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Review Article| Volume 26, P9-17, 2023

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Training on Congenital 3D Cardiac Models – Will Models Improve Surgical Performance?

  • David J Barron
    Correspondence
    Address correspondence to. David J Barron, MD, FRCS(CT), Division of Cardiovascular Surgery, Department of Surgery, Labatt Family Heart Centre, Hospital for Sick Children, University of Toronto, 555 University Ave, Toronto, ON M5G 1X8, Canada.
    Affiliations
    Division of Cardiovascular Surgery, Department of Surgery, Labatt Family Heart Centre, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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  • Nabil Hussein
    Affiliations
    Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, England, UK
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  • Shi-Joon Yoo
    Affiliations
    Department of Diagnostic Imaging, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada

    Division of Cardiology, Department of Pediatrics, Labatt Family Heart Centre, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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Published:February 02, 2023DOI:https://doi.org/10.1053/j.pcsu.2022.12.001
      Technical skill development in congenital heart surgery (CHS) is challenging due to numerous factors which potentially limit the hands-on operative exposure in surgical training. These challenges have stimulated the growth of simulation-based training through the development of 3D-printed models, providing hands-on surgical training (HOST). From its inception in 2015, the models used in the HOST program have constantly improved, and now include valvar/subvalvar apparatus and better materials that mimic real tissue. Evidence shows that deliberate, regular simulation practice can improve a surgeon's technical skills across the spectrum of CHS. Furthermore, surgical trainees who undergo simulation training are able to translate this improved performance into the operative environment with improved patient outcomes. Despite evidence to support the incorporation of simulation methods into congenital training, its widespread adoption into training curricula remains low. This is due to numerous factors including funding, lack of dedicated time or proctorship and access to models—all of which can be overcome with the newer generation of models and committed trainers. Training programs should consider incorporating simulation-methods as a routine component of congenital training programs.

