[guest author submission]

"In this video tutorial we present a beating-heart porcine model used as a high-fidelity training simulator for transcatheter cardiac valve procedures."

Abstract

"Transcatheter treatment of structural heart disease is becoming an everyday reality for an increasing number of surgeons, and effective training modalities for basic guide-wire skills, catheter handling, and periprocedural imaging are of growing relevance.

We* demonstrate a complete transcatheter edge-to-edge mitral valve repair procedure, including periprocedural imaging, clip deployment, and quality control.

Various mitral valve pathologies can be simulated, including the demonstrated leaflet prolapse.

Trainees practice clip navigation within the left atrium, transmitral passage, and clip orientation as well as grasping mitral valve leaflets to treat mitral regurgitation.

Periprocedural imaging is achieved via epicardial echocardiography and left ventricular cardioscopy, and these imaging modalities are also relied on to guide surgeons during the simulations, as required.

The beating heart model [link] enables realistic demonstration of the hemodynamic consequences of valve repair, and we believe that this simulator represents a valuable adjunct to surgical training.

In this video tutorial we* present a beating-heart porcine model [link] used as a high-fidelity training simulator for transcatheter cardiac valve procedures.

Introduction

The field of transcatheter valve interventions is evolving rapidly. However, high-fidelity simulation modalities providing realistic training experience are of limited availability.

Effective simulator training for inexperienced surgeons is essential to guarantee adequate education and provide high-quality patient care. 

In this tutorial we* describe a beating-heart porcine model, used as a high-fidelity simulator for transcatheter cardiac valve procedures, that mimics physiological flow conditions. Using epicardial echocardiography during the procedures, periprocedural imaging can be practiced together with handling of catheters, wires and balloons. A cardioscope in the left ventricle and hemodynamic monitoring of the heart provides additional feedback for the evaluation of procedural results.

  • LifeTec Group - Cardiac Biosimulator platform
    LifeTec Group - Cardiac Biosimulator platform
    LifeTec Group - Cardiac Biosimulator platform
  • LifeTec Group - Cardiac Biosimulator platform
    LifeTec Group - Cardiac Biosimulator platform
    LifeTec Group - Cardiac Biosimulator platform
  • LifeTec Group - Cardiac Biosimulator platform
    LifeTec Group - Cardiac Biosimulator platform
    LifeTec Group - Cardiac Biosimulator platform
  • LifeTec Group - Cardiac Biosimulator platform
    LifeTec Group - Cardiac Biosimulator platform
    LifeTec Group - Cardiac Biosimulator platform
  • LifeTec Group - Cardiac Biosimulator platform
    LifeTec Group - Cardiac Biosimulator platform
    LifeTec Group - Cardiac Biosimulator platform

Tutorial:

Link to: MMCTS

Outcome & Discussion

The field of transcatheter valve interventions is evolving rapidly and high-quality surgical training has never been more important. The porcine beating-heart simulator demonstrated in this video tutorial is a feasible and extremely useful option for advanced training.  

Due to the chosen configuration of the experimental set-up, demonstrations of procedures involving the right heart are not possible (for example, transseptal puncture). However, the set-up described here allows us to test and train using a range of transcatheter devices, and we believe this simulator could be advantageously implemented in resident programs for the benefit of surgeons, cardiologists, and patients."

Funding Disclosures & Competing Interests

The Cardiac Biosimulator Platform has been developed by LifeTec Group, Eindhoven, NL.

The videos have been recorded in the LifeTec Group’s laboratory and during the “Focus: Valve 2018” simulation session.

Marco Stijnen and Sjoerd van Tuijl are employees of LifeTec Group.

*Author & Tutorial Information

Primary Authors
Can Gollmann-Tepeköylü, Johannes Holfeld, Gerhard Pölzl, Bernhard Metzler, and Nikolaos Bonaros

Additional Authors
Florian Hintringer, Agne Adukauskaite, Markus Theurl, Guy Friedrich, Cenk Özpeker, Markus Koflera, Marco Stijnen, Sjoerd van Tuijl, Ludwig Müller, and Michael Grimm

Author Affiliations
(a) Department of Cardiac Surgery, Medical University of Innsbruck, Austria 
(b) Department of Internal Medicine III, Medical University of Innsbruck, Austria 
(c) LifeTec Group™ Eindhoven, The Netherlands

Corresponding Author
Nikolaos Bonaros
Department of Cardiac Surgery Medical University of Innsbruck Anichstr. 35, 6020 Innsbruck, Austria

© The Author 2018. 

Published by MMCTS on behalf of the European Association for Cardio-Thoracic Surgery.

All rights reserved.

Background information

Cardiac Biosimulator platform factsheet [link]

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