GOALS AND OBJECTIVES FOR  TRANSESOPHAGEAL  ECHOCARDIOGRAPHY  ELECTIVE

 

Rama S. Kulkarni, MD

 

Competency:  Patient care skills and Medical Knowledge

 

·        Understand physical principles of ultrasound technology and their intraoperative application

o       Understand the basic principles of 2D echo, spectral and color Doppler echocardiography

o       Learn to conduct basic TEE examination, recognize basic cardiac anatomy, and evaluate basic right and left ventricular function and cardiac valves

 

·        Understand left ventricular (LV) segmental wall motion analysis and its application in understanding normal and abnormal coronary anatomy

o       Myocardial LV segmental description and analysis

o       LV coronary blood flow and representative segments

o       Qualitative and quantitative assessment LV systolic function and detection of myocardial ischemia

 

·        Improve understanding of cardiovascular physiology by utilizing vital  parameters provided by TEE and its application in optimizing cardiac function  and vital organ perfusion.

o       LV volume assessment

o       LV ejection fraction measurement

o       Understanding of basic diastolic function

o       Use of TEE in determining etiology and extent of diastolic dysfunction

 

·        Be able to discuss how conventional hemodynamic monitoring techniques such as the pulmonary artery (PA) catheter compare to TEE.  Pros and cons of each:

o       Be able to discuss challenges faced in applying Lt ventricular pressure parameters provided by PA catheter monitoring in estimating  left  ventricular filling in patients with hypertensive and valvular heart disease with hypertrophied or dilated left ventricle

o       Application of knowledge gained from TEE training in better understanding and decision making process of  critically ill patients in the surgical intensive care unit setting post-operatively.

 

·        Ultrasound and vascular cannulation

o       Understand the rationale for the use of ultrasound technology to guide central venous catheter placement. Become familiar with views for vascular cannulation.