Comprehensive Middle-Fidelity Simulator for Training in Aortic Root Surgery

Abstract

The current training in aortic root surgery is affected by several factors: complexity of surgical procedures and the complex 3-dimensional anatomy of the aortic root. The aortic root simulator proposed in this study is an additional low-cost, reusable, and portable tool to improve surgical skills in a middle-fidelity model. The aortic root surgery simulator is a self-made portable box that can be used for an unrestricted number of procedures. It is supplied with a self-made aortic root substitute, which was tested to simulate the flexible property of the aortic root components. The building process is detailed in this study. Aortic root procedures were performed by use of this simulator, in which surgical handling was tested. The total cost was calculated in euros. Building the aortic root simulator resulted in the development of a new training tool for aortic root surgery. The use of silicone led to the construction of the aortic root components with similar diameters and properties as those of a real aortic root, which permitted performing the surgical procedures in unrestricted numbers. This involved the aortic valve including all types of aortic valve replacements such as interrupted and semicontinuous, and all types of aortic root procedures like enlargement, remodeling, reimplantation, and replacement. Moreover, the silicone allowed modeling of various pathological replicas of the aortic valve, which resulted in facilitating the practice of aortic valve repair techniques according to El Khoury׳s classification. The cost was approximately €1. Surgical skills in aortic root surgery could be improved by using a middle-fidelity simulator. The high cost of the training for residents and junior surgeons could be reduced effectively through the use of this low-cost, portable, reusable simulator and its accessories (aorta and valves). Familiarity with performing the surgical procedures could reduce the time consumed in the operation room.