L E C T U R E   O B J E C T I V E S

Monday, February 13

Cardiac Anatomy – Image Plane Correlation

Moderator: GS Hartman

Lecture: Probe Placement and Manipulation                          

Speaker: GS Hartman

At the conclusion of this lecture, the participant will:

1)      Understand the technical aspects to facilitate probe insertion;

2)      Be able to identify the anatomic considerations impacting probe insertion and manipulation;

3)      Understand the relation of the standard probe positions and normal cardiac anatomy

4)      Be able to identify their correlates to the standard – “SCA 20” views;

5)      Recognize the standard probe manipulation and scan plane nomenclature.

 

Lecture: Comprehensive Exam                                               

Speaker: JS Shanewise

At the conclusion of this lecture, the participant should:

1)      Know which echocardiographic views are recommended as part of a comprehensive examination;

2)      Understand image plane nomenclature and anatomic correlation;

3)      Be able to manipulate a TEE probe to acquire appropriate image planes.

 

Lecture: Principles of Ultrasound                                         

Speaker: AC Perrino Jr

At the conclusion of this lecture, the participant will:

1)      Understand the physical principles of ultrasound;

2)      Recognize ultrasound properties;

3)      Be able to explain ultrasound imaging principles.

 

Lecture: Knobology for Image Optimization                          

Speaker: ST Reeves

At the conclusion of this lecture, the participant will:

1)      Be able to identify the physical principles behind the knobs on common echocardiography platforms;

2)      Know how to use common echocardiography platform functions to obtain 2-D and Doppler images.

 

Session: Anatomic Workshop – Part 1 & 2

Moderator: GS Hartman

The purpose of this workshop is to enhance the participants understanding of the normal cardiac anatomy and TEE scan planes.  The audience will be divided into multiple subgroups and distributed to work-stations at which preserved anatomical cardiac sections, corresponding scan planes and recorded TEE video exam segments will be available to facilitate these small group “tutorial” sessions. Opportunities for hands-on anatomical section examination, group participation and extensive moderator interactions will be afforded by this framework.

The participants will be divided into 9 groups and rotate evenly through all stations across both parts 1 and 2 of the workshop.

 

Upon completion of this workshop, the participant should:

1)      Be able to recognize and identify structures in the SCA-20 views;

2)      Understand the different views required for complete imaging of different cardiac structures;

3)      Understand the probe manipulations required to obtain these views.

 

Session: Luncheon Series

Moderator: GS Hartman

Lecture: Update on Perioperative Certification               

Speaker: DM Thys

At the conclusion of this lecture, the participant should have a better understanding of:

1)      The guidelines for training and certification in perioperative TEE including prerequisite medical knowledge and training, echocardiographic knowledge and skills, training components and duration, training environment and supervision, and equivalence requirements for post graduate physicians already in practice;

2)      The process for obtaining certification including case-log, training documentation and lab requirements.

 

Session: Basic Principles of TEE

Moderator: KP Grichnik

Lecture: Artifacts

Speaker: LB Heller

At the conclusion of this lecture, the participant should be able to:

1)      Understand the sound principles that lead to artifacts;

2)      Explain the causes of the common artifacts;

3)      Recognize the difference between and artifact and a true pathological finding.

 

Lecture: Anatomic Pitfalls                                    

Speaker: KP Grichnik

At the conclusion of this lecture, the participant should be able to:

1)      Understand the embryological basis of many common anatomic variants;

2)      Classify the anatomic pitfalls by location in the heart;

3)      Differentiate anatomic pitfalls from a true pathological finding.

 

Lecture: Basic Hemodynamics                                  

Speaker: AC Perrino Jr

At the conclusion of this lecture, the participant should be able to:

1)      Comprehend the concept of time volume integral (volume time integral);

2)      Determine stroke volume, cardiac output from TEE measurements;

3)      Understand the modified Bernoulli equation;

4)      Deduce pulmonary artery and other intracardiac pressures from TEE measurements.

 

Session: Demonstration of Imaging Principles / Basic Measurements/Knobology Workshop

Moderator: Stanton Shernan, MD

Lecture: Performing an Exam: Structure Directed vs. Esophageal Level  

Speaker: GS Hartman

Upon completion of this lecture, the participant should understand:

1)      The correlation between transesophageal probe depth and orientation to intrathoracic structural anatomy;

2)      How to manipulate a transesophageal probe to obtain an imaging plane and structural orientation.

