Simulating aortic root replacement for a surgical wet laboratory in a resource-limited setting: an economical innovation.

Traditional cardiac surgery residency programs rely mainly on teaching surgical skills in the operating room. The increasing complexity of cardiac surgical operations on high-risk patients and the time constraints placed on residents in this surgical discipline negatively impact the learning opportunities for those residents. Simulation models, though efficient, are very expensive. In Third World Countries, they are unavailable for trainees due to financial constraints. We have introduced an innovative and cost-effective way of simulating aortic root replacement in a wet laboratory by applying a hand-made valve conduit or 'pencil conduit' to a bovine heart. It is reproducible, easy to assemble, cost-effective and simple to use. It can help develop and enhance the surgical skills of residents and junior surgeons for this advanced operation, which requires a meticulous surgical technique performed within a limited time frame.

Late presenting partially displaced atrial septal closure device: Surgical vs percutaneous correction? A case report.

INTRODUCTION: Atrial Septal Defect (ASD) is one of the most common congenital cardiac defect. Even though surgical repair of ASD is the current method of choice but percutaneous device closure is rapidly gaining popularity as it is less invasive. Dislodgment and embolization of the device may occur requiring urgent surgical retrieval. CASE PRESENTATION: We report a case of 54-years-old female patient with a history of ASD device closure 4 years ago, presenting with progressive shortness of breath for past 2 months. She had a partial dehiscence of an ASD device causing a residual ASD of 17 mm. She underwent urgent surgical repair of an ASD with a bovine pericardial patch without ASD device being explanted. CLINICAL DISCUSSION: Management of a dislodged ASD device may be percutaneous or surgical. Dislodged ASD devices that present months after deployment may become fibro-adhered to the site of embolization. Hence its retrieval can be challenging even via open surgical method. Our case describes a novel method to repair a residual ASD and prevent complications associated with dislodgement of device without completely explanting the device. CONCLUSION: In this case, the late presentation of the patient with a partially dehisced device makes it a distinctive case with a novel way on how to treat such a presentation surgically, ensuring that the device doesn't embolize further causing fatal complications.