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      References

        • Tchervenkov C.I.
        • Herbst C.
        • Jacobs J.P.
        • et al.
        Current Status of training and certification for congenital heart surgery around the world: proceedings of the meetings of the global council on education for congenital heart surgery of the world society for pediatric and congenital heart surgery.
        World J. Pediatr. Congenit. Hear. Surg. 2021; 12: 394-405
        • Karl T.R.
        • Jacobs J.P.
        Paediatric cardiac surgical education: Which are the important elements?.
        Cardiol. Young. 2016; 26: 1465-1470
        • Morales D.L.S.
        • et al.
        Report of the 2015 society of thoracic surgeons congenital heart surgery practice survey.
        Ann. Thorac. Surg. 2017; 103: 622-628
        • Kogon B.
        • Karamlou T.
        • Baumgartner W.
        • Merrill W.
        • Backer C.
        Congenital cardiac surgery fellowship training: a status update read at the 41st annual meeting of the western thoracic surgical association, whistler, British columbia, canada, june 24-27, 2015.
        J. Thorac. Cardiovasc. Surg. 2016; 151: 1488-1495
        • Burkhart H.M.
        Simulation in congenital cardiac surgical education: We have arrived.
        J. Thorac. Cardiovasc. Surg. 2017; 153: 1528-1529
        • Beckerman Z.
        • Mery C.M.
        Teaching congenital heart disease: A new era?.
        J. Thorac. Cardiovasc. Surg. 2017; 153: 1541
        • Trehan K.
        • Kemp C.D.
        • Yang S.C.
        Simulation in cardiothoracic surgical training: Where do we stand?.
        J. Thorac. Cardiovasc. Surg. 2014; 147: 18-24
        • Ribeiro I.B.
        • Ngu J.M.C.C.
        • Lam B.-K.K.
        • Edwards R.A.
        Simulation-based skill training for trainees in cardiac surgery: a systematic review.
        Ann. Thorac. Surg. Mar. 2018; 105: 972-982
        • Ramphal P.S.
        • et al.
        A high fidelity tissue-based cardiac surgical simulator.
        Eur. J. Cardio-Thoracic Surg. May 2005; 27: 910-916
        • Hussein N.
        • Honjo O.
        • Haller C.
        • et al.
        Hands-on surgical simulation in congenital heart surgery: literature review and future perspective.
        Semin. Thorac. Cardiovasc. Surg. 2019; 2: 98-105
        • Mavroudis C.D.
        • Mavroudis C.
        • Jacobs J.P.
        • DeCampli W.M.
        • Tweddell J.S.
        Simulation and deliberate practice in a porcine model for congenital heart surgery training.
        Ann. Thorac. Surg. 2018; 105: 637-643
        • Yoo S.J.
        • Spray T.
        • Austin E.H.
        • Yun T.J.
        • van Arsdell G.S.
        Hands-on surgical training of congenital heart surgery using 3-dimensional print models.
        J. Thorac. Cardiovasc. Surg. 2017; 153: 1530-1540
        • Peel B.
        • Voyer-nguyen P.
        • Honjo O.
        • Yoo S.
        • Hussein N.
        Development of a dynamic chest wall and operating table simulator to enhance congenital heart surgery simulation.
        3D Print Med. 2020; 6
        • Peel B.
        • Lee W.
        • Hussein N.
        • Yoo S.J.
        State-of-the-art silicone molded models for simulation of arterial switch operation: Innovation with parting-and-assembly strategy.
        JTCVS Tech. 2022; 12: 132-142
        • Yoo S.-J.
        • Hussein N.
        • Barron D.J.
        Congenital heart surgery skill training using simulation models: not an option but a necessity.
        J. Korean Med. Sci. 2022; 37: 1-16
        • Hussein N.
        • Honjo O.
        • Barron D.J.
        • Haller C.
        • Coles J.G.
        • Yoo S.-J.
        The incorporation of hands-on surgical training in a congenital heart surgery training curriculum.
        Ann. Thorac. Surg. 2020; 4975: 32088
        • Hussein N.
        • Van den Eynde J.
        • Callahan C.
        • et al.
        The use of objective assessments in the evaluation of technical skills in cardiothoracic surgery: a systematic review.
        Interact. Cardiovasc. Thorac. Surg. 2022; 35
        • Hussein N.
        • et al.
        Development and validation of a procedure-specific assessment tool for hands-on surgical training in congenital heart surgery.
        J. Thorac. Cardiovasc. Surg. 2020; 160: 229-240
        • Hussein N.
        • et al.
        Assessment tool validation and technical skill improvement in the simulation of the Norwood operation using three-dimensional-printed heart models.
        Eur. J. Cardio-Thoracic Surg. Feb. 2021; 59: 316-324
        • Hussein N.
        • et al.
        Quantitative assessment of technical performance during hands-on surgical training of the arterial switch operation using 3-dimensional printed heart models.
        J. Thorac. Cardiovasc. Surg. 2020; 160: 1035-1042
        • Hussein N.
        • Honjo O.
        • Barron D.J.
        • Haller C.
        • Coles J.G.
        • Yoo S.-J.
        The incorporation of hands-on surgical training in a congenital heart surgery training curriculum.
        Ann. Thorac. Surg. 2020; 112: 1672-1680
        • Nam J.G.
        • et al.
        Three-dimensional printing of congenital heart disease models for cardiac surgery simulation: evaluation of surgical skill improvement among inexperienced cardiothoracic surgeons.
        Korean J. Radiol. 2021; 22: 706-713
        • Li Q.
        • et al.
        Clinical translation of surgical simulated closure of a ventricular septum defect.
        Interact. Cardiovasc. Thorac. Surg. 2022; 35: 1-9
        • Wang X.
        • et al.
        Effect of 3D-printed hearts used in left ventricular outflow tract obstruction: a multicenter study.
        BMC Cardiovasc. Disord. 2022; 22: 1-10
        • Mazzone E.
        • et al.
        A systematic review and meta-analysis on the impact of proficiency-based progression simulation training on performance outcomes.
        Ann. Surg. 2021; 274: 281-289