 

Lecture: Basic Measurements                                                                        

Speaker: N Skubas

Upon completion of this lecture, the participant should understand:

1)      The values for normal anatomic dimensions and functional measurements using transesophageal echocardiography;

2)      How to measure and calculate the normal basic anatomic dimensions and functional values using transesophageal echocardiography.

 

Lecture: Live Knobology Workshop: Demonstration of Echocardiography Principles

Speakers: KP Grichnik/D Shook/ ST Reeves

Upon completion of this workshop, the participant should understand:

1)      The function of basic knobs on a echocardiography console;

2)      How to use basic knobs and function to optimize image resolution using live imaging.

L E C T U R E   O B J E C T I V E S

Tuesday, February 14

Session: Basic Transesophageal Echocardiography I

Moderator: LB Heller

Lecture: Left Ventricular Global Systolic Function                     

Speaker: MJ London

At the conclusion of this lecture, the participant will be able to:

1)      Identify normal and abnormal left ventricular systolic function;

2)      Perform qualitative and quantitative assessment of left ventricular systolic function;

3)      Recognize the LV segments and their corresponding coronary distribution;

4)      Perform LV volume assessment.

 

Lecture: Right Ventricular Global Systolic Function                     

Speaker: JB Mark

At the conclusion of this lecture, the participant will be able to:

1)      Identify normal and abnormal right ventricular systolic function

2)      Develop pertinent TEE views for RV function assessment

3)      Perform qualitative assessment of right ventricular systolic function

4)      Understand the concept of ventricular interdependence

 

Lecture: Diastolic Function                                                         

Speaker: SK Shernan

At the conclusion of this lecture, the participant will be able to:

1)      Understand the importance of diastolic function assessment in the perioperative setting

2)      Define diastolic physiology by 2D and Doppler echocardiography

3)      Determine the degree of diastolic dysfunction using echocardiographic modalities

 

Lecture: Aortic Regurgitation                                                 

Speaker: CA Troianos

At the conclusion of this lecture, the participant will:

1)      Understand the structural anatomy of the normal aortic valve

2)      Be able to develop TEE views of the aortic valve

3)      Understand mechanisms of aortic regurgitation

4)      Know how to perform basic quantitative assessment of aortic regurgitation

 

Lecture: Aortic Stenosis                                                           

Speaker: L Shore-Lesserson

1)      At the conclusion of this lecture, the participant will:

2)      Solidify knowledge and understanding of structural anatomy of the normal aortic valve

3)      Be able to develop TEE views of the aortic valve

4)      Understand the mechanisms of aortic stenosis

5)      Recognize the 2D TEE findings of aortic stenosis

6)      Be able to perform basic quantitative assessment of aortic stenosis

 

Lecture: Evaluation of the Aorta                                            

Speaker: KE Glas

At the conclusion of this lecture, the participant will:

1)      Understand the basic TEE views used to define aortic anatomy

2)      Be able to diagnose intrathoracic aortic pathologies using TEE

3)      Delineate aortic pathology from common aortic artifacts

4)      Recognize the risks and contraindications of probe placement in patients with aortic disease

 

Session: Basic Transesophageal Echocardiography II

Moderator: CA Troianos

Lecture: Mitral Regurgitation                                     

Speaker: SA Lambert

Upon completion of this lecture, the participant should understand:

1)      Structural anatomy of the normal mitral valve.

2)      2-D echo anatomy of the normal mitral valve.

3)      Anatomical pathology of mitral valve regurgitation.

4)      Mechanisms of mitral regurgitation.

5)      The diagnosis of unknown examples of mitral regurgitation and their quantitative assessment.

 

Lecture: Mitral Stenosis                                               

Speaker: LB Heller

Upon completion of this lecture, the participant should understand:

1)      Anatomical pathology of mitral stenosis.

2)      Mechanisms of mitral stenosis.

3)      Basic quantitative assessment of mitral stenosis.

4)      The diagnosis of unknown examples of MS and their quantitative assessment.

 

Lecture: Tricuspid Valve & Pulmonic Valve              

Speaker: JB Mark

Upon completion of this lecture, the participant should understand:

1)      Structural anatomy of the normal tricuspid and pulmonic valves.

