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18th Annual Echo Week
Learning Objectives
18th Annual ECHO WEEK
March 22-27, 2015 • Loews Atlanta Hotel • Atlanta, GA
LEARNING OBJECTIVES
SUNDAY
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
Sunday, March 22
PBLD: “The Surgeon Asks You…”
Moderator: Annmarie Thompson, Mark Taylor
7:00-8:00 pm
“The Surgeon Asks You…Should I be worried about SAM?” —Douglas Shook, Mark
Taylor
At the conclusion of this PBLD, the participant should be able to
1. Describe the mechanisms of mitral regurgitation in association with SAM
2. Describe the echocardiographic and surgical risk factors, which increase the likelihood to develop SAM
following a mitral valve repair
3. Discuss surgical and anesthetic management techniques to minimize the likelihood SAM after mitral valve
repair
4. Discuss surgical and anesthetic management techniques to consider if SAM occurs following a mitral
valve repair
“The Surgeon Asks You…How bad is the LV function?” —Edwin Avery, John Fox
At the conclusion of this PBLD, the participant should be able to
1. Describe systolic LV function using 2D ultrasound and tissue Doppler
2. Recognize the echocardiographic manifestations of regional LV systolic
dysfunction
3. Describe the hibernating myocardium and stunned myocardium in the setting of coronary artery
disease.
4. Discuss the utilization of dobutamine to help define revascularization plans in patients with segmental
wall motion abnormalities
“The Surgeon Asks You…Do I need to replace the aortic valve?” —Nikolaos Skubas,
Jonathan Leff
At the conclusion of this PBLD, the participant should be able to
1. Discuss the management of patients with moderate aortic stenosis in association with other cardiac
surgical procedures
2. Define the echocardiographic evidence suggesting replacement
3. Define low gradient aortic stenosis and discuss the differences between severe aortic stenosis vs.
pseudostenosis
4. Discuss the utilization of dobutamine to help evaluate low flow/low gradient aortic stenosis
5. Discuss current management guidelines regarding the echocardiographic evaluation and
management of aortic stenosis.
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March 22-27, 2015
Loews Atlanta Hotel | Atlanta, GA
18th Annual Echo Week
Learning Objectives
Monday, March 23
Image Creation and Views
Moderator: Douglas Shook
Ultrasound Physics: Breakfast with Edelman —Sidney Edelman
7:30–8:50 am
At the conclusion of this lecture, the participant should be able to
1. identify the principles and properties of a 2D ultrasound beam
2. describe the types, structure, and components of the ultrasound probes
3. explain ultrasound-imaging principles and the interaction of ultrasound with tissues
4. explain how an echo image is generated from a 2D ultrasound beam
8:50–9:10 am
You are the Artist: Optimizing the Image – Kathy Glas
At the conclusion of this lecture, the participant should be able to
1. describe probe manipulations necessary to optimize an image
2. explain the use of settings to optimize imaging
3. describe the optimal use of color-flow Doppler to recognize anatomic and pathologic findings
8:50–9:10 am
Principles of Hemodynamics – Nikolaos Skubas
At the conclusion of this lecture, the participant should be able to
1. identify the types of flow profiles
2. recognize the Doppler profile of normal and pathologic valves and vessels
3. comprehend how to use Doppler for hemodynamic calculations
9:10-9:30 am
Panel Discussion and Audience Q&A
The Views and Function
Moderator: Nikolaos Skubas
10:00–10:20 am
The Comprehensive Exam: When Time is Essential – Jack Shanewise
At the conclusion of this lecture, the participant should be able to
1. review the essential components of an abbreviated, focused TEE exam
2. develop a technique to evaluate for the most frequent cardiovascular emergencies
3. explore how pattern recognition assists during a brief TEE exam
10:20–10:40 am
LV – Assessment of Coronary Perfusion and Wall Motion – John Fox
At the conclusion of this lecture, the participant should be able to
1. review the echocardiographic views and match LV wall segments with coronary territories
2. quantify the normal and abnormal regional wall motion
3. recognize the difference between dysrhythmia and ischemia
10:40-11 am
LV – Assessment of Systolic Function – Mark Taylor
At the conclusion of this lecture, the participant should be able to
1. describe the normal LV anatomy and function using 2D ultrasound and Doppler
2. identify systolic LV pathology using 2D ultrasound and Doppler
3. recognize the echocardiographic manifestations of regional LV systolic dysfunction
11-11:20 am
Basic Concept of Diastolic Function – Annemarie Thompson
At the conclusion of this lecture, the participant should be able to
1. explore the importance of diastolic function assessment in the perioperative setting
2. define the relationship between pulmonary venous and transmitral flow parameters
2
March 22-27, 2015
Loews Atlanta Hotel | Atlanta, GA
18th Annual Echo Week
Learning Objectives
3. determine the degree of diastolic dysfunction using echocardiographic modalities
