Experience with porcine beating heart simulator for coronary artery bypass surgery residency training

Abstract

Objective: To evaluate the effect of our uniquely designed beating heart simulator for coronary artery bypass surgery residency training.

Methods: The balloon of intra-aortic balloon pump (IABP) was inserted into the left ventricle of an isolated porcine heart to form a beating heart simulator. This model simulated off-pump coronary artery bypass grafting (OPCABG), and the nonbeating heart model simulated the on-pump coronary artery bypass grafting (ONCABG) for training of surgeons. From 2017 to 2019, 60 trainees were randomly divided into nonbeating and beating heart simulator training groups. The training period was 3 months. The performance of anastomosis was evaluated at the beginning (after 1 month), midpoint (after 2 months), and at the end of the assessment (after 3 months).

Results: Trainees improved their performance of coronary artery anastomosis respectively after 3 months of training, whether they were trained on beating heart simulator or nonbeating heart simulator (P < .05). On both nonbeating and beating heart simulator test, trainees in the beating group performed better than those in the nonbeating group in the use of microsurgical instruments, anastomotic quality, and anastomotic speed after 3 months of training (P < .05).

Conclusions: The effect of our uniquely developed beating heart simulator training was better than those of nonbeating heart simulator for OPCABG and ONCABG training of surgeons during residency.

Keywords: off-pump coronary artery bypass grafting; on-pump coronary artery bypass grafting; simulation-based training.