Un consensus d’experts sur la formation en échocardiographie périopératoire au Québec

Canadian guidelines for training in adult perioperative transesophageal echocardiography

“…Training guidelines in adult echocardiography by the ASE in 1987, the ACC in 1995, and the ASE and the SCA in 2002 (Table 1) were reviewed and used as a template for the creation of the 2003 Quebec expert consensus for training in perioperative echocardiography (2)(3)(4)7,8,12). In 2003, a clinical competence statement on echocardiography by the the AHA and the ACC in collaboration with the ASE, SCA and the Society of Pediatric Echocardiography was also reviewed (9-11).…”

“…In 2003, a clinical competence statement on echocardiography by the the AHA and the ACC in collaboration with the ASE, SCA and the Society of Pediatric Echocardiography was also reviewed (9-11). The Quebec expert consensus and the 2005 guidelines for the provision of echocardiography in Canada formed the basis of the Canadian training guidelines (12) in adult perioperative TEE (Table 3). Once a consensus was achieved, this document was circulated to every member of the PEG and to the executive of the CSE for further review.…”

“…Basic level: A trainee with a basic level of expertise has to master the acquisition of all the views of a comprehensive examination as described by the ASE and the SCA (16,17). The anesthesiologist with a basic level of training will also have the ability to use intraoperative TEE independently as a monitoring and diagnostic tool at a basic level as outlined in the present document (Appendix 1) (7,8,12). Therefore, at a basic level of training, the anesthesiologist may monitor and diagnose hemodynamic problems related to preload, ventricular systolic or diastolic dysfunction, myocardial ischemia and valvular dysfunction (7)(8)(9)(10)(11)(12).…”

“…The anesthesiologist with a basic level of training will also have the ability to use intraoperative TEE independently as a monitoring and diagnostic tool at a basic level as outlined in the present document (Appendix 1) (7,8,12). Therefore, at a basic level of training, the anesthesiologist may monitor and diagnose hemodynamic problems related to preload, ventricular systolic or diastolic dysfunction, myocardial ischemia and valvular dysfunction (7)(8)(9)(10)(11)(12). Following uncomplicated valve replacement, a trainee with basic training will have the ability to recognize valvular lesions or dysfunction that may be significant and that would require consultation with a physician who has advanced training in perioperative echocardiography (12).…”

“…Therefore, at a basic level of training, the anesthesiologist may monitor and diagnose hemodynamic problems related to preload, ventricular systolic or diastolic dysfunction, myocardial ischemia and valvular dysfunction (7)(8)(9)(10)(11)(12). Following uncomplicated valve replacement, a trainee with basic training will have the ability to recognize valvular lesions or dysfunction that may be significant and that would require consultation with a physician who has advanced training in perioperative echocardiography (12). A trainee with basic training will also have the expertise to provide TEE guidance for the positioning of a coronary sinus catheter, intra-aortic balloon pump or other assist devices.…”