11:20-11:40 am
Evaluation of RV Function in Simple Steps – Sasha Shillcutt
At the conclusion of this lecture, the participant should be able to
1. explore the pertinent TEE views for the comprehensive assessment of RV function
2. review the qualitative assessment RV systolic function
3. quantify the normal and abnormal RV systolic function
11:40-12 pm
Panel Discussion and Audience Q&A
Aortic and Mitral Valve Structure and Function
Moderator: Katherine Grichnik
1–1:20 pm
Valve Anatomy and Imaging Views – Douglas Shook
At the conclusion of this lecture, the participant should be able to
1. choose the views used to image the mitral and aortic valves
2. describe the echocardiographic findings in normal valves
3. contrast the echocardiographic modes to examine the cardiac valves
1:20–1:40 pm
Mitral Regurgitation – Annette Vegas
At the conclusion of this lecture, the participant should be able to
1. review the anatomy of the normal mitral valve apparatus
2. describe the mechanisms and types of mitral regurgitation
3. recognize the 2D and Doppler findings in mitral regurgitation
4. assess and quantify mitral regurgitation
1:40–2 pm
Mitral Stenosis – Lori Heller
At the conclusion of this lecture, the participant should be able to
1. describe the mechanisms and causes of mitral stenosis
2. recognize the 2D and Doppler findings of mitral stenosis
3. assess and quantify mitral stenosis
2–2:20 pm
Aortic Regurgitation— Jonathan Leff
At the conclusion of this lecture, the participant should be able to
1. describe the mechanisms and causes of aortic regurgitation
2. recognize the 2D and Doppler findings of aortic regurgitation
3. assess and quantify aortic regurgitation.
2:20–2:40 pm
Aortic Stenosis – Roman Sniecinski
At the conclusion of this lecture, the participant should be able to
1. review the structural anatomy of the normal aortic valve
2. describe the mechanisms and causes of aortic stenosis
3. recognize the 2D and Doppler findings of aortic stenosis
4. assess and quantify aortic stenosis
2:40-3 pm
Panel Discussion and Audience Q&A
Right-Sided Valves and Great Vessels
Moderator: Lori Heller
3:30- 3:50 pm
Valve and Vessel Anatomy and Views – Meghann Fitzgerald
At the conclusion of this lecture, the participant should be able to
3
March 22-27, 2015
Loews Atlanta Hotel | Atlanta, GA
18th Annual Echo Week
Learning Objectives
1. choose the views used to image the tricuspid, pulmonic valves and great vessels
2. describe the normal echocardiographic findings
3. contrast the echocardiographic modes to examine the valves and vessels
3:50–4:10 pm
Tricuspid and Pulmonic Valves – Katherine Grichnik
At the conclusion of this lecture, the participant should be able to
1. understand the common mechanisms for tricuspid/pulmonic regurgitation and stenosis
2. describe the 2D and Doppler findings of tricuspid/pulmonic pathology
3. evaluate and quantify the severity of tricuspid/pulmonic regurgitation and stenosis
4:10–4:30 pm
Aortic Root and Great Vessels – Jack Shanewise
At the conclusion of this lecture, the participant should be able to
1. recognize the echocardiographic characteristics of aortic aneurysms and dissections
2. differentiate normal aortic anatomy from pathologic findings
3. compare the diagnostic utility of imaging modalities in the evaluation of aortic pathology
4. recognize the echocardiographic findings associated with pulmonary embolism
5. identify common echocardiographic findings associated with SVC/IVC pathology
4:30–4:50 pm
Epiaortic/Epicardial Imaging – Kathy Glas
At the conclusion of this lecture, the participant should be able to
1. understand the indications for surface imaging and the relevant imaging planes
2. describe the available windows for Doppler interrogation during epicardial imaging
3. explain how epiaortic and epicardial echocardiography may impact on surgical decision making
4:50-5:10 pm
Pericardial Disease – Edwin Avery
At the conclusion of this lecture, the participant should be able to
1. diagnose pericardial tamponade and pericardial constriction with 2D and Doppler
2. compare and contrast the findings of tamponade and constriction from myocardial disease
3. describe the echocardiographic effects of tamponade and constriction in the right vs left chambers
(ventricular interdependence).
5:10-5:30 pm
Panel Discussion and Audience Q&A
Physics and Hemodynamics
Moderator: Nikolaos Skubas
7:30–8:15 pm
Physics and Artifacts—Sidney Edelman & Nikolaos Skubas
At the conclusion of this lecture, the participant should be able to
1. describe the artifacts on the basis of 2D ultrasound principles
2. classify the anatomic pitfalls by location in the heart
3. differentiate pitfalls from true findings with manipulation of settings
8:15–9 pm
Hemodynamics Made Easy—Douglas Shook, Nikolaos Skubas
At the conclusion of this lecture, the participant should be able to
1. define the various 2D and Doppler ultrasound methods used for hemodynamic assessment
2. choose the appropriate Doppler modality for hemodynamic calculations
3. calculate intracardiac pressures using Doppler ultrasound
4. explain the use of M-mode Doppler for specific pathological assessments.
