Abstract
Background
Coronary artery disease, due to stenosis in the coronary arteries, is the most common cause of death globally. A remedy is coronary artery bypass graft (CABG) surgery, executed over 10.000 times per year in the Netherlands.
CABG can be done on a beating heart, without a cardiopulmonary bypass machine, and is then called off-pump CABG (OPCAB). An advantage of OPCAB is avoiding manipulation of the aorta, reducing the likelihood of stroke compared to on-pump CABG. Unfortunately, OPCAB is a complex surgical intervention. A large number of interventions is required to achieve proficiency and represents a steep learning curve. In the first interventions there is a high probability of conversion to on-pump CABG with associated complications such as myocardial infarction and kidney failure.
Currently, only a few low-fidelity simulators for this procedure are available, meaning that most of the learning takes place on real patients. A shortcoming of available simulators is lack of realistic hemodynamic behaviour.
Aim
The aim of this study is to develop a realistic OPCAB simulator to shorten the learning curve of surgeons and limit the number of OPCAB to CABG conversions, unstable hemodynamics, and early mortality.
Method
Training needs of cardiothoracic surgeons will be identified via a questionnaire. Several critical case scenarios will be described. Then a simulation-based training program will be outlined, and simulator specifications will be set to improve our first prototype simulator (Figure 1). Surgeons will practice
with this prototype, and give feedback to improve the prototype.
Coronary artery disease, due to stenosis in the coronary arteries, is the most common cause of death globally. A remedy is coronary artery bypass graft (CABG) surgery, executed over 10.000 times per year in the Netherlands.
CABG can be done on a beating heart, without a cardiopulmonary bypass machine, and is then called off-pump CABG (OPCAB). An advantage of OPCAB is avoiding manipulation of the aorta, reducing the likelihood of stroke compared to on-pump CABG. Unfortunately, OPCAB is a complex surgical intervention. A large number of interventions is required to achieve proficiency and represents a steep learning curve. In the first interventions there is a high probability of conversion to on-pump CABG with associated complications such as myocardial infarction and kidney failure.
Currently, only a few low-fidelity simulators for this procedure are available, meaning that most of the learning takes place on real patients. A shortcoming of available simulators is lack of realistic hemodynamic behaviour.
Aim
The aim of this study is to develop a realistic OPCAB simulator to shorten the learning curve of surgeons and limit the number of OPCAB to CABG conversions, unstable hemodynamics, and early mortality.
Method
Training needs of cardiothoracic surgeons will be identified via a questionnaire. Several critical case scenarios will be described. Then a simulation-based training program will be outlined, and simulator specifications will be set to improve our first prototype simulator (Figure 1). Surgeons will practice
with this prototype, and give feedback to improve the prototype.
| Original language | English |
|---|---|
| Publication status | Published - 18 Apr 2019 |
| Event | Wetenschapsdag Medisch Spectrum Twente 2019 - Medisch Spectrum Twente, Enschede, Netherlands Duration: 18 Apr 2019 → 18 Apr 2019 |
Conference
| Conference | Wetenschapsdag Medisch Spectrum Twente 2019 |
|---|---|
| Country | Netherlands |
| City | Enschede |
| Period | 18/04/19 → 18/04/19 |
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Cite this
Moejes, D. S., Halfwerk, F. R., Hagmeijer, R., van Meurs, W. L., & Grandjean, J. G. (2019). A simulator for training off-pump coronary bypass surgery. Abstract from Wetenschapsdag Medisch Spectrum Twente 2019, Enschede, Netherlands.