Perioperative Echocardiography Education

Toronto General Hospital Department of Anesthesia & Pain Management

Resources

Course Logistics

Other PTE courses on-line

  1. University of Utah, Perioperative Echocardiography Education

3D Model & Image Collections

  1. Normal Cardiac Anatomy (including the whole heart blood pool model)
  2. Toronto Adult Congenital Heart Disease Atlas
  3. Congenital Heart Disease diagrams from chd-diagrams.com (open source – cc-by license)
  4. Toronto General Hospital, Perioperative Interactive Education
  5. Wikimedia heart illustrations and video clips (open source – cc-by license) – See specifically the excellent images by P. Lynch.

Echo Simulators On-line

  1. APIL Echocardiography Simulator (TEE and TTE)

2019 Introduction to Perioperative TEE Series

Lecture 1: TEE Views (July 10)

Format: Live Lecture; (A. Omran)

  1. Omran – TEE Views (PPTX) (PDF)

References

Lecture 2: Comprehensive TEE Exam including Spectral and Color Doppler (July 17)

Format: Live Lecture; (A. Omran)

  1. Omran – Comprehensive TEE Exam and Doppler Echocardiography (PPTX) (PDF) Includes MCQ Quiz

Lecture 3: Mitral Valve: Anatomy, Imaging, Pathology (July 24)

Format: Live Lecture; (A. Omran)

  1. Omran – Mitral Valve: Anatomy, Imaging and Pathology (PPTX) (PDF) Includes MCQ Quiz

References

Lecture 4: Aortic Valve: Anatomy, Imaging, Pathology (July 31)

Format: Live Lecture; (A. Omran)

  1. Omran – Aortic Valve: Anatomy, Imaging and Pathology (PPTX) (PDF) Includes MCQ Quiz

References

Lecture 5: Tricuspid and Pulmonic Valves: Anatomy, Imaging, Pathology (August 7)

Format: Live Lecture; (A. Omran)

  1. Omran – Tricuspid Valve: Anatomy, Imaging and Pathology (PPTX) (PDF) Includes MCQ Quiz

References

Lecture 6: Systolic Ventricular Function: function of LV and RV (August 14)

Format: Live Lecture; (A. Omran)

  1. Omran – Systolic Ventricular Function: LV and RV (PTEX) (PDF)

References

Lecture 7: Cardiomyopathy HOCM and others (August 21)

Format: Live Lecture; (A. Omran)

  1. Omran – Cardiomyopathies (PTEX) (PDF)

Lecture 8: Basic Hemodynamics (August 28)

Format: Live Lecture; (A. Omran)

  1. Omran – Basic Hemodynamics(PTEX) (PDF)

References

2019 Perioperative TEE NBE Exam Preparation Course

Week 1 – Anatomy for Echocardiography

Format: Recorded Lecture; 3 segments. (A. Mashari)

Part 1: Morphology of the heart base

Human Heart Base by APIL

Part 2: Orientation of heart base in thorax; chambers, major vessels, relationship to esophagus & airway

Whole Heart Blood Pool Model by APIL

Standard echocardiographic imaging planes in 3D (12 clips)

Part 3: 3D Slicer Tutorial

Links

  • 3D Slicer: http://Slicer.org (Download the “stable” version)
  • 3D Cardiac CT and segmentation models for 3D Slicer

References

General
  1. Zimmerman, Basic Cardiac Anatomy for the Echocardiographer (Recorded lecture from University of Utah Perioperative Echocardiography Education)
  2. McGiffin D. Cardiac Anatomy.
  3. Faletra FF, Ho SY, Leo LA, Paiocchi VL, Mankad S, Vannan M, et al. Which Cardiac Structure Lies Nearby? Revisiting Two-Dimensional Cross-Sectional Anatomy. Journal of the American Society of Echocardiography. 2018 Sep 1;31(9):967–75.
Heart Base
Coronary arteries
  1. Loukas M, Groat C, Khangura R, Owens DG, Anderson RH. The normal and abnormal anatomy of the coronary arteries. Clin Anat. 2009 Jan;22(1):114–28.
  2. Chiu I-S, Anderson RH. Can we better understand the known variations in coronary arterial anatomy? Ann Thorac Surg. 2012 Nov;94(5):1751–60.
Embryology

Week 2 – Artifacts and Pitfalls

Format: Live Presentation (A. Vegas)

  1. Vegas – Handout 1 – Pitfalls (PDF) (PPTX) 
  2. Vegas – Handout 2 – Physics of Artifacts (PDF) (PPTX)

Week 3 – The Basic TEE Screening Examination & Rescue TEE

Format: Live Presentation (C. Hudson)

  1. Hudson –  Slides – Rescue TEE (PDF)

References

Perioperative TEE

  1. ** Basic Perioperative Transesophageal Echocardiography Examination: A Consensus Statement of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists, JASE, May 2013
  2. * ASE/SCA Guidelines for Performing a Comprehensive Intraoperative Multiplane Transesophageal Examination, JASE, October 1999.

