Emory CT Anesthesiology Fellowship Echo Training
The Division of Cardiothoracic (CT)
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
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.