The dynamic cardiac biosimulator: A method for training physicians in beating-heart mitral valve repair procedures

J Thorac Cardiovasc Surg. 2018 Jan;155(1):147-155. doi: 10.1016/j.jtcvs.2017.09.011. Epub 2017 Sep 18.


Objective: Previously, cardiac surgeons and cardiologists learned to operate new clinical devices for the first time in the operating room or catheterization laboratory. We describe a biosimulator that recapitulates normal heart valve physiology with associated real-time hemodynamic performance.

Methods: To highlight the advantages of this simulation platform, transventricular extruded polytetrafluoroethylene artificial chordae were attached to repair flail or prolapsing mitral valve leaflets. Guidance for key repair steps was by 2-dimensional/3-dimensional echocardiography and simultaneous intracardiac videoscopy.

Results: Multiple surgeons have assessed the use of this biosimulator during artificial chordae implantations. This simulation platform recapitulates normal and pathologic mitral valve function with associated hemodynamic changes. Clinical situations were replicated in the simulator and echocardiography was used for navigation, followed by videoscopic confirmation.

Conclusions: This beating heart biosimulator reproduces prolapsing mitral leaflet pathology. It may be the ideal platform for surgeon and cardiologist training on many transcatheter and beating heart procedures.

Keywords: biosimulator; chord; mitral; replacement; simulation; valve.

MeSH terms

  • Cardiology / education
  • Echocardiography, Three-Dimensional / methods*
  • General Surgery / education
  • Humans
  • Mitral Valve Annuloplasty* / education
  • Mitral Valve Annuloplasty* / methods
  • Mitral Valve Insufficiency / surgery*
  • Simulation Training / methods*