Perioperative Echocardiography Education

Toronto General Hospital Department of Anesthesia & Pain Management

Resources

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

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

rmat: Live Lecture; (A. Omran)

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

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

rmat: Live Lecture; (A. Omran)

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

References

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

Lecture; (A. Omran)

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

References

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

re; (A. Omran)

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

References

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

Omran)

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

References

Lecture 7: Cardiomyopathy HOC>Lecture 7: Cardiomyopathy HOCM and others (August 21)

Omran)

  1. Omran – Cardiomyopathies (PTEX) (PDF)

Lecture 8: Basic Hemodynamics>Lecture 8: Basic Hemodynamics (August 28)

Omran)

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

References

2019 Perioperative TEE NBE Exam Prepa>2019 Perioperative TEE NBE Exam Preparation Course

rdiography

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

Part 1: Morphology of the heart base<>Part 1: Morphology of the heart base

ocookie.com/embed/M8K_I7lKT7k" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen">

Human Heart Base by APIL

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

laylists/embed?collection=d316ed4ee1cb4832ad14099179c1487d" width="560" height="315" frameborder="0">

Whole Heart Blood Pool Model by APIL

Standard echocardiographic imaging planes in 3D (12 clips)

Part 3: 3D Slicer Tutorial

Links>Part 3: 3D Slicer Tutorial

f="http://Slicer.org">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 >Week 2 – Artifacts and Pitfallsf="https://apil.ca/wp-content/uploads/2019/01/Vegas-PTE-2019-Pitfalls.pdf">Vegas – Handout 1 – Pitfalls (PDF) (PPTX) 

  • Vegas – Handout 2 – Physics of Artifacts (PDF) (PPTX)
  • Week 3 – Week 3 – The Basic TEE Screening Examination & Rescue TEE

    f="https://apil.ca/wp-content/uploads/2019/01/20190123-PTE-Exam-Rescue-TEE.pdf">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:>Week 4 – Review Session: Ultrasound Physics. 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

    For>Week 5 – Rheumatic Heart Disease, Mitral Stenosis://apil.ca/wp-content/uploads/2019/02/Vegas-2019-Mitral-Stenosis.pdf">Vegas – Rheumatic Heart Disease and Mitral Stenosis (PDF) (PPTX)

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

    B. Ansari)

    Part 1: Aortic Valve Stenosis

    Part 2: Hypertrophic Cardiomyopathy and LVOT Obstruction

    Part 2: Hypertrophic Cardiomyopathy and LVOT Obstruction60" height="315" frameborder="0" allowfullscreen="allowfullscreen">

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

    ol>
  • Bledsoe (2016) Evaluation of Aortic Insufficiency (from University of Utah Perioperative Echocardiography Education)
  • Week 8 – Intracardiac Masses & Devices

    Format: Live Prese>Week 8 – Intracardiac Masses & Devices.ca/wp-content/uploads/2019/03/Snyman-2019-Cardiac-Masses.pdf">Snyman – Cardiac Masses (PDF) (PPTX)

    Week 9 – Left Ventricle Assessment; Review session

    Format: Recorded>Week 9 – Left Ventricle Assessment; Review sessions 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 RepairWeek 10 – Mitral Valve Insufficiency and Mitral Valve Repair

    ref="https://echo.anesthesia.med.utah.edu/mitral-apparatus-anatomy/">Zimmrman, Anatomy of the Mitral Valve Apparatus (from University of Utah Perioperative Echocardiography Education)
  • Birgenheier, Mitral Regurgitation (2 parts) (from University of Utah Perioperative Echocardiography Education)
  • Week 11 – ACHD 1: Fontan Circulation

    Format: Live P>Week 11 – ACHD 1: Fontan Circulationtion

    Week 12 – Pericardium; Review Session

    Format>Week 12 – Pericardium; Review Session
    temasters.com">PTE Masters); Live Review Session (C. Hudson)

    Part 1: Physiology

    An excellent case presentation and discussion on the ph>Part 1: Physiologydisease and the difference between constriction by the pericardium vs. myocardial restriction. From University of Washington.

    Part 2: Echocardiographic Evaluation

    1. See Part 2: Echocardiographic EvaluationPericardial Disease” Parts 1-8

    Week 13 – ACHD 2: Unrestricted Shunts

    Format: Live Presentation (J. >Week 13 – ACHD 2: Unrestricted Shuntsrgery; Epiaortic Imaging

    Format: Live Presentation (C. Srinivas)

    1. Srinivas – TEE For Aortic Surgery (PDF)

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

    f 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. >Week 16 – Hemodynamic Calculationse.com/embed/rcJLaku_jZQ" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen">

    Week 17  – ACHD – Contotruncal Abnormalities

    Format: Live Pres>Week 17  – ACHD – Contotruncal Abnormalities Heart Failure: LVAD, ECLS, Transplant, Contrast echo

    Format: Live Presentation (A. Snyman)

    Week 19 – ACHD – Transposition of Great Arteries

    Format: Live Pr>Week 19 – ACHD – Transposition of Great ArteriesFormat: 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>Week 21 – Study Week

    ns-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 Pr>Week 23 – Equipment, Infection Control, and Safety-nocookie.com/embed/4K0-_CsUo0U" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen">

    Week 24 – Review

    Format: Live Review Session (J. Moreno)

    Week >Week 24 – Review

    n & Cardiomyopathies (except HOCM)

    Format: Live Review Session (A. Omran)

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

    Other Topics

    3D Echo

    Congenital Heart Disease

      Congenital Heart Diseasehref="https://linkinghub.elsevier.com/retrieve/pii/S0894731718304759">Puchalski MD et al. Guidelines for Performing a Comprehensive Transesophageal Echocardiographic. JASE. 2019 Feb;32(2):173–215.
    1. Simpson J et al. Three-dimensional Echocardiography in Congenital Heart Disease: An Expert Consensus Document from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. JASE. 2017 Jan;30(1):1–27.
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