4
March 22-27, 2015
Loews Atlanta Hotel | Atlanta, GA
18th Annual Echo Week
Learning Objectives
Tuesday, March 24
Case-Based Small Group with Discussion
Moderator: Nikolaos Skubas
Seven 45-minute sessions
Rotation
1 to 7
2 to 1
3 to 2
4 to 3
5 to 4
6 to 5
7 to 1
Slot/Time
7:30–8:15 am
8:15–9 am
9:30–10:15 am
10:15–11 am
12:45–1:30 pm
1:30–2:15 pm
2:15–3 pm
Topic
Mitral Regurgitation
Mitral Stenosis
LV: Ischemia & Function
The Right Side
Aortic Stenosis
Aortic Regurgitation
Diastology
Speakers
Hartman
Heller
Taylor
Shillcutt
Sniecinski
Nyman
Thompson
Vegas
Avery
Fox
Fitzgerald
Ho
Leff
Burch
At the conclusion of these interactive lectures, the participant should be able to
1. review the normal and abnormal findings in cardiac disease
2. identify patterns of valvular pathology
3. explore an integrative approach during a comprehensive TEE exam
7:30–8:15 am
Small Group Session
8:15–9 am
Small
Group
Session
9:30–10:15am
Small
Group
Session
10:15–11 am
Small Group Session
Potpourri
Moderator: Douglas Shook
Simple Congenital Anomalies: ASD, VSDs, PFOs – Kathy Glas
11-11:20 am
At the conclusion of this lecture, the participant should be able to
1. review the normal echocardiographic characteristics of atrial and ventricular septa
2. identify the pathologic findings in atrial and ventricular septal defects
3. describe the echocardiographic steps for diagnosing a patent foramen ovale
11:20-11:40 am
Complex Congenital Anomalies – Thomas Burch
At the conclusion of this lecture, the participant should be able to
1. identify the cardiac situs with echocardiography
2. review the common complex cardiac anomalies
3. form a stepwise approach to diagnose the complex congenital anomalies
12:45–1:30 pm
Small Group Session
1:30–2:15 pm
Small Group Session
2:15–3 pm
Small Group Session
Potpourri
Moderator: Nikolaos Sukbas
3:40–4 pm
5
Cardiomyopathies— Andrew Maslow
March 22-27, 2015
Loews Atlanta Hotel | Atlanta, GA
18th Annual Echo Week
Learning Objectives
At the conclusion of this lecture, the participant should be able to
1. recall the ultrasound measurements of size, shape, and LV mass
2. recognize the 2D echocardiographic signature of hypertrophic, infiltrative, and dilated cardiomyopathy
3. describe the Doppler-based differential diagnosis of the cardiomyopathies
4. comprehend the use of echocardiography in ventricular pacing modalities.
4–4:20 pm
Prosthetic Valves— Charles Nyman
At the conclusion of this lecture, the participant should be able to
1. identify different types of prosthetic valves and their unique echocardiographic signature
2. describe the advantages and indications for each of the prosthetic valve options
3. identify the echocardiographic criteria for diagnosis of abnormal prosthetic valve function
4:20–4:40 pm
TEE Safety— Jack Shanewise
At the conclusion of this lecture, the participant should be able to
1. review the data related to complications of ultrasound and TEE
2. understand the anatomic and operator-dependent factors associated with TEE complications
3. classify the absolute and relative contraindications for TEE use and review alternative ultrasound imaging
modalities
4. create a structured plan for preventing, recognizing, documenting, and following up the TEE-related
complications
4:40–5 pm
Review of the Complete TEE Exam – Gregg Hartman
At the conclusion of this lecture, the participant should be able to
1. explain the technical aspects of probe insertion
2. relate the probe manipulation with the imaging plane
3. correlate the ASE/SCA views with normal cardiac anatomy
Who Wants to Be an Echo Millionaire?
