Continuing Education and Meeting Calendar The American Society of Echocardiography is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. ASE recognizes courses as supplements to formal training in an established echocardiographic laboratory. For more information about a course, please call the number listed. To list a course in the Continuing Education and Meeting Calendar, send the date(s), title, location, sponsor, course director(s), and contact information to ASE, Attn: Cheryl Williams, 2100 Gateway Centre Boulevard, Suite 310, Morrisville, NC 27560; Tel: 919-861-5574 x7160; E-mail: [email protected] Ongoing courses, preceptorships, accredited programs, and schools will be listed only once a year. Please refer to the ASE Web site,, for a complete listing of course offerings. January 19–23, 2015. 25th Annual Echo Hawaii. Hapuna Beach Prince Hotel, Kohala Coast, Big Island, HI. Jointly provided by ASE and the ASE Foundation. Course Director: Jonathan Lindner, MD, FASE. Contact: Brandi Delany. Tel: 919-2977171; Fax: 919-882-9900; E-mail: [email protected]; Web site: February 4–6, 2015. Fourth Annual Structural Heart Intervention and Imaging 2015: A Practical Approach. Marriott Del Mar, San Diego, CA. Sponsored by Scripps Health and held in cooperation with ASE. Course Directors: Matthew J. Price, MD and David Rubenson, MD, FASE. Contact: Scripps Conference Services & CME. Tel: 858-652-5400; Fax: 858-652-5565;

E-mail: [email protected]; Web site: structuralheartintervention. February 22–24, 2015. 28th Annual State-of-the-Art Echocardiography. Hyatt Regency Scottsdale Resort and Spa, Scottsdale, AZ. Special preconferences available on February 20-21. Jointly provided by ASE and the ASE Foundation. Course Director: Vera Rigolin, MD, FASE. Contact: Beth Fulk. Tel: 919297-7157; Fax: 919-882-9900; E-mail: [email protected]; Web site: May 2–5, 2015. 2015 ASCeXAM/ReASCE Review Course. Sheraton Philadelphia Downtown, Philadelphia, PA. Jointly provided by ASE and the ASE Foundation. Course Director: Martin Keane, MD, FASE. Contact: Brandi Delany. Tel: 919-297-7171; Fax: 919-882-9900; E-mail: [email protected]; Web site: June 13–16, 2015. 26th Annual Scientific Sessions. Hynes Convention Center, Boston, MA. Jointly provided by ASE and the ASE Foundation. Course Director: Rebecca Hahn, MD, FASE. Contact: ASE. Tel: 919-297-7157; Fax: 919-882-9900; E-mail: [email protected]; Web site: October 11–13, 2015. 4th Annual Echo Florida. Disney’s Yacht and Beach Club, Walt Disney WorldÒ, FL. Preconferences will be held on October 10. Jointly provided by ASE and the ASE Foundation. Course Director: Michael H. Picard, MD, FASE. Contact: Beth Fulk. Tel: 919-297-7157; Fax: 919882-9900; E-mail: [email protected]; Web site: www.asecho. org/education.

SONOGRAPHERS’ COMMUNICATION The Importance of Adding a Dedicated Study of Congenital Heart Disease to the Cardiac Sonographer Curriculum ‘‘As sonographers, we are always learning something new. If we don’t, we get left behind! During my career the application of echocardiography has grown exponentially. One area that has changed dramatically is pediatrics and congenital heart disease. This month’s communication is dedicated to the rapidly developing specialty of adult congenital cardiology.’’ — Elizabeth McIlwain, Council Chair Over the past 50 years, the study of cardiac sonography has changed dramatically- from the days of M-mode, to the use of twodimensional imaging, and more recently the development of three- and four-dimensional echocardiography. In this time period, the treatment for congenital heart disease (CHD) has also evolved, leading to improved patient outcomes for reparative and palliative operative procedures.1 As pre- and post-operative assessments continue to improve, the number of patients living into adulthood with CHD has increased, and as recently as the year 2000, it has

18A Journal of the American Society of Echocardiography

been reported that there are more adult patients living with CHD than pediatric patients.1,2 In the US, it is estimated that there are approximately 3 million citizens affected with CHD, with one million over the age of 18 years.1,3 Historically, these patients would have continued their care with their pediatric cardiologist throughout their lives, but with improved surgical techniques and postoperative care, they are surviving into adult- Lynne Brown, BA, hood and are requiring diagnosis and treat- RDCS, FASE ment of adult cardiac issues (for example, the development of coronary artery disease in addition to the repaired CHD).1 The specialty of adult congenital cardiology has emerged in response to this increased number of CHD patients and has become an important facet in the training of cardiac sonographers.

