Objectives
Demographic shifts & technical developments in therapeutic interventions and imaging are contributing to a significant expansion of the use of POCUS and TEE. In this two-day virtual symposium, our international multi-disciplinary faculty will illustrate the application of POCUS & TEE to address critical decisions in patient management across a wide range of acute care settings.
Upon completion of this program, participants should be able to
- Describe the expanding scope of perioperative echo, including the range of modalities and new areas of application
- Illustrate the application of TEE and POCUS to address critical point-of-care decisions in a variety of acute-care situations & settings
- Review recent updates on the current guidelines related to the application of perioperative echocardiography in different clinical settings
- Critically discuss factors limiting translation of echocardiography into improved patient outcomes, and outline strategies for addressing these challenges
Day 1 : Saturday, September 21
- 08:45 Opening Remarks – Drs. Marcin Wasowicz & Marcus Salvatori
Session 1: Adult Congenital Heart Disease
Curator: Dr. Yuji Hirasaki, Utsunomiya, Japan
- 09:00 – Perioperative TEE for adult congenital heart disease – Drs. Kentaro Fukano & Yuji Hirasaki
- 09:25 – Blood flow analysis in patients with congenital heart disease and its significance for decision making process – Dr. Koichi Akiyama
- 09:50 – New insights into the intraventricular pressure gradient and its significance for future adulthood surgical interventions – Dr. Ken Takahashi
- 10:15 – Four-dimensional imaging for assessing hemodynamics in complex congenital heart surgery – Dr. Keiichi Itatani
- 10:40 – Session Q&A
11:00 – 11:15 Break
Session 2: Vegetations & Masses
Curators: Drs. Marcin Wasowicz & Marcus Salvatori, Toronto, Canada
- 11:15 – Cardiac masses from the surgeon’s perspective – Dr. RJ Cusimano
- 11:45 – TEE evaluation of cardiac tumours – Dr. Annette Vegas
- 12:10 – TEE evaluation of endocarditis – Dr. Wendy Tsang
- 12:35 – TEE for endocarditis in the ACHD population – Dr. Rafa Alonso
- 13:00 – Session Q&A
13:20 – 14:00 Lunch
Session 3: Aortic Disease
Curators: Drs. Victor Neira and Neville Burke, Halifax, Canada
- 14:00 – TEE examination of the thoracic aorta, the introduction of aortopathies, and other image modalities – Dr. Victor Neira
- 14:25 – Bicuspid aortic valve, aortic root, and ascending aorta aneurysms – Dr. Braden Dulong
- 14:50 – Acute aortic syndromes: Type A Hematomas, dissections, rupture – Dr. Neville Burke
- 15:15 – Pathologies of the descending aorta: coarctation, aneurysms, dissections – Dr. Pieter De-Jager
- 15:40 – Session Q&A
16:00 Day 1 Adjourn
Day 2: Sunday, September 22
- 08:55 – Opening remarks – Drs. Marcin Wasowicz & Marcus Salvatori
Session 1: Right Heart Function
Curator: Dr. Massimiliano Meineri, Leipzig, Germany
- 09:00 – RV-Arterial Coupling – Dr. Fabio Guarracino
- 09:20 – RV Function assessment: how can we build RV Echo-loops? – Dr. Michael Vandenheuval
- 09:40 – Quantifying RV function: Is Strain the Answer? – Dr. Jakob Labus
- 10:00 – RV Function in ARDS and Respiratory failure – Dr. S Treschkatch
- 10:20 – Can we predict RV failure: echocardiographic assessment of RV reserve before LVAD implantation – Dr. S Bouchez
- 10:40 – Session Q&A
11:00 – 11:15 Break
Session 2: Solid Organ Transplantation
Curator: Drs. Jen Prete, Miami, USA
- 11:15 – TEE for heart transplant – Drs. Jen Prete & Jake Rachiele
- 11:40 – TEE for lung transplant – Drs. Jen Prete
- 12:05 – TEE for liver transplant – Dr. Cosmin Guta
- 12:30 – Select cases in liver transplantation – Dr. Raffael Zamper
- 12:55 – Session Q&A
13:15 – 14:00 Lunch
Session 3: State of the Art
Curator: Dr. Elmari Neethling, Kelowna, Canada
- 14:00 – How to implement advanced TEE technologies in your practice – Dr. Burkhard Mackensen
- 14:25 – Image misinterpretation – Dr. Fabio Papa
- 14:50 – Top Echo Articles of 2023 – Dr. Tonia Tauh
- 15:15 – Session Q&A
15:35 Perioperative Echocardiography Group (PEG) Award & Closing Remarks
16:00 Adjourn
Koichi Akiyama MD PhD
Associate Professor, Department of Anesthesiology, Kindai University Hospital, Osakasayama, Osaka, Japan
Dr. Akiyama graduated from Kyoto Prefectural University of Medicine in 2005. He completed residency at Kobe Ekisaikai Hospital and fellowship at Akashi Medical Center. He completed his PhD at Kyoto Prefectural University of Medicine graduate school. He was engaged in blood flow analysis at Columbia University in New York. His research focus on perioperative blood flow analysis.