7–9 pm
6
Andrew Maslow, Feroze Mahmood, Peter Panzica
March 22-27, 2015
Loews Atlanta Hotel | Atlanta, GA
18th Annual Echo Week
Learning Objectives
Wednesday, March 25
PBLD: “The Surgeon Asks You…”
Moderator: Annmarie Thompson, Mark Taylor
6:30-7:30 am
“The Surgeon Asks You…Should I be worried about SAM?” —Lori Heller, Jack
Shanewise, Mark Taylor
At the conclusion of this PBLD, the participant should be able to
5. Describe the mechanisms of mitral regurgitation in association with SAM
6. Describe the echocardiographic and surgical risk factors, which increase the likelihood to develop SAM
following a mitral valve repair
7. Discuss surgical and anesthetic management techniques to minimize the likelihood SAM after mitral valve
repair
8. Discuss surgical and anesthetic management techniques to consider if SAM occurs following a mitral
valve repair
“The Surgeon Asks You…How bad is the LV function?” —Edwin Avery, John Fox
At the conclusion of this PBLD, the participant should be able to
5. Describe systolic LV function using 2D ultrasound and tissue Doppler
6. Recognize the echocardiographic manifestations of regional LV systolic
dysfunction
7. Describe the hibernating myocardium and stunned myocardium in the setting of coronary artery
disease.
8. Discuss the utilization of dobutamine to help define revascularization plans in patients with segmental
wall motion abnormalities
“The Surgeon Asks You…Do I need to replace the aortic valve?” —Thomas Burch,
Jonathan Leff
At the conclusion of this PBLD, the participant should be able to
6. Discuss the management of patients with moderate aortic stenosis in association with other cardiac
surgical procedures
7. Define the echocardiographic evidence suggesting replacement
8. Define low gradient aortic stenosis and discuss the differences between severe aortic stenosis vs.
pseudostenosis
9. Discuss the utilization of dobutamine to help evaluate low flow/low gradient aortic stenosis
10. Discuss current management guidelines regarding the echocardiographic evaluation and
management of aortic stenosis.
You Are the Surgeon: Porcine Heart Wet Lab: Dissection With
Echocardiographic and Surgical Correlation
Moderator: Madhav Swaminathan
7:45–8:15 am
Overview of Cardiac Anatomy—Douglas Shook
At the conclusion of this lecture, the participant should be able to
1. Explain the gross external anatomy of the heart
2. Recite the external landmarks for cardiac anatomy
3. Describe the anatomic features and nomenclature of individual chambers
4. List the location of developmental anatomic remnants
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March 22-27, 2015
Loews Atlanta Hotel | Atlanta, GA
18th Annual Echo Week
Learning Objectives
5. Name the location, orientation and underlying structure of different cardiac valves
6. List the anatomic relationship of the coronary circulation and conduction system to the cardiac valve
structure
8:15–11 am
Porcine Heart Dissection—Douglas Shook, Matt Maxwell
This is a hands-on dissection lab in which participants have the opportunity to watch a prosection of the heart and
then perform a similar dissection on their own. Correlations of cardiac anatomy, valvular three-dimensional
orientation, external and internal anatomical and surgical landmarks, and their TEE scan plane correlates will be
illustrated. In addition, surgical decision-making will be incorporated throughout the learning process.
At the conclusion of this lab, the participant should be able to:
1. Identify surface porcine heart anatomy
2. Dissect a porcine heart
3. Identify internal porcine heart anatomy
4. Explain the correlation of anatomical to echocardiographic sections
5. Describe the 3-dimensional aspects of the heart and great vessels
6. Correlate probe scan planes to anatomical windows into the heart
7. Incoporate surgical decision-making in demonstrated dissection scenarios
Fundamentals of 3D Echocardiography and Tissue
Doppler/Strain/Speckle
This program will focus on the fundamental principles of 3D echocardiography, tissue Doppler, strain and speckle
imaging. The program will include didactics and interactive case discussions to review the role of new and
innovative imaging in perioperative decision-making. Part I of the afternoon is a large lecture format. During Part
II the audience will be divided into six subgroups to view and discuss 3D acquisition, 3D measurement, 3D
evaluation of mitral valve, 3D evaluation of the aortic valve, tissue Doppler/strain/speckle and interactive case
discussions. This framework will allow opportunities for group participation and interaction with faculty facilitators.
Upon completion of this course the participant will have a better understanding of how to incorporate 3D
echocardiography and tissue Doppler/strain/speckle into their perioperative practice.
