Emory CT Anesthesiology Fellowship Echo Training
The Division of Cardiothoracic (CT)
Anesthesiology provides
an active and valuable intraoperative
echocardiography experience for its fellows.
At Emory University Hospital (EUH),
4 echo machines (Hewlett-Packard & Acuson)
and 6 multiplane TEE probes are
dedicated solely to use in 4 CT operating roonts, and
perioperative ECHO studies are perforrmed
in 80% of all cardiac surgery cases; over
l 200 this year.
The director, Jack Shanewise is
a testamur of the ASEeXAM and a nlember of the
board of directors of ASEeXAM, Inc.,
as well as a fi,unding nlember of the SCA Task
Force for Certification in Perioperative
TEE. At Crawford Long Hospital (CLH) 2 echo
machines and 3 TEE probes
are dedicated to OR use and over 400 exanls a year are
perfbmled. The director at
CLH, Dr. Scott Sadel, trained in echocardiography at Emoly
with Dr. Randy Martin. Most CT anesthesiology
faculty have had fomnal training in
echocardiography as well. Many of
the VA Hospital cardiac surgery patients have
intraoperative ECHO studies which
provide additional experience for the fellows.
The fellows' echo experience is
divided into 3 parts. In the first 6 months of the year,
each fellow spends 3 weeks on the
CT anesthesiology ECHO sewice with the goa1 of
leaming to perform a complete, comprehensive
TEE exam. This is accomplished by
wokiting one-on-one with the CT
anesthesiology attending assigned each day to
perform ECHO sftldies in the OR.
Patients get three exams: before CPB, after CPB,
and after chest closure, so there
is ample opportunity to develop and practice the necessary
skills; All ECHO studies are videotaped
and subsequently read by Drs. Sadel or
Shanewise. The fellow assigned to
ECHO participates in the reading which affords
another oppotunity for teaching
and develops the fellow's knowledge of normal and
pathologic ECHO findings and provides
feedback on the fellow's skill as an
echocardiographer. After this initial
introduction, the fellow expands experience and
klowledge tluroughout the year by
participating in cases involving in:raoperative ECHO.
Finally, each fellow spends another
3 weeks on the intraoperative ECHO service in the
latter half of the yearproviding
another intense, nlll.time experience of performing and
reading echocardiograms.
An intraoperative ECHO conference
is held at EUH 3 Wednesday momings each
month; see attached lecture schedule.
From July through December this consists of a
series of didactic presentations
covering the fundamentals of echocardiography. During
the remainder of the year, interesting
cases are reviewed and discussed. Thus, CT
anesthesiology fellows are exposed
to an intense training profound and vast experience in
echocardiography. The total number
of ECHO studies by each fellow easily exceeds that
which would be achieved in a 3month
rotation at nlost other institutions.