Development of a 3D Printing Based Cardiac Surgical Simulation Curriculum to Teach Septal Myectomy
*Joshua L Hermsen, Thomas M Burke, L. Myria Jacobs, *Edward D. Verrier, *Nahush A Mokadam
University of Washington, Seattle, WA
Objective: The use of three-dimensional printing (3Dp) in medicine continues to evolve. We sought to explore its use in cardiac surgical education as a simulation tool for teaching extended septal myectomy to senior level trainees (clinical PGY 4-7).
Methods: A curriculum including didactic lectures, selected readings and an operative video was implemented. Six identical three-dimensional prints were constructed for each of three consecutive patients undergoing myectomy. Septal myectomy was performed on each printed heart by an attending surgeon and each of the 5 residents prior to operation. The volume of print resected was measured by liquid displacement in all cases. Technical feedback was given to the residents prior to resection of both the second and third models. All print resections were videotaped and blindly evaluated using a Likert scale assessment tool. A resident participated in each operation.
Results: Myectomy resection volume (averaged across all prints) differed significantly between attending and residents. (Attending 13.8±3.8 cm3 vs Resident 6.7±4.3 cm3, p=0.02 by unpaired t-test, Fig 1) However, the gap between attending and resident resection volumes decreased with each model to near equivalence (Print 1, 15 cm3 vs 3.1 cm3, Print 2, 17 cm3 vs 8.5 cm3, Print 3 9.5 cm3 vs. 8.4 cm3, Fig 2). The attending scored higher on the videotaped assessments and the resident scores decreased slightly during the study driven by a few important errors. (Fig 3)
Conclusions: A patient-specific 3D-printing based simulation module shows promise as a tool to improve cardiothoracic resident training in septal myectomy. This operation is difficult to teach compared to most other cardiac operations based upon limited visibility for the assistant and significant specific complications. The residents were quickly able to perform resections volumetrically on par with the attending. This study will enroll two additional patients (total n=5) and include assessment of this simulation platform itself.
Back to 2017 Program