James Fann, MD, Receives Donald B. Doty Award

An Interview with Danielle deLeon

Through a generous grant from Medtronic, the Western Thoracic Surgical Association (WTSA) has established the Donald B. Doty Educational Award. The purpose of the award is to foster innovative educational initiatives in cardiothoracic surgery by WTSA members and provide an opportunity for the dissemination of this information to other training centers and academic institutions. Active and senior members in good standing of the WTSA are eligible.

James Fann, MD, associate professor, was this year’s recipient based on his development of a cardiac surgical simulator.

Danielle deLeon (Dd): What are the main purposes of the simulator?

James Fann, MD (JF): Cardiac surgical simulation for training cardiac surgery residents is being addressed on two levels. One is directed at skills basic to the cardiovascular surgeon, such as small and large vessel anastomosis and suture placement for valve and intracardiac repair. These technical maneuvers will be addressed with “skills stations” using moderate and high fidelity models. The other component of simulation is focused on intraoperative management, which includes synthesis of multiple physiologic inputs and management of critical operative scenarios. This latter component will be conducted in a simulated operating room environment equipped with hemodynamic monitors, cardiopulmonary bypass machine, and a control room to input and alter physiologic information. The simulated operating room at the VA Palo Alto was developed by Drs. Gaba and Howard in the Department of Anesthesiology for Anesthesia Crisis Resource Management training.

Both of these components of cardiac surgical simulation are being developed and should be implemented within three months. Models for basic technical skills for cardiac surgery and tasks are being constructed and evaluated. For intraoperative simulation, clinical scenarios for the simulated operating room are being reviewed and refined.

Dd: What scenarios will be simulated?

JF: Simulation for cardiac surgery is directed at critical points and maneuvers during conventional cardiac cases requiring cardiopulmonary bypass. Technical aspects of the surgical procedure, including myocardial preservation strategies and surgical techniques, risks and critical junctures, will be emphasized. Advanced cardiac cases, including off-pump coronary revascularization, thoracic aortic surgery, and hypothermic circulatory arrest, will be demonstrated, as well as less common, more catastrophic crisis scenarios, such as inadvertent cardiotomy during redo-sternotomy.

Dd: What are your plans for the award funds?

JF: The grant from the Western Thoracic Surgical Association will be used for the cost of the use of the facility (simulated operating room), material and supplies (moderate and high fidelity models), and software development (to standardize the clinical scenarios for intraoperative simulation).