Educational program for intraoperative transesophageal echocardiography.

A lthough both disciplines have cooperated for many years, cardiovascular anesthesiology and echocardiography have recently grown and merged in part. Intraoperative echocardiography has demonstrated its usefulness in many aspects of cardiovascular surgery, including valvular repair and replacement, myocardial function, aortic aneurysm repair, congenital heart disease, pericardial disease, complications of surgery, endocarditis, myocardial ischemia, and many others. Given the enlarging scope of cardiovascular surgery, echocardiography can address the compelling need for precise and accurate intraoperative diagnostic and monitoring capabilities. With the rapid development and clinical application of this technology, little attention has been focused on the necessary skills, training, and means of confirming competency for physicians performing intraoperative echocardiography. This article will not address all the questions surrounding this subject, but will explore some of the relevant issues regarding the training of physicians in intraoperative echocardiography and describe the training program developed for anesthesiologists at the Cleveland Clinic. We present our program in the hope of stimulating further discussion and research. The ultimate objective in developing an organized training program in intraoperative echocardiography is to enhance patient care at our institution through the proficient use of echocardiography in the operating arena by physicians from varying specialties and practice backgrounds.