After attending the 3D echocardiography, tissue Doppler, strain, and speckle imaging educational activity the
participant should be able to:
1. Recognize and acquire routine 3D echocardiographic images;
2. Perform basic manipulation of 3D datasets
3. Recognize and acquire images for tissue Doppler analysis
4. Describe strain and speckle imaging
5. Incorporate these modalities in clinical decision-making
Part I: Introduction-Large Group Format
Moderator: Bruce Bollen
12:30–12:50 pm
3D Echo: How do I get started? Madhav Swaminathan
At the conclusion of this lecture, the participant should be able to:
1. Explain the different 3D imaging modalities
2. Describe the components of a standard 3D exam
3. Verbalize the appropriate sequence for a standard 3D exam
4. Understand image acquisition pitfalls
12:50–1:10 pm
Where 3D Makes a Difference - Douglas Shook
At the conclusion of this lecture, the participant should be able to:
1. Recite the advantages, disadvantages and limitations of 3D echocardiography
2. Discuss the potential advantages of 3D perioperative imaging
3. Discuss the potential disadvantages of 3D perioperative imaging
4. Recite specific examples where 3D imaging helps with decision-making
1:10–1:30 pm
Tissue Doppler: what is it and how do I use it? - Nikolaos Skubas
At the conclusion of this lecture, the participant should be able to:
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March 22-27, 2015
Loews Atlanta Hotel | Atlanta, GA
18th Annual Echo Week
Learning Objectives
1. State why and how Tissue Doppler imaging is used perioperatively
2. Understand the terminology used in tissue Doppler
3. Apply tissue Doppler to clinical scenarios
1:30–1:50 pm
Cardiac Kinetics: Taking the stress out of strain - Jonathan Ho
At the conclusion of this lecture, the participant should be able to:
1. Describe strain, how is it obtained, measured and quantified
2. Differentiate between longitudinal, radial, and circumferential strain.
3. Apply strain to clinical scenarios
Part II: Acquisition and Application—Small Group Interactive Sessions
Moderators: Bruce Bollen, Douglas Shook
2:30–3:15 pm
Session 1
3:15–4 pm
Session 2
4–4:45 pm
Session 3
5:15–6 pm
Session 4
6–6:45 pm
Session 5
6:45–7:30 pm
Session 6
Concomitant sessions the audience will rotate through (six listed):
3D Acquisition: How do I get the best image? —Madhav Swaminathan, Gregg Hartmann
At the conclusion of this lecture, the participant should be able to:
1. Understand the physics of 3D echocardiography
2. Compare and contrast the different acquisition modalities
3. Discuss knobology for imaging optimization
3D Measurements: Making it simple —Stanton Shernan, Bruce Bollen
At the conclusion of this lecture, the participant should be able to:
1. Use multiplanar reconstruction (MPR) to analyze 3D datasets
2. Understand how to make basic measurements using MPRs
3. Apply mulitplanar reconstruction to clinical-decision making
3D Mitral Valve: Changing how you look at the mitral valve —Feroze Mahmood,
Annemarie Thompson
At the conclusion of this lecture, the participant should be able to
1. discuss 3D imaging modalities specific to the mitral valve
2. discuss methods to optimize 3D imaging of the mitral valve
3. list important 3D measurements specific to the mitral valve
4. Understand how a 3D dataset and measurements can assist in decision-making
3D Aortic Valve: Measurements from the LVOT to Root—Annette Vegas, Kent Rehfeldt
At the conclusion of this lecture, the participant should be able to:
1. Discuss 3D imaging modalities specific to the aortic valve
2. Discuss methods to optimize 3D imaging of the aortic valve
3. List important 3D measurement specific to the LVOT, aortic valve and root
4. Understand how a 3D dataset and measurements can assist in decision-making
Tissue Doppler/Strain/Speckle: Take home points for daily practice—Nikolaos Skubas,
Jonathan Ho
At the conclusion of this lecture, the participant should be able to:
9
March 22-27, 2015
Loews Atlanta Hotel | Atlanta, GA
18th Annual Echo Week
Learning Objectives
1. Discuss Tissue Doppler/Strain/Speckle imaging modalities
2. Discuss methods to optimize image acquisition and application
3. Apply Tissue Doppler/Strain/Speckle imaging to a case
Practical cases where advanced imaging made a difference—Douglas Shook, Charles
Nyman
At the conclusion of this lecture, the participant should be able to:
1. Understand how 3D makes you better at 2D
2. Apply 3D imaging to cases seen in the operating room
3. Apply 3D imaging to cases seen in the catheterization lab
10
March 22-27, 2015
Loews Atlanta Hotel | Atlanta, GA
18th Annual Echo Week
Learning Objectives
Thursday, March 26
Mitral Valve Dilemmas with Case Discussions
Moderator: Bruce Bollen
This session will focus on the perioperative evaluation of the patient presenting with mitral valve disease.
Lectures will focus on the evaluation of the patient’s clinical presentation, risk factors, and appropriate evaluation
including echocardiography in determining perioperative management and decision making. The concept of the
Valve Heart Team, incorporating 2014 AHA.ACC Valvular Heart Disease Guidelines, European Guidelines, and
American Society of Echocardiography Guidelines will be discussed.
7:30–7:50 am
How do I determine the type of MR? Is it important? — Gregg
Hartman
At the conclusion of this lecture, the participant should be able to:
1. Describe the differences between degenerative (AHA/ACC Type I) MR vs Functional (AHA/ACC Type II)
MR
2. Review the echo approaches to define leaflet anatomy
3. Discuss the factors that determine treatment approaches based on type of MR
.
