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Eur J Cardiothorac Surg 2005;27:910-916
© 2005 Elsevier Science NL
a Department of Surgery, University of the West Indies, Mona Campus, Kingston, Jamaica
b Department of Mathematics and Computer Science, University of the West Indies, Kingston, Jamaica
c Faculty of Engineering, University of Technology, Kingston, Jamaica
d School of Electrical and Electronic Engineering, University of Nottingham, Nottingham, UK
Received 29 October 2004; received in revised form 7 December 2004; accepted 17 December 2004.
* Corresponding author. Tel.: +876 702 4992; fax: +876 970 4302. (E-mail: pabloram{at}cwjamaica.com).
Objective: Issues concerning the training and certification of surgical specialists have taken on great significance in the last decade. A realistic computer-assisted, tissue-based simulator developed for use in the training of cardiac surgical residents in the conduct of a variety of cardiac surgical procedures in a low-volume cardiothoracic surgery unit of a typical developing country is described. The simulator can also be used to demonstrate the function of technology specific to cardiac surgical procedures in a way that previously has only been possible via the conduct of a procedure on a live animal or human being. Methods: A porcine heart in a novel simulated operating theatre environment with real-time simulated haemodynamic monitoring and coronary blood flow, in arrested and beating-heart modes, is used as a training tool for surgical residents. Results: Standard and beating-heart coronary arterial bypass, aortic valve replacement, aortic homograft replacement and pulmonary autograft procedures can be simulated with high degrees of realism and with the superimposition of adverse clinical scenarios requiring valid decision making and clinical judgments to be made by the trainees. Conclusions: The cardiac surgical simulation preparation described here would appear to be able to contribute positively to the training of residents in low-volume centres, as well as having the potential for application in other settings as a training tool or clinical skills assessment or accreditation device. Collaboration with larger centres is recommended in order to accurately assess the utility of this preparation as an adjunctive cardiothoracic surgical training aid.
Key Words: Surgical simulation • Resident training • Cardiac surgery
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