2)      2-D echo anatomy of the normal tricuspid and pulmonic valves.

3)      Anatomical pathology of tricuspid and pulmonic valvular regurgitation.

4)      Mechanisms of tricuspid valve stenosis and regurgitation.

5)      Qualitative assessment of tricuspid valve stenosis and regurgitation.

6)      The diagnosis of unknown examples of tricuspid valve stenosis or regurgitation and their qualitative assessment.

 

Lecture: Prosthetic Valves                                    

Speaker: ATW Cheung

Upon completion of the lecture, the participant should be able to:

1)      Identify the different types of prosthetic valves and their echocardiographic “signature”.

2)      Describe the advantages and indications of each of the prosthetic valve options.

3)      Recognize the echocardiographic criteria establishing abnormal prosthetic valve function.

 

Lecture: Basic Congenital                                         

Speaker: K Rouine-Rapp

Upon completion of this lecture, the participant should understand:

1)      Normal embryological development of the heart.

2)      The echocardiographic features of commonly encountered adult congenital heart lesions.

3)      Pitfalls in differentiating congenital heart lesions from normal variants.

4)      Lesions to be covered include: ASD, VSD, PFO, PLSVC

 

Lecture: Cardiac Masses                                    

Speaker: L Shore-Lesserson

Upon completion of this lecture, the participant should understand:

1)      How echocardiography can be used to differentiate normal cardiac structure from artifacts and pathological masses.

2)      Potential physiological consequences and complications associated with intracardiac masses.

 

Session: Regional Wall Motion Workshop

Moderator: D Vezina

At the conclusion of this workshop, the participant will be able to describe:

1)      The global left ventricular contractile function;

2)      The regional left ventricular contractile function;

3)      The global and regional right ventricular contractile function;

4)      The most common misinterpretations of the contractile function based on echocardiography assessment

L E C T U R E   O B J E C T I V E S

Wednesday, February 15

Session: Cardiac Anatomy Wet Lab

Moderator: BA Bollen, GS Hartman

Lecture: Cardiac Anatomy                                                         

Speaker: CMG Duran

At the conclusion of this lecture, the participant should understand:

1)      Gross external anatomy of the heart;

2)      External landmarks for cardiac anatomy;

3)      Nomenclature and location of epicardial vessels;

4)      Anatomic features and nomenclature of individual chambers;

5)      Location of developmental anatomic remnants;

6)      Location, orientation and underlying structure of different cardiac valves;

7)      Anatomic relationship of the coronary circulation and conduction system to the cardiac valve structure;

8)      Anatomic basis of surgical procedures and complications involving cardiac valves.

 

Lecture: TEE Correlations of Cardiac Anatomy                     

Speaker: BA Bollen

Upon completion of this lecture, the participant should understand the TEE correlates of the anatomical structures discussed in the previous lecture and wet-lab demonstrations, including:

1)      Correlation of anatomical to echocardiographic sections;

2)      3-dimensional aspects of the heart and great vessels;

3)      Correlation of probe scan planes to anatomical windows into the heart.

 

Session: Non-Cardiac Surgical Applications of Echocardiography

Moderator: LK Wallace

Lecture: Echocardiography in the ER/Trauma     

Speaker: ST Reeves

At the conclusion of this lecture, the participant will be able to describe:

1)      The role of echocardiography (TEE or TTE) in the evaluation of chest pain in the ER/trauma

2)      The role of echocardiography (TEE or TTE) in the evaluation of hemodynamic instability in the ER/trauma

 

Lecture: Echo in the ICU & Cath Lab                    

Speaker: JG Ramsay

At the conclusion of this lecture, the participant will:

1)      Be able to describe the role of echocardiography (TEE or TTE) in the ICU in the evaluation of hemodynamic instability or hypoxemia

2)      Be able to describe the role of echocardiography (TEE or TTE) in the ICU in the evaluation of suspected endocarditis

3)      Understand the expanding role of echocardiography in the Cath Lab

 

Lecture: Ultrasound Guidance of Vascular Cannulation   

Speaker: BC Spence

At the conclusion of this lecture, the participant will:

1)      Understand the rationale for the use of ultrasound guidance during central venous catheterization

2)      Be able to describe the techniques used and the currently available ultrasound equipment for ultrasound guided vascular cannulation

