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A new simulator for training off-pump coronary bypass surgery

Moejes, D.S. (2020) A new simulator for training off-pump coronary bypass surgery.

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Abstract:Background: Coronary artery bypass graft surgery (CABG) is a solution for patients suffering from coronary artery disease. Off-pump CABG (OPCAB) is better tolerated by high-risk patients than on-pump CABG but requires over 100 procedures to achieve proficiency. To reduce risks for patients, an OPCAB training program and simulator are designed. Methods: A published design method consisting of the steps Training Needs Analysis (TNA), Training Program Design (TPD), and Training Media Specification (TMS), is used. In this study, these steps are substantiated by eleven interviews with stakeholders. In part two of this study, we adapt a published model to simulate the OPCAB situation. Result 1: Training program and simulator design After an in-depth analysis of clinical and educational aspects, four OPCAB training norm scenarios were formulated. Main requirements of the OPCAB simulator include: a beating heart, the ability to perform anastomoses and hemodynamic feedback. Result 2: Hemodynamic model development Adaptations were made to a published model to make cardiac output and systemic arterial blood pressure respond to tilting of the heart, application of external pressure to it, the Trendelenburg manoeuvre, and changes in total blood volume. Discussion and conclusion: The resulting training program, simulator specifications, and hemodynamic model all constitute significant steps in the direction of more efficient and better training in the OPCAB procedure, thereby reducing costs and risks to the patient.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:42 biology, 58 process technology, 81 education, teaching
Programme:Technical Medicine MSc (60033)
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