A three-dimensional model of aortic dissection for hybrid surgical simulation and training.

Abstract

Thoracic endovascular aortic repair is widely performed in complicated and uncomplicated type B aortic dissection cases. After the introduction of a stent graft, the use of several types of hybrid approaches has been reported for patients with type A aortic dissection. The procedure is advanced because the complications are fatal; therefore, training is required. However, the surgical simulation of aortic dissection is challenging because no favourable animal model is available. This study aimed to simulate hybrid surgical simulation using a novel three-dimensional aortic dissection model. Three-dimensional polyurethane models of type A and B aortic dissection, both of which have true and false lumens, were manufactured based on computed tomography data. Under fluoroscopy, the entry tear and false lumen flows were visualized using a contrast medium. A stent graft was delivered and deployed under pulsatile conditions in the type B aortic dissection model. Total arch replacement was performed in the type A and B aortic dissection models after thoracic endovascular aortic repair as a hybrid approach. In conclusion, a model with a mock circuit is a useful tool to simulate both open and endovascular aortic repair for aortic dissections as a hybrid approach.