Imagine a typical Tuesday morning in the holding area outside a cardiac surgery suite at the Mayo Clinic’s Rochester campus. fluorescent lighting. Somewhere down the hall, there was a low mechanical hum of hospital equipment. IV lines, gowns, and the unique silence of a room filled with people waiting to have their chests opened. Imagine one of those patients putting on a virtual reality headset and, ten minutes before surgery, standing next to a waterfront while the surrounding trees subtly change from summer green to autumn red and gold, with a soothing voice directing their breathing. A lower pulse is recorded by the monitors. Anxiety scores decline. Measurably calmer than they would have been otherwise, the patient enters surgery.
Twenty volunteers are being tested in a research annex, but this is not a pilot program. It is the outcome of a randomized, controlled trial that was published in Mayo Clinic Proceedings in March 2025. This is the first study of its kind to assess immersive virtual reality specifically for patients having their first open heart surgery. One hundred patients. anxiety tests that have been clinically validated both before and after the intervention. The results were so evident that the cardiovascular surgery team at Mayo is now actively preparing to make the technology available to all patients undergoing cardiac surgery at the Rochester facility. Eventually, family members will be able to use it while their loved ones are in the operating room.
| Category | Details |
|---|---|
| Institution | Mayo Clinic — nonprofit healthcare organization headquartered in Rochester, Minnesota; operates across multiple U.S. states with specialized cardiovascular, surgical, and research divisions |
| Study published | March 2025 — Mayo Clinic Proceedings; randomized, controlled trial; first study of its kind to evaluate immersive VR for preoperative anxiety specifically in open-heart surgery patients |
| Lead researchers | Dr. John M. Stulak (cardiovascular surgeon, Rochester); Dr. Joseph Dearani (cardiac surgeon); Dr. Jordan Miller (cardiovascular disease researcher, senior author) |
| Study population | 100 patients scheduled for first-time open-heart surgery; older adult population; patients monitored with vital sign recording and a standardized, clinically validated anxiety assessment |
| VR experience design | 10-minute immersive nature experience with guided breathing; participants viewed trees and a waterfront environment that progressed through four seasons; delivered via VR goggles or tablet screen |
| Anxiety score results | Average anxiety scores dropped 2.9 points with VR goggles and 2.0 points with the tablet; improvement noted in up to 7 of 20 anxiety-related questions; pulse rates reduced in both groups |
| Vs. anti-anxiety medication | Standard pharmacological anxiolytics linked to: increased intubation difficulty, prolonged extubation time, transient postoperative cognitive dysfunction, and adverse respiratory events — VR avoids all of these |
| Known anxiety-outcome link | Elevated preoperative anxiety is associated with more postoperative pain, higher pain medication use, lower levels of post-surgery daily activity, and poorer overall recovery outcomes |
| Hospital design application | Mayo Clinic Health System used VR headsets to let nurses walk through the design of its new La Crosse hospital before construction was complete — a 290,000 sq ft, 70-bed, six-floor facility that opened in 2024 |
| Existing comfort therapies | Mayo Clinic’s cardiovascular team already offers music therapy and massage therapy post-cardiac surgery — VR is being explored as a pre- and post-surgical extension of this care philosophy |
| Next development phase | Integration with first-in-class enhanced biofeedback and generative AI modules to create individualized VR experiences tailored to each patient’s anxiety profile and response patterns |
| Broader rollout plan | Mayo Clinic exploring wider implementation across all cardiac surgery patients in Rochester; potential expansion to in-hospital postoperative recovery; interest in extending to family members waiting during procedures |
The issue of anxiety during heart surgery has long been recognized. The extent to which it influences results on the other side of the procedure is less well recognized outside of clinical circles. In addition to being uncomfortable, elevated preoperative anxiety is linked to increased postoperative pain, a greater need for painkillers during recuperation, and decreased physical activity in the weeks after surgery. Anti-anxiety medications administered prior to the procedure are the standard pharmacological response to this, but it has its own set of drawbacks, such as more challenging intubation, a longer recovery period for the breathing tube, and temporary impairment of cognitive function in certain patients. Basically, exchanging one issue for another. According to Mayo’s research, immersive virtual reality might lessen anxiety without requiring any of those compromises.
The trial’s results are modest but significant. On a standardized scale, patients’ anxiety scores decreased by an average of 2.9 points when using VR goggles and by 2 points when using a tablet version of the same content. Both groups’ pulse rates decreased. For a surgical population, where those numbers are closely monitored, the fact that respiration and oxygen levels remained unchanged is significant. One of the study’s lead surgeons, Dr. John Stulak, observed that while the tablet provided a useful substitute for the subset of patients who experience motion sickness with headsets, the majority of patients found that the immersive nature of the goggles helped them focus more fully. The intervention—trees, water, changing seasons, a guiding voice—works this consistently in one of the most high-stakes medical settings imaginable because it is almost disarmingly simple.
It’s important to note that Mayo Clinic has been quietly and unobtrusively working toward this kind of setting for a number of years. When the health system was designing its new hospital in La Crosse, a 290,000-square-foot, six-story building that opened in 2024 as Mayo’s most technologically advanced campus in that area, nurses used virtual reality headsets to tour the unbuilt patient rooms and labor and delivery suites before a single wall had been built. This allowed them to make recommendations and spot design flaws that blueprints alone would have missed. That project reveals something about Mayo’s way of thinking: not only about what occurs in hospital rooms, but also about how the experience of being in one can be completely reimagined.
Generative AI is the next step in the VR anxiety program. In order to adapt the virtual environment in real time based on each patient’s physiological response, Mayo’s cardiovascular team is collaborating with developers on biofeedback-enabled modules. This is essentially a system that learns during the ten-minute session what kind of visual and auditory input works for that particular person and adjusts accordingly. This could take the intervention from being broadly effective to truly individualized, which would be a significant advancement in clinical practice. However, that technology is still in the early stages of development. Scaling what works now is the more pressing priority.
Observing how this develops gives the impression that medicine is gradually catching up to something that patients have long desired: not just better treatment, but also a better treatment experience. Hospitals have long recognized the importance of a patient’s emotional state. Given the connection between stress and recuperation, Mayo already provides massage and music therapy following heart surgery. VR is an extension of that idea, with more flexible deployment options and better data supporting it. In a hospital, a headset can be used anywhere. A therapist, a practitioner, or a scheduled session are not necessary. Ten minutes and a willingness to let a waterfront and four seasons of trees do some of the work that medicine has been doing for years, albeit with less consistency.
