Computer Simulation as Training Tool for Coronary Interventions

  • Wolfram Voelker


Virtual-reality (VR) simulation can serve as a platform to provide transfer of knowledge and skills for catheter-based coronary procedures. Presently, five VR simulators with X-ray simulation and catheter and wire tracking are available. These simulators can be used to train mandatory skills for coronary arteriography and coronary intervention. In conjunction with advanced-life-support mannequins, they can be used for team training and crisis resource management in the catheterization laboratory.

The success of simulation-based catheter training does not dependent only on the individual potential of the VR simulator but also on the underlying training concept as a whole. The selection of the simulator should be driven by the training curriculum and not vice versa. An experienced, enthusiastic, and motivated trainer, who is able and willing to use the simulator as a means of transfer of his knowledge and skills, is critical to the success of simulation-based training.

Continuing development of computer technology employing increasingly higher-resolution graphics, more realistic modeling of catheter and guidewire behavior, and a set-up close to reality will further improve the technical settings of simulation-based catheter training.

Nevertheless, albeit the initial experiences are promising, validation studies are mandatory to determine the ultimate role of this technology in interventional cardiology. Depending on the outcome of these studies, simulation-based catheter training may play a crucial role in the education of future cardiologists and their teams.


Balloon Catheter Transcatheter Aortic Valve Implantation Force Feedback Chronic Total Occlusion Simulator Training 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Didwania A, Feinglass J et al (2008) Simulation based education improves quality of care during cardiac arrest team responses at an academic teaching hospital: a case–control study. Chest 133:56–61PubMedCrossRefGoogle Scholar
  2. 2.
    Hays RT, Jacobs JW, Prince C et al (1992) Flight simulator training effectiveness: a meta-analysis. Mil Psychol 4:63–74CrossRefGoogle Scholar
  3. 3.
    Müller MP, Hänsel M, Fichtner A et al (2009) Excellence in performance and stress reduction ­during two different full scale simulator training courses: a pilot study. Resuscitation 80:919–924PubMedCrossRefGoogle Scholar
  4. 4.
    Voelker W, Lengenfelder B, Petersen J et al (2009) An innovative hybrid-model to train the management of acute pericardial tamponade in the cath lab (abstract). Simul Healthc 4(Suppl 5):172Google Scholar
  5. 5.
    Schuetz M, Moenk S, Vollmer S et al (2008) High degree of realism in teaching percutaneous coronary interventions by combining a virtual reality trainer with a full scale patient simulator. Simul Healthc 3:242–246PubMedCrossRefGoogle Scholar
  6. 6.
    Boyle E, O’Keeffe DA, Naughton PA et al (2011) The importance of expert feedback during endovascular simulator training. J Vasc Surg 54:240–248PubMedCrossRefGoogle Scholar
  7. 7.
    Flin R (2010) CRM (non-technical) skills-applications for and beyond the flight deck. In: Kanki B, Helmreich R, Anca J (eds) Crew resource management, 2nd edn. Academic Press, San DiegoGoogle Scholar
  8. 8.
    Gallagher AG, Ritter EM, Champion H et al (2005) Virtual reality simulation for the operating room. Proficiency-based training as a paradigm shift in surgical skills training. Ann Surg 241:364–372PubMedCrossRefGoogle Scholar
  9. 9.
    Grantcharov TP, Kristiansen VB, Bendix J et al (2004) Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg 91: 146–150PubMedCrossRefGoogle Scholar
  10. 10.
    Seymour NE, Gallagher AG, Roman SA et al (2002) Virtual reality training improves operating room performance: results of a randomized, double-blinded study. Ann Surg 236:458–463PubMedCrossRefGoogle Scholar
  11. 11.
    Chaer RA, DeRubertis BG, Lin SC et al (2006) Simulation improves resident performance in catheter-based intervention - results of a randomized, controlled study. Ann Surg 244:343–352PubMedGoogle Scholar
  12. 12.
    Van Herzeele I, Aggarwal R, Neequaye S et al (2008) Experienced endovascular interventionalists objectively improve their skills by attending carotid artery stent training courses. Eur J Vasc Endovasc Surg 35:541–550PubMedCrossRefGoogle Scholar
  13. 13.
    Patel AD, Gallagher AG, Nicholson WJ, Cates CU (2006) Learning curves and reliability measures for virtual reality simulation in the performance assessment of carotid angiography. J Am Coll Cardiol 47:1796–1802PubMedCrossRefGoogle Scholar
  14. 14.
    De Ponti R, Marazzi R, Ghiringhelli S et al (2011) Superiority of simulator-based training compared with conventional training methodologies in the performance of transseptal catheterization. J Am Coll Cardiol 19:359–363CrossRefGoogle Scholar
  15. 15.
    Cates CU, Patel AD, Nicholson WJ (2007) Use of virtual reality simulation for mission rehearsal for carotid stenting. JAMA 297:265–266PubMedCrossRefGoogle Scholar
  16. 16.
    Lipner R, Messenger J, Kangilaski R et al (2010) A technical and cognitive skills evaluation of performance in interventional cardiology procedures using medical simulation in healthcare. Simul Healthc 5:65–74PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Department of Internal Medicine IUniversity Hospital WuerzburgWürzburgGermany

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