Feasibility, safety and outcomes of a virtual ward with remote monitoring for patients awaiting urgent coronary artery bypass graft surgery
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Authors
Kirupananthavel, Arun
Woldman, Simon
Jones, Daniel A.
Ferguson, Gordon
Knight, Charles
Ozkor, Mick
Edmondson, Stephen
Archbold, Andrew
Radley, Jason
Niblock, Cora
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Issue Date
2026
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Article
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BACKGROUND: 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. OBJECTIVES: To evaluate the feasibility, safety and outcomes of a virtual ward pathway using RPM for patients awaiting urgent CABG surgery. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
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Open heart
Volume
13
Issue
1