 

Session: Echocardiography for Aortic Aneurysms & Dissections

Moderator: LK Wallace

Lecture: Aortic Aneurysms & Dissection                   

Speaker: DA Zvara

At the conclusion of this lecture, the participant will be able to:

1)      Describe the echocardiographic characteristics and classification of aortic aneurysms

2)      Describe the echocardiographic characteristics and classification of aortic dissections

3)      Compare the diagnostic utility of various imaging modes, including TEE and TTE, in the evaluation of suspected aortic dissection

4)      Be able to describe the echocardiographic characteristics and prognostic significance of an intramural hematoma or a penetrating ulcer

 

Session: Echocardiography for Off-Pump CABG

Moderator: LK Wallace

Lecture: Echocardiography for Off-Pump CABG  

Speaker: JS Shanewise

At the conclusion of this lecture, the participant will:

1)      Be able to describe to role of TEE in evaluating hemodynamic function during Off-Pump CABG

2)      Understand the role of TEE in surgical decision making during Off-Pump CABG procedures

 

Session: Emerging Applications of Perioperative Ultrasound

Moderator: LK Wallace

Lecture: Hand-held Echo for Transthoracic Echo   

Speaker: D Oxorn

At the conclusion of this lecture, the participant will:

1)      Be able to describe the capabilities of modern hand-held echocardiographic machines

2)      Be familiar with the most important transthoracic images

3)      Understand the role of perioperative echocardiography using hand-held devices

 

Lecture: Periop Ultasonography for Peripheral Nerve Block               

Speaker: BC Spence

At the conclusion of this lecture, the participant will:

1)      Understand the rational for using ultrasound to guide peripheral nerve blocks

2)      Be able to describe how ultrasound can be used to guide peripheral nerve blocks

 

Session: Advanced Echocardiography I

Moderator: S Aronson

Lecture: Advanced Systolic Function                     

Speaker: ATW Cheung

At the conclusion of this lecture, the participant will:

1)      Be prepared to apply echocardiography for assessment of LV systolic function;

2)      Be able to recognize the advantages and disadvantages of various techniques.

 

Lecture: Advanced Diastolic Function: “Beyond the E- and A-Wave”

Speaker: JD Thomas

At the conclusion of this lecture, the participant will:

1)      Be able to differentiate systolic function from diastolic function as a basis for pathophysiology;

2)      Be able to assess diastolic dysfunction with various echocardiographic techniques;

3)      Recognize the advantages and limitations of each technique.

 

Lecture: Echocardiographic Assessment of Myocardial Viability            Speaker: S Aronson

At the conclusion of this lecture, the participant will:

1)      Be able to illustrate the need to identify viable myocardium for acute care;

2)      Be able to describe the methodologies available to assess viability;

3)      Be able to evaluate the functionability of echocardiography for evaluating viability perioperatively.

 

L E C T U R E   O B J E C T I V E S

Thursday, February 16

 

Session: Echocardiography for Heart Failure & Pericardial Disease

Moderator: S Aronson

Lecture: Echocardiographic Evaluation of Cardiomyopathies     

Speaker: A Maslow

At the conclusion of this lecture, the participant will be able to:

1)      Identify subcategories of cardiomyopathies;

2)      Apply echo for quantitative analysis of LV function in patients with cardiomyopathies.

 

Lecture: Intraop Echo for VAD and Heart Transplant                  

Speaker: D Oxorn

At the conclusion of this lecture, the participant will understand:

1)      The risk of VAD;

2)      Critical information required to manage the risk of VAD;

3)      How Echo can help manage the risk of VAD.

 

Lecture: Echocardiographic Evaluation of Pericardial Disease           

Speaker: EG Avery

At the conclusion of this lecture, the participant will be able to:

1)      Identify subcategories of pericardial disease;

2)      Apply Echo for quantitative analysis of LV function in patients with pericardial disease.

 

Lecture: Aortic Atheromatous Disease & Neurocognitive Outcome      

Speaker: I Kronzon

At the conclusion of this lecture, the participant will:

1)      Understand the risk of aortic atheromatous disease;

2)      Understand techniques needed to assess aortic atheromatous with Echo;

3)      Know how to grade lesions.

