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Open Access Special Issue

Simulation in cardiac surgery: current evidence

  • Joana Berger-Estilita1,2,3,*,†,
  • Ana Beatriz Noronha4,†
  • Katharina Goltz2
  • David Berger5
  • Robert Greif6,7

1Institute for Medical Education, University of Bern, 3012 Bern, Switzerland

2Institute of Anaesthesiology and Intensive Care, Salemspital, Hirslanden Medical Group, 3013 Bern, Switzerland

3CINTESIS-Center for Health Technology and Services Research, Faculty of Medicine, 4200-450 Porto, Portugal

4Department of Anaesthesiology, Perioperative Medicine and General Intensive Care, Landeskrankenhaus, Uniklinikum Salzburg, 5020 Salzburg, Austria

5Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland

6University of Bern, 3012 Bern, Switzerland

7School of Medicine, Sigmund Freud University Vienna, 1020 Vienna, Austria

DOI: 10.22514/sv.2023.034

Submitted: 04 November 2022 Accepted: 13 February 2023

Online publish date: 09 May 2023

*Corresponding Author(s): Joana Berger-Estilita E-mail:

† These authors contributed equally.


Simulation permeated healthcare curricula and has become a powerful teaching tool to improve manual and cognitive skills in medicine today. Amongst other skill sets, cardiothoracic anaesthetists are expected to make safe life-saving decisions to improve patient outcome during rare critical events. These stressful situations require leadership and problem solving skills from all medical personnel, which traditional learning by “apprenticeship” may not cover. This narrative review looks at current simulation modalities used in cardiothoracic anaesthesia, which include critical scenarios for the placement of arterial and central venous lines, as well as the interpretation of the pulmonary artery catheter derived data. Simulation in transthoracic and transoesophageal echocardiography has proven to be very useful. Of particular importance in cardiothoracic clinical practice is simulation for cardiopulmonary bypass, veno-arterial and veno-venous extracorporeal membrane oxygenation. Trainees’ working hour regulations may affect patient safety, because of decreased exposure to real life patient-related scenarios. The complexity of patient interventions in a high-stakes discipline like cardiothoracic anaesthesia may necessitate the development of further simulation-enhanced educational processes.


Simulation; Cardiothoracic anaesthesia; Hemodynamic monitoring; ECMO; Debriefing

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Joana Berger-Estilita,Ana Beatriz Noronha,Katharina Goltz,David Berger,Robert Greif. Simulation in cardiac surgery: current evidence. Signa Vitae. 2023.doi:10.22514/sv.2023.034.


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