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Traditionally, cardiac sonography programs have focused on adult cardiology and the issues facing an aging population. Most educational topics were centered on acquired heart disease and cardiac issues that are typically brought on by aging. Congenital heart disease may have been acknowledged, taught in an introductory course, or taught in the curriculum without dedicated pediatric clinical or adult congenital heart disease rotations. For many educational programs, it may be difficult to find clinical rotations for students, due to a small number of sites performing specialized congenital heart disease exams. The lack of clinical rotation sites results in many sonographers receiving their congenital heart disease clinical instruction through on-the-job training or independent study. Today, there is a need for sonographers with experience and training in CHD to assist cardiologists with their adult congenital patients. This should no longer be reserved for specialists but be added to a comprehensive echocardiography curriculum to prepare new graduates to image congenital heart defects and post-operative procedures in both pediatric and adult patients. One way that pediatric and adult congenital cardiac sonographers can help to promote this is for sites that perform CHD echocardiograms to become clinical sites for educational programs (see Mitchell & Korcarz4 for detailed information for how to become a clinical site). Providing students ‘‘real’’ clinical hands-on experience with imaging CHD helps them understand that imaging CHD is very different from imaging acquired heart disease. To be an effective CHD cardiac sonographer, students need at least a basic understanding of the underlying pathology, anatomy, and physiology pre-repair, as well as of the surgical techniques used to correct it. Complex heart defects have not only anatomical implications but physiological effects that continue even after repair.1 Very often these patients will require serial monitoring and follow-up,5 and students must be prepared to ‘‘tailor the exam to answer the clinical question.’’6 Many of these exams will require creative and even off-axis views to demonstrate the pathology and repair (e.g., conduit, baffle, etc.). Only real-time hands-on experience in echocardiography laboratories that perform CHD exams will provide students the knowledge to tailor the exam to answer the clinical question. Many sonography programs now provide embryology and pediatric echocardiography training as part of their core curriculum. Recently the Commission on Accreditation of Allied Health Education Programs (CAAHEP) has added specific learning concentrations for cardiovascular technology (CVT) and diagnostic medical sonography (DMS) programs.7,8 With the addition of these learning concentrations and focused clinical education requirements in the study of CHD, students will be well prepared for the challenges of a changing population needing cardiac testing and care. Directors of programs in which it is not feasible to have dedicated rotations or

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become accredited in the pediatric/CHD concentrations are encouraged to seek out adult congenital cardiologists, pediatric cardiologists, and registered congenital/pediatric sonographers as guest lecturers to supplement their curriculums. In conclusion, the addition of a dedicated CHD course of study to the cardiac sonographer curriculum will better prepare graduates as well as equip future sonographers to care for all adult patients who may enter their clinics and hospitals. Resources for learning about congenital heart disease. Formal educational programs: Search under ‘‘cardiovascular technology’’ and under the concentration: ‘‘pediatric Echocardiography’’ from the dropdown menu. Search under the profession name: ‘‘diagnostic medical sonographer’’ and the concentration: ‘‘pediatric cardiac’’ from the dropdown menu. Websites with educational information: has information on the latest guidelines for performing pediatric echocardiography. Society of Pediatric Echocardiography.

REFERENCES 1. Guleserian KJ. Adult congenital heart disease: Surgical advances and options. Prog Cardioavasc Dis 2011;53:254-64. 2. Allan CK. Intensive care of the adult patient with congenital heart disease. Prog Cardiovasc Dis 2011;53:274-80. 3. Marelli A, Gilboa S, Devine O, Kucik J, lonescu-lttu R, Oster M, Jenkins K. Estimating the congenital heart disease population in the united states in 2010-what are the numbers? J Am Coll Cardiol 2012;59(13s1):E787. 4. Mitchell C, Korcarz CE. The advantages of becoming a clinical site for ultrasound schools. J Am Soc Echocardiogr 2005;18:367-9. 5. Lai WW, Geva T, Shirali GS, Frommelt PC, Humes RA, Brook MM, et al. Guidelines and standards for performance of a pediatric Echocardiogram: A report from the task force of the pediatric council of the American Society of Echocardiography. J Am Soc Echocardiogr 2006;19:1413-30. 6. Mitchell CKC. Defining the path from a technical occupation or a profession: the role of the diagnostic medical sonographer [Dissertation]. Kansas City: University of Missouri; 2002. 7. Commission on Accreditation of Allied Health Education Programs. Standards and Guidelines for the Accreditation of Educational Programs in Cardiovascular Technology. 2009. Available from: StandardsCVT2009%20040109.pdf. Accessed September 3, 2014. 8. Commission on Accreditation of Allied Health Education Programs. Standards and Guidelines for the Accreditation of Educational Programs in Cardiovascular Technology. 2009. Available from: http://www.caahep. org/documents/file/For-Program-Directors/DMSStandards.pdf. Accessed September 3, 2014.

Journal of the American Society of Echocardiography 19A

The importance of adding a dedicated study of congenital heart disease to the cardiac sonographer curriculum.

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