Surgical Training Improves Performance in Minimally Invasive Left Ventricular Assist Device Implantation Without Cardiopulmonary Bypass

Objective We introduced a live animal model for training of minimally invasive implantation of a continuous-flow left ventricular assist device (CF-LVAD) without cardiopulmonary bypass for operator’s performance improvement. Design After watching a videotape of LVAD implantation on the beating heart through the cardiac apex, the surgical team performed implantation of LVADs into 5 pigs during 3 training sessions in a time series. The procedure success rate, operating time, and technical and global performances by self-evaluation and senior evaluation were compared among the sessions. Setting Animal Experiment Center in Peking University Third Hospital. Participants Surgical team comprising a surgical operator, surgical assistant, anesthetist, and scrub nurse performed 3 training sessions in a time series. Results The urgent situations requiring proper management were myocardial laceration, massive blood loss, and ventricular arrhythmia induced by hemodynamic instability. After practice, the success rate increased to 100% in session 3. The operating times of session 2 (189.80 ± 14.34 min) and session 3 (149.00 ± 22.85 min) were significantly lower than that of session 1 (262.20 ± 28.26 min). The technical and global performances by self-evaluation and senior evaluation were significantly better in session 3 than session 1. Conclusion Simulation training with high-fidelity in vivo model for minimally invasive CF-LVAD implantation improves the surgical team’s global performance, success rate, and the ability to manage emergency situations in surgery.