General TEE

  1. * Guidelines for Performing a Comprehensive Transesophageal Echocardiography Examination: Recommendations from the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists, JASE, September 2013 (ASE Webinar)

TTE

  1. * Focused Cardiac Ultrasound: Recommendations from the American Society of Echocardiography, JASE, June 2013
  2. Guidelines for Performing a Comprehensive Transthoracic Echocardiographic Examination in Adults, JASE, January 2019

Other References

Week 4 – Review Session: Ultrasound Physics

Format: Live Review Session – Survival rates variable (A. Mashari)

  1. Mashari – Ultrasound Physics Questions and Answers (PDF)

References

  1. Basic ultrasound for clinicians
  2. Hunting Bats (Video)
  3. An Interactive Guide to the Fourier Transform
  4. PTEmasters, Physics of Ultrasound (11 parts)
  5. Edelman SK. Understanding Ultrasound Physics. 3rd ed. ESP; 2003.
  6. Fish P. Physics and Instrumentation of Diagnostic Medical Ultrasound. Wiley; 1990. 268 p.
  7. Miele FR. Ultrasound Physics and Instrumentation. 4th ed. Forney, TX: Miele Enterprises, Inc.; 2006.
  8. Thomas JD, Rubin DN. Tissue harmonic imaging: why does it work? J Am Soc Echocardiogr. 1998 Aug;11(8):803–8.

Week 5 – Rheumatic Heart Disease, Mitral Stenosis

Format: Live Presentation (A. Vegas)

  1. Vegas – Rheumatic Heart Disease and Mitral Stenosis (PDF) (PPTX)

Week 6 – Aortic Stenosis, LVOT Obstruction and Hypertrophic Cardiomyopathy; Review session

Format: Recorded Presentation (J. Moreno); Live Review Session (B. Ansari)

Part 1: Aortic Valve Stenosis

Part 2: Hypertrophic Cardiomyopathy and LVOT Obstruction

References

  1. Baumgartner H et al. Recommendations on the Echocardiographic Assessment of Aortic Valve Stenosis: A Focused Update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. JASE. 2017 Apr;30(4):372–92. (ASE Webinar)

Week 7 – Aortic Valve Insufficiency & Aortic Valve Repair; Review session

Format: Recorded Presentation; Live Review Session (J. Fiorellino)

  1. Bledsoe (2016) Evaluation of Aortic Insufficiency (from University of Utah Perioperative Echocardiography Education)

Week 8 – Intracardiac Masses & Devices

Format: Live Presentation (A. Snyman)

  1. Snyman – Cardiac Masses (PDF) (PPTX)

Week 9 – Left Ventricle Assessment; Review session

Format: Recorded Presentation (PTE Masters LV Basic, Additional Topics and Advanced); Live Review Session (C. Srinivas)

  1. Bledsoe (2017) Left Ventricular Quantification and Systolic Function (from University of Utah Perioperative Echocardiography Education)
  2. Curtis (2016) Segmental Wall Motion Abnormalities & Ischemia  (from University of Utah Perioperative Echocardiography Education)

Week 10 – Mitral Valve Insufficiency and Mitral Valve Repair

Format: Recorded Presentation (University of Utah Collection)

  1. Zimmrman, Anatomy of the Mitral Valve Apparatus (from University of Utah Perioperative Echocardiography Education)
  2. Birgenheier, Mitral Regurgitation (2 parts) (from University of Utah Perioperative Echocardiography Education)

Week 11 – ACHD 1: Fontan Circulation

Format: Live Presentation (J. Heggie)

  1. Heggie (2019) Fontan Circulation

Week 12 – Pericardium; Review Session

Format: Recorded Presentation (University of Washington; PTE Masters); Live Review Session (C. Hudson)

Part 1: Physiology

An excellent case presentation and discussion on the physiology of pericardial disease and the difference between constriction by the pericardium vs. myocardial restriction. From University of Washington.

Part 2: Echocardiographic Evaluation

  1. See PTE Masters lectures “Pericardial Disease” Parts 1-8

Week 13 – ACHD 2: Unrestricted Shunts

Format: Live Presentation (J. Heggie)

Week 14 – TEE for Aortic Surgery; Epiaortic Imaging

Format: Live Presentation (C. Srinivas)

  1. Srinivas – TEE For Aortic Surgery (PDF)

Week 15 – Right Heart: RV function, Tricuspid and Pulmonary Valve Assessment

Format: Recorded Presentation (University of Utah Collection) and Live review of studies by Dr. Jariani

  1. Silverton (2016) Right Heart Function (from University of Utah Perioperative Echocardiography Education)
  2. Bledsoe (2015) Evaluation of RV Function (from University of Utah Perioperative Echocardiography Education)
  3. Gnadinger (2016) Tricuspid and Pulmonary Valve Assessment (from University of Utah Perioperative Echocardiography Education)

Week 16 – Hemodynamic Calculations

Format: Live Review Session (Dr. Moreno)

Week 17  – ACHD – Contotruncal Abnormalities

Format: Live Presentation (J. Heggie)

Week 18  – TEE for Advanced Heart Failure: LVAD, ECLS, Transplant, Contrast echo

Format: Live Presentation (A. Snyman)

Week 19 – ACHD – Transposition of Great Arteries

Format: Live Presentation (J. Heggie)

Week 20 –  Mock Exam

Format: On-line Mock Exam (A. Mashari); Live Review Session (A. Omran)

  1. Mock Exam
  2. Omran – Mock Exam Review (PDF) (PPTX)

Week 21 – Study Week

Week 22 – TEE for Structural Heart Disease Interventions: TAVI, TEVAR, Trans-Septal Puncture

Format: Live Presentation (A. Omran)

  1. Omran-TEE for Structural Heart Disease Interventions (PDF) (PPTX)

Week 23 – Equipment, Infection Control, and Safety

Format: Recorded Presentation (J. Moreno)

Week 24 – Review

Format: Live Review Session (J. Moreno)

Week 25 – Diastolic Function & Cardiomyopathies (except HOCM)

Format: Live Review Session (A. Omran)

  1. Omran – Diastolic Function and Cardiomyopathies (PDF) (PPTX)

Other Topics

3D Echo

Congenital Heart Disease

Theme: Overlay by Kaira