Robert James "RJ" Cusimano MD
Professor of Surgery & Staff Cardiac Surgeon, Peter Munk Cardiac Center, Toronto General Hospital, University of Toronto.
Dr Cusimano is the inaugural Cynamon Professor in Cardiovascular Innovation and Education at the Peter Munk Cardiac Centre. In addition to his clinical duties, he has been deeply interested in education. He was the
program director of Cardiac surgery at the University of Toronto and at the Royal Collage of
Physicians and Surgeons of Canada, helped in the development and implementation of the competency,
based curriculum now in existence in Canada. He has taught both within the University, Canada and
internationally, having either taught or helped in program development in China, Ethiopia, Sri Lanka,
Brazil, Europe, and the US. In 2016 he conceived and held the first Toronto Cardiac Tumour Conference,
which brings the world's experts in the field of cardiac tumours on a yearly basis. Recently, he conceived,
and has been working on the INTERACT project (International Registry to Assess Cardiac Tumours), a
global initiative to capture all cardiac tumours in the world. This is a multi-national, multidisciplinary
endeavour which will bring centres around the world together to try to improve care and outcome in
these very rare tumours. Recently he was in Africa to help develop a plan to harmonize interaction on the
continent. Eventually he would like to develop a subspecialty of cardiac surgery in the area of cardiac
tumours.
Keiichi Itatani MD PhD
Associate Professor, Department of Cardiovascular Surgery; Director of the Adult Congenital Heart Disease Center, Nagoya City University Graduate School of Medical Sciences. Cardio Flow Design Inc. Founder & Executive Adviser
Dr. Itatani is a cardiac surgeon (congenital / adult congenital heart surgery) and researcher of fluid mechanics (blood flow imaging / hemodynamics). Graduate from the medical school 2002, and postgraduate course in the University of Tokyo.
Previously, an endowed chair at Kitasato University, and Kyoto Prefectural University of Medicine, and now an attending cardiac surgeon at Nagoya City University and Osaka Metropolitan University.
In 2015, Cardio Flow Design Inc. is founded to deliver the software and services of blood flow imaging.
G. Burkhard Mackensen MD PhD FASE FSCAI
Professor and Chair, Department of Anesthesiology & Pain Medicine, Director of Interventional Echocardiography, Adjunct Professor of Medicine, University of Washington School of Medicine
Dr. G. Burkhard Mackensen is the Allan J. Treuer Endowed Professor of Anesthesiology and Chair of the University of Washington Department of Anesthesiology & Pain Medicine in Seattle, WA. He also serves as the Director of Interventional Echocardiography at the UW Medicine Heart Institute.
Dr. Mackensen is a practicing cardiothoracic anesthesiologist and a key member of the UW structural heart valve team. As an internationally recognized expert in perioperative and interventional echocardiography, Dr. Mackensen is intimately involved in multidisciplinary efforts that aim to advance minimally invasive transcatheter cardiovascular care. He has given numerous national and international lectures on the role of 2D and 3D TEE in interventional/structural heart disease and surgical decision making, and has published over 140 peer-reviewed journal articles and is the author of more than 20 book chapters.
