Hundreds of cardiologists from around the world have 'virtually' taken part in a groundbreaking heart operation at Belfast's Royal Victoria Hospital.
As a patient underwent life saving keyhole surgery in Belfast, leading international cardiologists were watching thousands of miles away via satellite at a conference in Amsterdam.
The interactive surgery was part of the European Society of Cardiology annual congress.
With 29,000 delegates attending, it is considered the largest congress in the world and showcases new and potentially revolutionary treatment.
This year it focused on the work of a Northern Ireland heart team carrying out the valve replacement procedure–or transcatheter aortic valve implantation (TAVI).
Since 2003 the Ulster Hospital has pioneered cardiac CT imaging, allowing radiologists to "virtually" slice the heart open and look inside.
This 'X-ray' can let the surgeons know if a patient is suitable for the TAVI, which is less invasive.
Now cardiologists from both the RVH and Ulster Hospital can assess patients in 20 seconds in a pioneering new technique.
The modern 3-D CAT scan technology means the team at the Ulster can take images from the head to top of the legs – allowing them to see if the arteries are suitable for the new procedure.
They then work with a team of heart specialists at the RVH who are regarded to be at the forefront implant techniques. During the 90-minute procedure, delegates in Amsterdam took part in a virtual arena by discussing challenges, grappling with problems as they arose and creating debate on how the live case should proceed.
The latest procedure was a success with the patient able to go home within 24 hours.
Dr Mark Spence, consultant interventional cardiologist and co-founder of the Belfast TAVI programme, led the Belfast heart team.
He said he was "privileged" to have hosted the interactive session.
Consultant cardiologist Dr Patrick Donnelly, who chaired the session in Amsterdam, said: "Recent medical reports have demonstrated that the role of CT has made a real difference to patient outcomes and I am delighted that we can provide this cutting edge technology for patients in Northern Ireland.
"This was a wonderful opportunity to showcase the work that we do in Northern Ireland and a privilege to share our experience to the wider cardiology community."
Who was in the Belfast medical team?
Dr Mark Spence (consultant cardiologist); Dr Ganesh Manoharan; Dr Sandra Gowdy (cath lab nurse); Sean O'Connaire (radiographer) Dr Nicola Johnston (consultant cardiologist, echo expertise); Dr Bob Taylor (anaesthetist on standby in the lab); Mr Reuben Jeganathan (cardiac surgeon on standby in the lab),
Dr James Shand (registrar).