Echocardiography Service

Adult Echocardiography Service

The Yale Adult Echocardiography service covers echocardiography performed within the Heart and Vascular Center at the Yale-New Haven Hospital, outpatient facilities in New Haven, Branford, and Guilford, as well as within the West Haven Veterans Administration Medical Center (WHVAMC). The laboratory performs over 15,000 transthoracic echoes, over 700 transesophageal echoes, and over 2,000 stress echoes.

Sonographers

Nancy Cavallaro, RCDS, heads seventeen registered diagnostic cardiac sonographers to form the staff of the echocardiographic service at Yale-New Haven Hospital. Three sonographers staff the WHVAMC.

Equipment

Within the hospital, echocardiograms are acquired digitally on seven state-of-the-art digital machines, including five Philips iE33’s, one GE Vivid 7, and one Philips CX50. The studies are interpreted on a Syngo (Siemens) information system with supplemental capability from QLAB (Philips) and EchoPac (GE) software. A digital archive enables rapid access to previous studies from the past 10 years for comparison. The images and reports are available through the hospital information system for review by referring clinicians. The affiliated WHVAMC uses three state-of-the-art digital iE33 machines and the Xcelera information system.

Education

All cardiology fellows are trained to meet at least the American College of Cardiology Level I requirements, including three months within the first two years in the Yale-New Haven Hospital and WHVAMC echo labs. Select fellows receive additional training to Levels II and III. Cardiology fellows receive personalized instruction in developing their scanning skills by the experienced technologists who perform the lab's studies. All fellows become proficient in acquisition and interpretation of transthoracic imaging. Cardiology fellows are given the opportunity to preread studies on three complete digital workstations within the reading room using an electronic reporting system. These studies are then reviewed with an attending cardiologist. Experience with transesophageal and stress echocardiography is also an integral part of the echocardiography rotations. Close relations exist with the pediatric cardiac service, including a program of echocardiographic imaging during percutaneous procedures, and the cardiac anesthesia service.

In addition to hands-on clinical training, fellows attend didactic and case conferences. Multiple conferences are held each week with active participation by attendings, fellows, and sonographers. These conferences include cardiovascular imaging conferences, echo case conferences, and CME didactic conferences. Practical scanning sessions early in fellowship training facilitate performance and interpretation skills. Echocardiography is displayed prominently in the weekly Cardiology Grand Rounds and cardiology fellows’ conferences. In addition, fellows are encouraged to attend monthly cardiac anesthesia conferences and pediatric cardiology conferences.

Web-based software created by the previous echocardiography director, Dr. C. Carl Jaffe, covering Adult Transthoracic and Transesophageal Echocardiography and Adult Congenital Heart Disease are available for individual learning.

Research

Faculty interests in cardiac imaging are broad-ranging. Drs. McNamara, Krumholz, and Chen investigate cardiac outcomes and quality of care. Dr. Sugeng has been integral in the development and evaluation of 3-Dimensional imaging, particularly related to valvular heart disease. Dr. Russell uses echocardiography on the mouse model to study cellular signaling and has established a Cardio-Oncology clinic. Dr. Mani’s research in cardiovascular genetics is supplemented by imaging to characterize phenotypes. Dr. Tandon investigates the interaction among various cardiac imaging modalities.

Faculty

Nine board-certified cardiologists: