Perioperative Hemodynamic Echocardiography

The aim of the program is to produce qualified echocardiographers with a main interest in utilizing echocardiography in non-cardiac surgery for optimal patient management with the following objectives:

• Acquire cognitive and technical skills in advanced-level perioperative transesophageal echocardiography(TEE) and transthoracic echocardiography (TTE).
• Develop proficiency in performing qualitative echocardiographic assessment of the hemodynamics.
• Acquire specialized expertise in the performance and interpretation of echocardiographic findings.
• Develop expertise in mastering hemodynamic management in high risk patients and in patients presenting for high risk surgery
• Understand the indications, contraindications, clinical applications and quality assurance of the perioperative hemodynamic echocardiography.
• Ability to perform quantitative echocardiographic exams at different settings (pre-op, intra-op and post-op) with the specific goal of attaining the National Board of Echocardiography's Certification in Perioperative echocardiography at completion of fellowship training.
• Provide leadership in perioperative echocardiography.

There are periodic formal evaluations of Fellow's progress at the end of each rotation. Each fellow keeps a log of all cases performed and reviewed during his/her training to assess the Fellow's exposure and knowledge. The case numbers is used to obtain the NBE Certification. The fellow is expected to be actively involved in a research project with national presentation at the Canadian Society of Anesthesiology Annual meeting.

The Fellowship is of a 12-month duration, which allows enough exposure time to a wide variety of cases. The Fellow will be based at one of The Ottawa Hospital campuses. While the majority of the fellowship time will be spent at the main operating rooms, the Fellow will be assigned for one block to perform transthoracic echocardiography at the pre-anesthetic unit (PAU).

A total of three days per week will be considered as echo days while two days per week the Fellow is expected to work independently in the operating rooms.

Further details about the echo rotation will be provided to the Fellow during the interview.

The Fellow is expected to be actively involved in a research project with an aim to present the work at the Canadian Society of Anesthesiology’s annual meeting.

A series of echo lectures and discussions will be conducted on regular basis and will focus on:

• Physics and basics of the ultrasounds
• Hemodynamics (systolic and diastolic function)
• Valve lesions and impact on hemodynamics
• Cardiac hemodynamic measurement and Calculations

In addition, there are biweekly echo rounds presented by the echo Fellows.

The University of Ottawa Skills and Simulation Centre has an echo simulator with the ability to perform both TTE and TEE study. Echo probe with an adjustable scan plane can produce an echo view that is demonstrated in real time. Allocation of time for the Fellow to ensure enough exposure to simulator will be addressed. Full range of normal views is obtainable by the echo simulator, in addition to some pathology and clinical scenarios. Emerging data shows that the echo simulator is a very useful teaching tool for beginners.