Impact of novel off-pump coronary artery bypass simulator on the surgical training

We evaluated the utility of novel simulator for off-pump coronary artery bypass grafting for surgical residents.

The novel simulator system "BEAT, YOUCAN" has 2 components. (1) A pink disposable silicone vessel model having a 3-layer structure mimicking the internal mammary artery. The disposable silicone vessels mimicking the coronary artery are embedded in a 4 × 7-cm yellow silicone piece. (2) A beating table with a holder compatible with the yellow silicone piece. The arbitrary heartbeat pattern and angle are compatible with the controller. With aforementioned simulator, four cardiovascular surgical residents with no experience as an operator in coronary artery bypass grafting performed end-to-side anastomosis with 7-0 polypropylene, simulating the anastomosis of the mammary to the coronary artery. For each anastomosis, the time to complete the anastomosis, the number of sutures placed, and the number of troubles were recorded. The performance of the anastomosis was evaluated and compared between early (1-10th anastomoses) and late phase (30-40 anastomoses) using the special made score with full mark of 25 points.

In total, 160 anastomoses were done (early, 40; late, 40). The time to complete anastomosis was significantly shortened with practice, and the number of troubles in each anastomosis was significantly decreased. The number of sutures placed in each anastomosis had become stable at late phase. The performance score also significantly improved with practice. The learning curve for operative time and the number of events plateaued at approximately the 30th anastomosis.

The novel simulator is effective for cardiovascular trainees.