Introduction to Transesophageal Echocardiography

Introduction to transesophageal echocardiography (TEE) is a comprehensive online course developed by practicing clinicians. It is suitable for anyone who wishes to learn or consolidate their understanding of TEE, such as sonographers, cardiologists, anesthesiologists, intensivists and emergency room physicians.

Each module is supported by video and images that benefit from the unique realism of the HeartWorks simulator, with diagrams and self-tests that help learners check their understanding. Learners receive a CME recognition certificate from the American Society of Echocardiography (ASE) upon successfully completing the end-of-course multiple-choice assessment.

By the end of the course, learners will be better able to:

  • Describe the elements of cardiac anatomy most relevant to echocardiography

  • Demonstrate basic probe manipulation

  • Correlate cardiac anatomy and echocardiography imaging planes

  • Identify the key aspects of safe clinical practice

  • List the echocardiographic features of common cardiac abnormalities.

Course Content

  • Module 1: How TEE images are created – the basic physics of ultrasound

  • Module 2: TEE probe manipulation and imaging planes

  • Module 3: Measurements, equations and reference values

  • Module 4: The mitral valve

  • Module 5: The aortic valve

  • Module 6: The left ventricle

  • Module 7: The right ventricle

  • Module 8: The aorta

  • Module 9: Other structures of importance

  • End-of-course assessment

Module 1: How TEE images are created — the basic physics of ultrasound

Gain an understanding of the physical principles behind ultrasound image generation, useful in interpreting the echocardiogram.

Learn:

  • The characteristics of ultrasound waves

  • How ultrasound waves interact with tissue to produce an echocardiogram image

  • Different modes of ultrasound imaging

  • How image artifacts can appear in ultrasound images

Module 2: TEE probe manipulation and imaging planes

Learn about the practical use of the TEE probe with comprehensive video demonstrations and become familiar with the standard imaging planes.

Understand the:

  • Process of TEE probe insertion and removal

  • Orientation of the echo image

  • TEE probe manipulations involved in the acquisition of the 20 conventional TEE views

  • Relationship between ultrasound plane position and the representation of anatomical structures in the echo image

  • Nomenclature used to describe probe manipulation and standard views

Module 3: Measurements, equations and reference values

This section provides all the TEE methodology in one place. It clearly explains the principles and equations that form the basis of echocardiographic measurements and gives a comprehensive list of normal and abnormal values.

In this module, learn:

  • The commonly used echocardiographic calculations and equations

  • The clinical context in which these equations are used

  • To recognize normal and abnormal findings

Module 4: The mitral valve

The uniquely realistic and accurate 3D heart model clearly demonstrates the complex mitral valve anatomy, which enables understanding of the mitral valve imaging planes and aids interpretation of 2D ultrasound images.

In this module, gain a better understanding of:

  • The anatomy of the mitral valve

  • Which TEE views are used to examine of the mitral valve

  • Using different imaging modalities to assess mitral valve function

  • How to recognize and assess mitral valve pathology

Module 5: The aortic valve

The uniquely detailed and realistic 3D heart model images clearly demonstrate the aortic valve anatomy and function, which enables understanding of the aortic valve imaging and its functional assessment.

This module covers:

  • Understanding the structure and function of the aortic valve

  • Recognizing which TEE views are used to examine the aortic valve and root

  • Using a range of echocardiographic techniques to assess the anatomy and function of the aortic valve

  • Identifying and assessing aortic valve pathology

Module 6: The left ventricle

Learn to evaluate the left ventricle, pivotal in the echocardiographic assessment of cardiac function and hemodynamic status. Gain knowledge of the relevant anatomy and physiology, essential to the recognition and interpretation of abnormal findings.

In this module:

  • Understand the anatomy of the left ventricle

  • Recognize the conventional TEE imaging planes used in left ventricular assessment

  • Understand the assessment of systolic and diastolic function

  • Recognize common left ventricular pathological states

Module 7: The right ventricle

Gain a better understanding of the complex shape and function of the right ventricle. This module explains its imaging and assessment, emphasizing its place in the overall assessment of cardiac function.

This module covers:

  • Understanding the anatomy of the right ventricle

  • Understanding the terms used to describe the right ventricle

  • Obtaining the standard and modified views required to image the right ventricle

  • Understanding the normal systolic and diastolic function of the right ventricle and how it can be assessed

  • Recognizing pathology commonly associated with the right ventricle

Module 8: The aorta

This module examines the imaging and assessment of the pathologies of the aorta. The clinical importance of aortic pathologies underlines the role of echocardiography in the assessment of this structure.

In this module:

  • Understand the anatomy and relations of the thoracic aorta

  • Understand how to obtain the standard imaging planes employed in imaging the aorta

  • Understand the limitations of TEE in aortic imaging

  • Understand and recognize common aortic pathology

Module 9: Other structures of importance

Learn about structures of special relevance to clinical practice, in particular to emerging interventional cardiographic procedures.

Included in this module, learn the echocardiographic assessment of the:

  • pulmonary veins

  • atrial septum

  • left atrial appendage

  • tricuspid valve

  • pulmonic valve

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