PICS Live Case Demonstrations: Five‐Year Review of a Collaborative Experience

BACKGROUND: Live case demonstrations are widely used in interventional cardiology for procedural education and exchange of techniques and experience. Their educational value must be balanced against concerns regarding patient safety, privacy, and the potential influence of live discussion on procedural decision-making. We sought to characterize the Pediatric and Congenital Interventional Cardiovascular Society (PICS) live case experience and identify potential effects of live broadcasting on patient care. METHODS: We performed a retrospective qualitative and semi-quantitative review of PICS live case demonstrations from 2018 to 2023 for which a digitized archive was available. Case characteristics, procedures, devices, discussion content, procedural outcomes, adverse events, broadcast-related "red flags," and changes in procedural strategy associated with live discussion were recorded. Qualitative content was analyzed using a general inductive approach. RESULTS: Ninety-four clinical cases from 28 hospitals in 11 countries were analyzed. Patients ranged from premature neonates to adults, with 54 (57.4%) involving adults with congenital/structural heart disease. Transcatheter pulmonary valve replacement was the most frequently presented procedure (27.7%). Two significant procedural adverse events (2.1%) occurred; neither could be directly attributed to the live broadcast. Live discussion influenced the stated procedural strategy in seven cases (7.4%). CONCLUSIONS: PICS live case demonstrations encompass a broad spectrum of patients, procedures, institutions, and international practice. No adverse events were directly attributed to live broadcasting, although issues related to patient privacy, procedural delays, and the influence of discussion on procedural decision-making were identified. Structured case selection, experienced moderation, separation of procedural and communication responsibilities, and adherence to a standardized code of conduct may help preserve educational value while prioritizing patient safety.