Validação do modelo ex vivo para treinamento de sutura vascular do bypass coronariano sem circulação extra-corpórea ( off pump CABG)

Abstract

INTRODUCTION: Coronary artery bypass grafting (CABG) surgery requires specific surgical techniques acquired with intensive training. Off pump conditions demands additional practice due to vascular suture in an unstable surface. A high fidelity, ethically correct, affordable and available simulator could be used to teach vascular anastomosis to novice surgeons and maintain professional ability, if validation results are significant, constituting the aim of our study. MATERIAL AND METHODS: Vessel dissection, arteriotomy, vascular anastomosis and vascular anastomosis within a pulsatile surface performed in human and bovine placenta simulator reproduced off pump CABG main surgical tasks. Ten participants voluntarily joined the study to conduct construct and concurrent validity after experiencing the simulator, with acquired data submitted to statistical analysis. RESULTS: Human and bovine placentas are suitable to simulate technical aspects of off pump CABG. Construct validity highlighted simulator fidelity, stratifying surgical competence level with a p .005 among surgeons with and without CABG experience. Concurrent validity faced placenta ex vivo simulator with synthetic, live and dead animal models, emphasizing proposed model advantages and limitations. CONCLUSION: Off pump CABG can be technically simulated in an ex vivo model with positive validation parameters. Advantages over existing simulators are availability, fidelity and ethical acceptance without any specific infra-structure required to be executed, potentially promoting its global usage. Predictive validity studies are mandatory to translate this research into clinical significance.