7:50–8:10
Functional MR in CABG: How do I measure severity?—Stanton
Shernan
At the conclusion of this lecture, the participant should be able to:
1. Review the clinical features of functional MR (AHA/ACC Type II) in coronary artery disease.
2. Describe the echocardiographic approach to define MR mechanism, including leaflet anatomy, leaflet
tethering and LV function
3. Discuss LV function and volume changes in ischemic MR
4. Quantify functional (Type II ) MR using intraoperative TEE
8:10–8:30 am
Choosing the right repair for MR: what do I need to make the
decisions? — Daniel Drake
At the conclusion of this lecture, the participant should be able to:
1. Review the anatomical features of mitral valve lesions most suitable for repair
2. Delineate the echocardiographic measurements that are necessary to determine type of repair
3. Discuss surgical approaches to minimizing complications of mitral repair
8:30–8:50 am
MR after repair: How to evaluate it and can it be fixed? —Christopher
Troianos
At the conclusion of this lecture, the participant should be able to:
1. Describe the importance of understanding repair technique
2. Discuss the risk factors for persistent MR after repair and its implications
3. Review the echocardiographic features of post-repair MR
4. Discuss methods of assessment of severity of post-repair MR
8:50–9:10 am
Imaging Essentials after mitral valve replacement: What is
important to know? —Donald Oxorn
At the conclusion of this lecture, the participant should be able to:
1. Delineate the approach to imaging newly seated prosthetic valves in the mitral position using TEE
2. Discuss the echocardiographic features of a normally functioning prosthetic valve after MVR
3. Describe the echocardiographic features of post MVR complications
11
March 22-27, 2015
Loews Atlanta Hotel | Atlanta, GA
18th Annual Echo Week
Learning Objectives
9:10–9:30 am
Mitral Valve Dilemmas Panel Discussion
At the conclusion of this discussion, the participant should be able to:
Case presentation and discussion of types of MR and their TEE features
1. Discuss echocardiographic features that assist with surgical and clinical decision-making
2. Describe the importance of interaction and discussion of echocardiographic features and surgical anatomy
between echocardiographer and surgeon
Aortic Valve Dilemmas with Case Discussion
Moderator: Christopher Troianos
10:00-10:20am
Low-Gradient AS: Valve Area or Gradient? – Feroze Mahmood
At the conclusion of this lecture, the participant should be able to:
1. Describe the phenomenon of low gradient AS
2. Review the echocardiographic approaches to differentiate between low-gradient severe AS and true severe
AS
3. Discuss the value of echocardiographic measurements in surgical and clinical decision-making in low
gradient AS
10:20-10:40am
Moderate AS in CABG Surgery: When to Operate and What
Measurements Are Important – Vinod Thourani
At the conclusion of this lecture, the participant should be able to:
1. Discuss the importance/incidence of aortic stenosis in patients presenting for CABG surgery
2. Review the indications for concurrent aortic valve surgery in patients undergoing CABG
3. Describe the echocardiographic measurements that are critical in surgical decision-making for concurrent
AVR in moderate AS in patients undergoing CABG.
10:40-11:00am
Case: When Transcatheter Aortic Valve Replacement (TAVR) Goes
Well—What Measurements Are Important for Success? – Roman
Sniecinski
At the conclusion of this lecture, the participant should be able to:
1. Discuss the echocardiographic approach for ensuring successful deployment of a prosthesis during TAVR
2. Describe the echocardiographic features of a successfully deployed TAVR prosthesis
3. Review the pre and post-TAVR deployment echo imaging objectives
11:00-11:20am
Case: When TAVR Goes Bad—How Does Imaging Help? – Alina
Nicoara
At the conclusion of this lecture, the participant should be able to:
1. Discuss the risk factors for complications after TAVR
2. Describe the echocardiographic approaches to ensure timely detection of complications
3. Review the echocardiographic determination of severity of paravalvular and intravalvular regurgitation
11:20-11:40am
Post Aortic Valve Replacement (AVR): Are Gradients Important?
What Is? – Kent Rehfeldt
At the conclusion of this lecture, the participant should be able to:
1. Describe the imaging approach for evaluation of a newly seated prosthesis in the aortic position
2. Define the echocardiographic features of prosthetic stenosis after AVR
3. Review the importance and etiology of high transvalvular gradients after AVR
11:40am-12:00pm
Panel Discussion and Audience Q & A
At the conclusion of this lecture, the participant should be able to:
12
March 22-27, 2015
Loews Atlanta Hotel | Atlanta, GA
18th Annual Echo Week
Learning Objectives
1. Review the echocardiographic approach to evaluation of prosthetic valves implanted in the aortic position
by surgical and transcatheter techniques
2. Discuss the techniques to detect complications after AVR
3. Describe the importance of interaction and discussion of echocardiographic features and clinical
presentation between echocardiographer and surgeon
Cardiomyopathy: Success with Failure
Moderator: Kent Rehfeldt
1:00-1:20pm
Imaging Essentials before Ventricular Assist Device (VAD) Placement:
What Does the Surgeon Need to Know? – Michele Sumler
At the conclusion of this lecture, the participant should be able to:
1. Identify the essential components of an intraoperative TEE examination in a patient who presents for VAD
placement.
