\nConclusions\n

A virtual ward pathway with remote monitoring for selected patients awaiting urgent CABG was safe, feasible and associated with high patient acceptability and major reductions in inpatient utilisation. These findings support this model as a scalable approach to managing urgent surgical pathways while preserving safety and surgical timelines.

\n"}