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Canadian guidelines for training in adult perioperative transesophageal echocardiography: Recommendations of the Cardiovascular Section of the Canadian Anesthesiologists’ Society and the Canadian Society of Echocardiography

[Lignes directrices canadiennes pour la formation en echocardiography transæsophagienne chez l’adulte Recommandations de la Section cardiovasculaire de la Société canadienne des anesthésiologistes et de la Société canadienne d’échocardiographie]

¹ Associate Professor, Department of Anesthesia, Director of Cardiac Anesthesia, SMBD Jewish General Hospital, McGill University, Montreal, PQ
² Assistant Professor, Department of Anesthesia and Surgery, Director of Perioperative Echocardiography and, Cardiac Anesthesiology, Kingston General Hospital, Queen’s University, Kingston, ON
³ Assistant Professor, Department of Anesthesia and Critical Care Medicine, Ottawa Heart Institute, University of Ottawa, ON
⁴ Associate Professor, Departments of Anesthesia and Medicine, Medical Director, Cardiac Anesthesia, St. Boniface General Hospital, University of Manitoba, Winnipeg, MB
⁵ Clinical Associate Professor, Department of Anesthesiology, Department of Medicine, Critical Care Division, Montreal Heart Institute, University of Montreal, Montreal, PQ
⁶ Department of Anesthesia, Quebec Heart Institute / Laval Hospital, Laval University, Quebec City, PQ.
⁷ Clinical Associate Professor, Department of Anesthesia, Foothills Medical Centre, University of Calgary, AB
⁸ Assistant Professor, Department of Anesthesia, McMaster University, Hamilton, ON
⁹ Assistant Professor, Department of Anesthesia, Director, Perioperative TEE Service, Queen Elizabeth II Health Sciences Center, Capital Health, Dalhousie University, Halifax, Nova Scotia
¹⁰ Clinical Assistant Professor, Department of Anesthesia, Anesthesia Head of Intra-operative TEE, Vancouver General Hospital, University of BC, Vancouver, BC
¹¹ Associate Professor, Department of Anesthesia, Clinical Director Cardiac Anesthesia, Medical Director Cardiovascular Surgery, Business Unit, Toronto General Hospital, University of Toronto, Toronto, ON
¹² Director of Noninvasive Cardiology, SMBD Jewish General Hospital, Associate Professor of Medicine, McGill University, Montreal, PQ
¹³ Department of Medicine, Division of Cardiology, St. Paul’s Hospital and Providence Health Care, University of British Columbia, Vancouver, BC
¹⁴ Professor of Medicine, Director of Echocardiography Laboratory, Program Medical Director (medicine), Kingston General Hospital, Queen’s University, Kingston, ON
¹⁵ Professor, Departments of Anesthesia and Surgery, University of Manitoba and, Health Sciences Centre, Winnipeg, MB

Address correspondence to: Dr. François Béïque, SMBD Jewish General Hospital, 3755 chemin de la Côte Ste-Catherine, Montreal, Quebec H3T 1E2, Canada. Phone: 514-340-8222, ext 5701; Fax: 514-340-8108; E-mail: fbeique{at}ana.jgh.mcgill.ca

Purpose: To establish Canadian guidelines for training in adult perioperative transesophageal echocardiography (TEE).

Methods: Guidelines were established by the Canadian Perioperative Echocardiography Group with the support of the cardiovascular section of the Canadian Anesthesiologists’ Society (CAS) in conjunction with the Canadian Society of Echocardiography.

Guidelines for training in echocardiography by the American Society of Echocardiography, the American College of Cardiology and the Society of Cardiovascular Anesthesiologists were reviewed, modified and expanded to produce the 2003 Quebec expert consensus for training in perioperative echocardiography. The Quebec expert consensus and the 2005 Guidelines for the provision of echocardiography in Canada formed the basis of the Canadian training guidelines in adult perioperative TEE.

Results: Basic, advanced and director levels of expertise were identified. The total number of echocardiographic examinations to achieve each level of expertise remains unchanged from the 2002 American Society of Echocardiography-Society of Cardiovascular Anesthesiologists guidelines. The increased proportion of examinations personally performed at basic and advanced levels, and the level of autonomy at the basic level suggested by the Quebec expert consensus are retained. These examinations can be performed in a perioperative setting and are not limited to intraoperative TEE. Training "on the job", the role of the perioperative transesophageal echocardiography examination, requirements for maintenance of competence, and duration of training are also discussed for each level of training. The components of a TEE report and comprehensive TEE examination are also outlined.

Conclusion: The Canadian guidelines for training in adult perioperative TEE reflect the unique Canadian practice profile in perioperative TEE and address the training requirements to obtain expertise in this field.

Related articles in CJA:

Progress through cooperation: securing a sound training pathway for perioperative transesophageal echocardiography/Le progrès par la coopération : concrétiser l’accès à une formation solide sur l’échocardiographie transsophagienne périopératoire

Barry A. Finegan
CJA 2006 53: 969-972. [Full Text]  

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