2. Review the importance of detecting intra-cardiac shunting in patients undergoing VAD placement.
3. Discuss the clinical significance of valvular regurgitation in patients undergoing VAD placement.
1:20-1:40pm
Diastolic Heart Failure: Do Measurements Work? – Alina Nicoara
At the conclusion of this lecture, the participant should be able to:
1. Review the distinction between diastolic dysfunction and failure.
2. Identify techniques to assess diastolic dysfunction by TEE.
3. Discuss algorithms for grading diastolic dysfunction and their limitations.
1:40-2:00pm
When Right Goes Wrong: How to Identify Right Heart Failure – Donald
Oxorn
At the conclusion of this lecture, the participant should be able to:
1. Review the echocardiographic features of right heart failure.
2. Describe the qualitative and quantitative techniques used to assess right ventricular dysfunction.
3. Discuss how intraoperative TEE can be used to assess the response to therapy for right heart failure
2:00-2:20pm
Using Transesophageal Echocardiography (TEE) to Detect VAD
Complications - Michele Sumler
At the conclusion of this lecture, the participant should be able to:
1. Review the echocardiographic assessment of patients following VAD placement.
2. Describe how echocardiography can assist in the management of hemodynamic compromise in the VAD
patient.
3. Discuss the use of two-dimensional and Doppler echocardiography in differentiating normal from abnormal
function of a newly implanted VAD.
2:20-2:40pm
Using TEE in Extracorporeal Membrane Oxygenation (ECMO)
Deployment: Problems with Venovenous (VV) and Venoarterial (VA)
ECMO – Robert Savage
At the conclusion of this lecture, the participant should be able to:
1. Review the various cannulation strategies for venovenous and venoarterial ECMO.
2. Discuss how echocardiography can assist in identifying complications associated with ECMO deployment.
3. Describe how TEE can be used when weaning a patient from ECMO.
13
March 22-27, 2015
Loews Atlanta Hotel | Atlanta, GA
18th Annual Echo Week
Learning Objectives
2:40-3:00pm
Panel Discussion and Audience Q&A
At the conclusion of this lecture, the participant should be able to:
1. Review the approach to the intraoperative echocardiographic assessment of patients with heart failure
2. Discuss various echocardiographic modalities that are used in the assessment of heart failure
3. Identify advantages and limitations to the intraoperative echocardiographic assessment of heart failure
Complex Imaging Dilemmas
Moderator: Alina Nicoara
3:30-3:50pm
Aortic Root Replacement: Should the valve be fixed or spared? – Kent
Rehfeldt
At the conclusion of this lecture, the participant should be able to:
1. Describe echocardiographic features of repairable and unrepairable aortic valve pathology
2. Delineate various surgical approaches for aortic valve repair with aortic root replacement
3. Describe post-procedure echocardiographic analysis of the repaired aortic valve
3:50-4:10pm
Tricuspid Valve in Left Heart Surgery: When to fix? – Feroze Mahmood
At the conclusion of this lecture, the participant should be able to:
1. Describe the impact and progression of tricuspid regurgitation in left heart disease
2. Describe echocardiographic evaluation of secondary tricuspid regurgitation and of the tricuspid annulus
3. Delineate the steps in the surgical decision to address secondary tricuspid regurgitation
4:10-4:30pm
MR in AVR: When to fix? – Stanton Shernan
At the conclusion of this lecture, the participant should be able to:
1. Describe the impact and progression of untreated mitral regurgitation after aortic valve replacement
2. Identify the mechanisms of mitral regurgitation in patients with aortic valve disease
3. Describe salient echocardiographic features used in surgical decision-making.
4:30-4:50pm
TEE in
the Unstable Postoperative Patient: When do we go back
to the operating room? – Christopher Troianos
At the conclusion of this lecture, the participant should be able to:
1. Define the role of TEE in the integrated approach to evaluating hemodynamic instability in the
postoperative patient
2. Describe clinical situations in which information provided by TEE can be useful in surgical decision-making
3. Review the echocardiographic approach to evaluation of hemodynamic instability in the postoperative
patient
4:50-5:00pm
Panel Discussion and Audience Q&A
3D Imaging and Cardiac Kinetics Laptop Computer Workshop
Moderators: Madhav Swaminathan, Douglas Shook
This program will focus on the advance application of 3D echocardiography, tissue Doppler, strain and speckle
imaging. The program will include didactics and hands-on teaching of advanced dataset image analysis in clinical
scenarios. The teaching groups will be smaller to allow more interactive discussion. Upon completion of this
course, the participant will have a better understanding of how to use image analysis software and apply the
information to clinical decision-making.
