Novel, intermediate-fidelity simulator for aortic arch surgery for the cardiothoracic surgical trainee.

Abstract

Training cardiothoracic surgeons in open aortic surgery is challenging due to limited operator experience, low patient volume and technically demanding skills to be performed within a deep thoracic cavity. Surgical simulation has become a cornerstone of cardiothoracic surgical training and has been shown to improve skill acquisition and performance in the operating theatre. Due to the complexity of aortic surgery, there is a paucity of simulators that are concomitantly accessible and of sufficient fidelity. The purpose of this study was to develop a reproducible, intermediate-fidelity simulator for aortic surgery. This novel simulator was constructed from plastic storage containers to simulate the depth of a thoracic cavity. Head vessels and distal arch were reconstructed within the stimulator with synthetic Dacron polyester grafts to maximize model fidelity. A porcine or bovine heart was used for the simulation of aortic root replacement and anastomosis to the distal arch graft. The simulator was reproduced in a wet-lab skills session at an annual Australian cardiothoracic trainee meeting. Qualitative feedback was obtained from the current cardiothoracic trainees. It is a feasible model for the practice of aortic surgery. As the surgical education paradigm shifts towards simulation, this easily reproducible, intermediate-fidelity model provides an effective avenue to equip the trainee for the operating room and is a method of surgical training that can be considered by colleges.