Shota Yasuda1,2, Jef Van den Eynde3, Katrien Vandendriessche3, Munetaka Masuda4, Bart Meyns3, Wouter Oosterlinck3. 1. Department of Cardiovascular Diseases, Research Unit of Cardiac Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. shorty@mtj.biglobe.ne.jp. 2. Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 2360004, Japan. shorty@mtj.biglobe.ne.jp. 3. Department of Cardiovascular Diseases, Research Unit of Cardiac Surgery, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. 4. Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 2360004, Japan.
Abstract
BACKGROUND: Several training devices have been developed to train anastomotic skills in off-pump coronary artery bypass grafting (OPCAB). However, assessment of trainees' improvement remains challenging. The goal of this study was to develop a new practical scoring chart and investigate its reliability and utility for anastomotic skills in OPCAB and minimally invasive direct coronary artery bypass (MIDCAB). METHODS: A training device was used, which included a beating heart model installed in a dedicated box. A soft plastic tube was used as the left anterior descending artery, and a porcine ureter was used as the left internal mammary artery. Five cardiac surgery fellows (Fellows, > 5 year of surgical experience) and five residents or medical students (Residents, ≤ 5 year of surgical experience) were enrolled for this study. Before and after training, skills were evaluated using a scoring chart that took into account anastomotic time, leakage, shape, flow measurement, and self-estimation. RESULTS: Mean total score of all trainees was 15.4 ± 4.0 at pre-training and 18.5 ± 2.4 at post-training (P = 0.05). Before training, there was a significant difference in the total score between Fellows and Residents (18.6 ± 2.2 vs 12.2 ± 2.4 points, P = 0.002), which disappeared after training (19.4 ± 2.5 vs 17.6 ± 2.2 points, P = 0.262). Residents benefitted from training with improvements in their time, total score, score for time, score for flow and subtraction score; however, these effects were not seen in Fellows. The most evident training effect was improvement of self-estimation, which was also seen in Fellows. CONCLUSIONS: Residents were most likely to derive benefit from these training models with regard to both efficiency and quality. Training models seem to have an important role in making surgeons feel more comfortable with the procedure.
BACKGROUND: Several training devices have been developed to train anastomotic skills in off-pump coronary artery bypass grafting (OPCAB). However, assessment of trainees' improvement remains challenging. The goal of this study was to develop a new practical scoring chart and investigate its reliability and utility for anastomotic skills in OPCAB and minimally invasive direct coronary artery bypass (MIDCAB). METHODS: A training device was used, which included a beating heart model installed in a dedicated box. A soft plastic tube was used as the left anterior descending artery, and a porcine ureter was used as the left internal mammary artery. Five cardiac surgery fellows (Fellows, > 5 year of surgical experience) and five residents or medical students (Residents, ≤ 5 year of surgical experience) were enrolled for this study. Before and after training, skills were evaluated using a scoring chart that took into account anastomotic time, leakage, shape, flow measurement, and self-estimation. RESULTS: Mean total score of all trainees was 15.4 ± 4.0 at pre-training and 18.5 ± 2.4 at post-training (P = 0.05). Before training, there was a significant difference in the total score between Fellows and Residents (18.6 ± 2.2 vs 12.2 ± 2.4 points, P = 0.002), which disappeared after training (19.4 ± 2.5 vs 17.6 ± 2.2 points, P = 0.262). Residents benefitted from training with improvements in their time, total score, score for time, score for flow and subtraction score; however, these effects were not seen in Fellows. The most evident training effect was improvement of self-estimation, which was also seen in Fellows. CONCLUSIONS: Residents were most likely to derive benefit from these training models with regard to both efficiency and quality. Training models seem to have an important role in making surgeons feel more comfortable with the procedure.
Entities:
Keywords:
Anastomosis; Coronary artery bypass; Program evaluation; Simulation training
Authors: Lakhmir S Chawla; Yue Zhao; Fredrick C Lough; Elizabeth Schroeder; Michael G Seneff; J Matthew Brennan Journal: J Am Soc Nephrol Date: 2012-05-17 Impact factor: 10.121
Authors: Dong Fang Zhao; J James Edelman; Michael Seco; Paul G Bannon; Michael K Wilson; Michael J Byrom; Vinod Thourani; Andre Lamy; David P Taggart; John D Puskas; Michael P Vallely Journal: J Am Coll Cardiol Date: 2017-02-28 Impact factor: 24.094
Authors: John D Puskas; Michael E Halkos; Joseph J DeRose; Emilia Bagiella; Marissa A Miller; Jessica Overbey; Johannes Bonatti; V S Srinivas; Mark Vesely; Francis Sutter; Janine Lynch; Katherine Kirkwood; Timothy A Shapiro; Konstantinos D Boudoulas; Juan Crestanello; Thomas Gehrig; Peter Smith; Michael Ragosta; Steven J Hoff; David Zhao; Annetine C Gelijns; Wilson Y Szeto; Giora Weisz; Michael Argenziano; Thomas Vassiliades; Henry Liberman; William Matthai; Deborah D Ascheim Journal: J Am Coll Cardiol Date: 2016-07-26 Impact factor: 24.094
Authors: Jef Van den Eynde; Hannah Vaesen Bentein; Tom Decaluwé; Herbert De Praetere; MaryAnn C Wertan; Francis P Sutter; Husam H Balkhy; Wouter Oosterlinck Journal: J Thorac Dis Date: 2021-07 Impact factor: 2.895