After attending this workshop the participant should be able to:
1. Utilize image analysis software to assist with clinical decision-making
2. Incorporate these modalities into their clinical practice
14
March 22-27, 2015
Loews Atlanta Hotel | Atlanta, GA
18th Annual Echo Week
Learning Objectives
6:30 -7:30 pm Session I
7:30 - 8:30 pm Session II
8:30 - 9:30 pm Session III
Concomitant sessions the participants will rotate through (three listed):
Mitral valve analysis - Bruce Bollen; Stanton Shernan
At the conclusion of this hands-on session, the participant should be able to:
1. Demonstrate the process to analyze a 3D datasets for MV assessment and decision-making
2. Recognize normal and abnormal MV anatomy in 3D echocardiography
3. Hands-on manipulate multiplanar reconstructions of 3D datasets
3D MV Cases and AV Cases - Charles Nyman, Kent Rehfeldt
At the conclusion of this hands-on session, the participant should be able to:
1. Demonstrate the process to analyze 3D datasets for AV assessment and decision-making
2. Recognize normal and abnormal AV anatomy in 3D echocardiography
3. Hands-on manipulate multiplanar reconstructions of 3D datasets
Left ventricular function - Alina Nicoara; Nikolaos Skubas
At the conclusion of this hands-on session, the participant should be able to:
1. Verbalize the process for performing Tissue Doppler Imaging
2. State the process for performing Strain assessment
3. State the process to accomplish Speckle assessment
4. Hands-on manipulate datasets and apply the information to clinical decision-making
15
March 22-27, 2015
Loews Atlanta Hotel | Atlanta, GA
18th Annual Echo Week
Learning Objectives
Friday, March 27
Training and (Re)Certification: Keeping Up to Date
Moderators: Madhav Swaminathan
7:30-7:50am
Case Studies: What Is Expected From an Echocardiographer With
Basic Certification? – Robert Savage
At the conclusion of this lecture, the participant should be able to:
1. Review the essential concept of a ‘Basic Perioperative TEE’ exam
2. Discuss the scope of practice that defines ‘Basic Perioperative TEE’
3. Describe examples of cases which an echocardiographer with basic TEE certification should be able to
cover
7:50-8:10am
Case Studies: What Is Expected From an Echocardiographer With
Advanced Certification? – Donald Oxorn
At the conclusion of this lecture, the participant should be able to:
1. Review the essential concept of an ‘Advanced or Comprehensive Perioperative TEE’ exam
2. Discuss the scope of practice that defines ‘Advanced Perioperative TEE’
3. Describe examples of cases which an echocardiographer with advanced TEE certification should be
able to cover
8:10-8:30am
Recertification: How Do I Keep My Skills and Knowledge Current? –
Alina Nicoara
At the conclusion of this lecture, the participant should be able to:
1. Review the essential concept of recertification in perioperative TEE
2. Describe the process of recertification in perioperative TEE
3. Discuss options available to maintain cognitive and technical skills in TEE
8:30-8:50am
Perioperative Echo Training: How to Get It Done – Christopher
Troianos
At the conclusion of this lecture, the participant should be able to:
1. Review requirements for anesthesiologists in various settings to for achieving cognitive and technical
skill in perioperative TEE
2. Discuss options available for anesthesiologists in various settings to obtain training in perioperative
TEE
3. Describe possible training needs in the coming future for perioperative echo training.
8:50-9:10am
Perioperative Echo Certification: What You Need to Know – Stanton
Shernan
At the conclusion of this lecture, the participant should be able to:
1. Discuss the rationale for certification in perioperative echo
2. Describe the requirements for certification in ‘Basic Perioperative TEE’
3. Describe the requirements for certification in ‘Advanced Perioperative TEE’
9:10-9:30am
Panel Discussion and Audience Q & A
“Test Your Self” – A Comprehensive Review of Echo Week
Moderators: Feroze Mahmood, Peter Panzica
At the conclusion of this lecture, the participant should be able to:
1. Discuss the fundamental concepts of ultrasound, including two-dimensional image creation, Doppler,
16
March 22-27, 2015
Loews Atlanta Hotel | Atlanta, GA
18th Annual Echo Week
Learning Objectives
color flow, and their application in perioperative transesophageal echocardiography
2. Describe the echocardiographic techniques used to evaluate valvular and ventricular structure and
function
3. Delineate the basic techniques of using three-dimensional echo to optimize spatial recognition of valve
pathology.
4. Review the use of echocardiography to assist with clinical decision making in cardiac surgery
17
March 22-27, 2015
Loews Atlanta Hotel | Atlanta, GA