 

Session: Luncheon Series

Lecture: Future of Echocardiography                                         

Speaker: CM Otto

This lecture is an overview presentation on the future of Echocardiography and its application to patient care.

Upon conclusion of the presentation, the participant should have:

1)      A greater appreciation of the application of ultrasound to cardiac pathophysiology;

2)      An overview of the new applications of echocardiography;

3)      An exposure to research frontiers in echocardiography.

 

Session: Advanced Echocardiography II

Moderator: D Shook

Lecture: 3D/4D Echocardiography                             

Speaker: D Shook

At the conclusion of this lecture, the participant will be able to:

1)      Describe the techniques for acquiring and reconstructing 3D echocardiographic images;

2)      Describe the techniques for acquiring Real Time 3D echocardiographic images;

3) Identify perioperative applications of 3D echocardiography.

 

Lecture: Tissue Doppler/Strain                                   

Speaker: NJ Skubas

At the conclusion of this lecture, the participant will:

1)      Understand techniques for acquiring Doppler tissue imaging, strain, and strain rate;

2)      Be able to describe applications for Doppler tissue imaging, strain, and strain rate in the evaluation of myocardial performance.

 

Session: Aortic Valve – Advanced

Moderator: D Shook

Lecture: Timing of Surgery/Intervention for Asymptomatic Valve Disease 

Speaker: C Otto

At the conclusion of this lecture, the participant will be able to:

1)      Describe the important factors in evaluating aortic valve disease and the timing of surgical intervention;

2) Identify when intervention is necessary in patients with asymptomatic aortic valve disease.

 

Lecture: Intraoperative Echo Assessment of the Aortic Valve  

Speaker: I Kronzon

At the conclusion of this lecture, the participant will be able to:

1)      Explain how echocardiography can be used to evaluate normal aortic valve anatomy;

2)      Explain how echocardiography can be used to evaluate aortic valve pathology and function;

3)      Describe the impact of echocardiography on surgical decision making during aortic valve procedures.

 

Lecture: Surgical Options for the Dysfunctional Aortic Valve   

Speaker: N Smedira

At the conclusion of this lecture, the participant will be able to:

1)      Identify the surgical options available in patients with aortic valve disease;

2)  Understand the technical issues, which must be addressed to insure success of each procedure;

3)  Compare the advantages and disadvantages of each of these procedures;

4)  Describe the potential complications of each of these surgical procedures.

 

Session: Hemodynamic Workshop

Moderator: S Shernan

Lecture: Review of Hemodynamic Principles & Quantitative Doppler          

Speaker: JS Shanewise

Upon completion of this lecture, the participant should understand:

1)      The physics and formulae used in Quantitative Doppler Echocardiography;

2)      How Quantitative Doppler Echocardiography and knowledge of Hemodynamic Principles can be used;

3)      how to calculate intracardiac velocity, flow, chamber pressures and valve areas;

4)      The limitations of Quantitative Doppler Echocardiography.

 

Lecture: Case Discussions Demonstrating Clinical Applications of Quantitative Doppler

Speakers: SN Konstadt, MG Licina, JS Shanewise, SK Shernan, LK Wallace

Upon completion of this lecture, the participant should understand:

1)      How to obtain estimates of intracardiac velocity, flow, chamber pressures and valve areas using a Case Discussion format;

2)      clinical applications of measurements and calculations obtained by  Quantitative Doppler Echocardiographic techniques.

L E C T U R E   O B J E C T I V E S

Friday, February 17

 

Session: Role of Echocardiography in Perioperative Clinical Decision-making

Moderator: RM Savage

Lecture: What to do about Pre-CPB 2+ MR?

Speaker: RM Savage

At the conclusion of this lecture, the participant will understand:

1) The underlying anatomy of the mitral ventriculo-annular complex;

2) The pathophysiologic mechanisms leading to MV apparatus dysfunction;

3) Severity assessment in patients with mild-to-moderate MR;

4) “Mechanism specific” surgical options in mitral valve repair in moderate MR.

 

Lecture: MS/MR Post Repair of MV                                      

Speaker: MG Licina

At the conclusion of this lecture, the participant will understand:

1) Mechanisms of post-repair MS and MR;

2) Efficient MS/MR severity assessment methods in post-CPB MV repair;

3) Surgical considerations in re-repair of the mitral valve;

4) Long term outcomes of different MV repair techniques.

