Faculty Education

Basic Transesophageal Echocardiography Course

July 11, 2011 - September 4, 2011

The Basic Transesophageal Echocardiography (TEE) Lecture Series Presentations are currently planned and coordinated for the Department by Dr. Irena Vaitkeviciute, Assistant Professor and Dr. Wanda Popescu, Associate Professor of Anesthesiology.  Speaker selection was made from among the faculty of the Department of Anesthesiology, which currently hold a valid TEE certificate issued by the National Board of Echocardiography.  The participation is opened to the Department's faculty, sub-specialty fellows, resident anesthesiology house staff and Physician Assistants. Planning of these lecture presentations started two months prior to the academic year.

The Basic Transesophageal Echocardiography Lecture Series Presentations are intended to educate the participants in the area of intraoperative transesophageal echocardiography. As the population presenting to the operating rooms has become increasingly sicker and older, the anesthesiologists are faced with caring for patients with significant co-morbidities undergoing complicated surgical procedures. Intraoperative echocardiography has a long-standing record of being safe, versatile and reliable hemodynamic monitoring device, which allows for real time visualization of the cardiovascular anatomy and function. It provides immediate diagnosis of potential life threatening causes of hemodynamic instability and represents an excellent monitor of cardiovascular function that guides optimal resuscitation therapy. One significant limitation of echocardiography is the necessity of having personnel trained in performing and interpreting the examinations. Therefore, the American Society of Anesthesiologists together with the Society of Cardiovascular Anesthesiologists and the National Board of Echocardiography have decided to set forth a Board Examination in the area Basic Echocardiography which would evaluate the candidate's competency in performing, interpreting and analyzing intraoperative transesophageal examinations. We have designed the present course with the aim of helping the participants understand basic concepts of ultrasound physics, evaluate the cardiac anatomy and function and understand the basic principles of echocardiography hemodynamic monitoring.

Communication related to the Basic Transesophageal Echocardiography Lecture Series Presentation for the Department of Anesthesiology is provided through weekly email announcements.  Need assessment revisions are made on an on-going basis through direct audience participation, feedback and evaluation.

BASIC PTE EXAM LECTURE SCHEDULE (Held in NP3-133 at 4:00-5:00 PM)

  • 7/11    Patient Safety: Indications, Contraindications and Cleaning Techniques, Dr. Irena Viatkevicute
  • Normal cardiac anatomy and basic views, Dr. Irena Vaitkeviciute
  • 7/18    Echocardiographic imaging acquisition and optimization techniques, Dr. Albert Perrino
  • 7/25    Ventricular function (systolic and diastolic), Dr. Terence Rafferty
  • 8/1     Surface ultrasound for vascular access, Dr. Benjamin Sherman
  • 8/8     Basic exam of mitral and tricuspid valves, Dr Sherif Assaad
  • 8/15    Related diagnostic modalities (MRI,CT,TTE), Dr.Edward Prokop
  • 8/22    Basic recognition of congenital heart disease, Dr. Qing-Bing Zhu
  • 8/29    Basic exam of aorta and aortic valve, pulmonary artery and pulmonary valve, Dr. Wanda Popescu
  • 9/7     Identification of intra-cardiac masses in non-cardiac surgery, Dr. Viji Kurup
  • 9/14    Basic hemodynamic assessment, Dr. Gerry McCloskey

Preparation for TEE Process

The National Board of Echocardiography now offers an examination entitled "Examination of Special Competence in Perioperative Transesophageal Echocardiography (PTEeXAM).

The American Board of Medical Specialties states that "The intent of certification is to provide assurance to the public that a physician specialist who is certififed has succesfully completed an approved educational program and an evaluation process that includes an examination designed to assess the knowledge, skills and experience required to provide quality patient care in that specialty."

This TEE review course offers an opportunity to revise the entire content of the published syllabus of the PTEeXAM under the guidance of the Directorof Non-Invasive Diagnostic Cardiology of St. Raphael's Hospital, New Haven, Dr. Prokop, who is a nationally and internationally renowned expert on echocardiography.  The review course not only targets those hoping to sit the PTEeXAM, but serves as a referesher course for those wo have already passed the exam.  In passing the PTEeXAM, an individual become a Testamur, the definition of which is:  Someone who has passed an examination of special competence administered by the Ntional Board of Echocardiography.  A Testamur may 'convert' to a Diplomat of the National Board of Echocardiography who is:  Someone who has successfully completed the Certification process, i.e., has passed an Examination of Special Competence adminstered by the National Board of Echocardiography, has documentd training in cardiovascular disease, has extended training in echocardiography, and has maintained these skills for a minimum of 2 years prior to applying for certification.

Proof of maintaining these skills includes performing a minimum number of echo studies and acquiring 50 TEE specific CMEs over a period of 4 years prior to application.  It is the intention of this course to provide TEE specific CMEs on an annual basis so that practioners may not only apply for Diplomat status after becoming a Testamur by passing the PTEeXAM, but also fulfill the National Guidelines of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiology which state that the physicians who perform and interpret echo studies should maintain active and continuing education in the field.

Each year the ASE/SCA publishes a syllabus for the upcoming PTEeXAM.  This provides the basis for the review course which is expanded to incorporate new and developing technologies in the fields of echocardiography and other cardiac imaging.