 

Lecture: Echocardiography to Facilitate Weaning from CPB    

Speaker: RF Brooker

At the conclusion of this lecture, the participant will understand:

1) Anesthetic-hemodynamic considerations in successful weaning from CPB;

2) Etiologies of myocardial dyfunction during separation from CPB;

3) The use of intraoperative echo in guiding the separation from CPB;

4) The therapeutic options available in difficult weaning from CPB and their indications.

 

Lecture: Unanticipated Ascending Aortic Dilatation: How Big is Too Big?                     

Speaker: ATW Cheung

At the conclusion of this lecture, the participant will understand:

1) The integrated anatomy of the aortic root complex;

2) Etiologies of ascending root dilatation;

3) Surgical considerations in unanticipated ascending aortic dilatation;

4) Intraoperative echo in directing the management of ascending aortic dilatation.

 

Lecture: Echo for Adult Congenital Heart Disease             

Speaker: IA Russell

At the conclusion of this lecture, the participant will:

1) The embryologic basis of congenital abnormailities seen in adult patients;

2) The pathophysiology of common congenital defects in the adult patient;

3) A systematic intraoperative exam for the adult patient with congenital heart disease;

4) The use of intraoperative echocardiography in guiding the management of patients with congenital heart disease.

Lecture: Echocardiographic Options when TEE is Contraindicated

Speaker: KE Glas

At the conclusion of this lecture, the participant will understand:

1) The indications for epicardial imaging;

2) The different epicardial imaging planes;

3) The available windows for Doppler interrogation provided by epicardial imaging;

4) How epicardial echocardiography is utilized in guiding the decision making process in cardiovascular surgery.

 

Session: Luncheon Series

Lecture: Future of Cardiac Surgery                                               

Speaker: SF Bolling

At the conclusion of this lecture, the participant will understand:

1) Demographic trends impacting the future of cardiovascular surgery;

2) Evolving technologies that will impact the management of cardiovascular disease;

3) Complications of newer technologies and their perioperative management;

4) Future of training in the cardiovascular disciplines.

 

Session: Advanced Mitral Valve

Moderator: RM Savage

Lecture: Intraoperative Assessment of the Mitral Valve  

Speaker: SN Konstadt

At the conclusion of this lecture, the participant will understand:

1) Etiologies of mitral valve dysfunction and corresponding anatomic changes;

2) Mechanisms of mitral valve dysfunction;

3) Intraoperative methods of assessing severity of mitral valve dysfunction;

4) Use of intraoperative echocardiography in the management of mitral valve disease.

 

Lecture: Ischemic Mitral Regurgitation                         

Speaker: WJ Stewart

At the conclusion of this lecture, the participant will understand:

1) Anatomy and function of the mitral valve apparatus;

2) The definition of ischemic mitral regurgitation;

3) Changes of the MV apparatus associated with chronic myocardial ischemia;

4) Long-term strategies in the surgical management of ischemic MR.

 

Lecture: Surgical Repair of the Mitral Valve                           

Speaker: SF Bolling

At the conclusion of this lecture, the participant will understand:

1) Surgical anatomy of the mitral valve apparatus;

2) The surgeon’s systematic examination of the mitral valve apparatus;

3) Correlation of surgical inspection with the intraoperative echo examination;

4) Surgical considerations and options in MV repair;

5) Causes of unsuccessful MV repair.

 

Session: “Test Yourself”

Moderator: DA Zvara

At the conclusion of this workshop, the participant will:

1)      Assess a broad range or echocardiographic knowledge in a simulated testing environment;

2)      Determine relative areas of strength and weakness in preparation for the PTEexam;

3)      place their relative testing knowledge against other participants taking the mock examination;

4)      Devise test study strategies, which may help guide preparation for the PTEeXAM.

L E C T U R E   O B J E C T I V E S

Saturday, February 18

 

You’re the Intraoperative Echocardiography Consultant: Case Discussions with the Experts          

Moderators: Shernan and Hartman

Upon completion of this session, the participant will have a better understanding of:

1)      How to be a perioperative echocardiography consultant;

2)      The utility of echocardiography for perioperative decision-making through the use of interactive case discussions;

3)      Unusual cases and the application of perioperative ultrasound to clinical care of patients with cardiovascular disease.