As a Fellow of the American Society of Echocardiography (FASE), Dr. Mackensen is the Chair of the ASE’s Industry Relations Committee (IRT) and the immediate past Chair of the Council on Perioperative Echocardiography (COPE). Dr. Mackensen also represents the Society of Cardiovascular Anesthesiologists (SCA) at the echocardiography board of the Intersocietal Accreditation Commission (IAC) and as part of that board created the opportunity for perioperative echocardiography services to be accredited by the IAC.
Ken Takahashi MD
Professor, Department of Pediatrics, Juntendo Urayasu University Hospital, Urayasu, Japan
Dr. Takahashi graduated from Shinshu University School of Medicine in 1994. He then joined the Department of Pediatrics at Juntendo University, where he earned his Doctor of Medicine in 2000. Following this, he served as a Clinical Research Fellow at the Echocardiography Division of the Hospital for Sick Children in Toronto, Ontario, Canada, from 2004, and at the Pediatric Cardiology Division of the University of Alberta, Alberta, Canada from 2005 to 2007. Upon returning to Japan, he rejoined the Department of Pediatrics at Juntendo University. His research areas include congenital heart diseases, cardiac function assessment via echocardiography, and autonomic nervous system function evaluation.
Raffael Zamper MD PhD
Staff Anesthesiologist, Cardiac Anesthesia Program Director and Cardiac Anesthesia Fellowship Coordinator, Faculty of Medicine. Assistant Professor, Western University, London ON.
Dr. Zamper, graduated from Medicine University of Sao Paulo, Brazil and completed his anesthesiology residency at the General Hospital of The University of Sao Paulo. He completed his PhD on coagulation in cirrhotic patients undergoing liver transplantation at the Albert Einstein Jewish Hospital, Sao Paulo. He subsequently completed clinical fellowships in cardiac anesthesia and perioperative echocardiography and ultrasound at the London Health Science Center, Western University where he currently works as staff anesthesiologist and director of the cardiac anesthesia fellowship program.
Marcin Wasowicz MD PhD
Staff Cardiovascular Anesthesiologist & Critical Care Physician, Department of Anesthesia & Pain Management, Toronto General Hospital. Associate Professor of Anesthesiology, University of Toronto.
Rafael Alonso-Gonzalez MD MSc
Director, Adult Congenital Heart Disease Program, Toronto General Hospital, Toronto, Canada
Dr. Alonso-Gonzalez is the current director of the Adult Congenital Heart Disease program at Toronto General Hospital. He completed his specialist cardiology training in Badajoz and Madrid, Spain, and his ACHD fellowship at the Royal Brompton Hospital in London, UK, between 2009 and 2011. In 2011, he was appointed as staff cardiologist in Badajoz, Spain, where he was the Director of the Pulmonary Hypertension Unit. In 2012, he moved to the Royal Brompton Hospital in London, UK, as Consultant Cardiologist in ACHD and Pulmonary Hypertension. He was the Director of the ACHD inpatient services and established the ACHD Heart Failure Unit. He joined the Toronto ACHD Unit in 2018 where he is also the Fellowship director.
Pieter de Jager MBChB MSc
Assistant Professor, Staff Cardiovascular Anesthesiologist, Queen Elizabeth II Hospital, Dalhousie University, Halifax, Canada
Kentaro Fukano MD
Assistant Professor, Department of Anesthesia and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Japan.
Dr. Fukano graduated Tohoku University of Medical Science in 2014 and completed emergency medicine residency training in 2018 and anesthesia residency training in 2023. His clinical research focuses on pulmonary artery catheter, transesophageal echocardiography, and procedural sedation and analgesia.
Yuji Hirasaki MD PhD
Consultant Anesthesiologist, Department of Anesthesia, Saiseikai Utsunomiya Hospital, Tochigi, Japan.
Dr. Hirasaki graduated Shiga University of Medical Science in 1995 and completed anesthesia residency training in 2000. In 2005, he completed fellowship training in cardiac anesthesia at Toronto General Hospital. He studied comparative anatomy at Jikei University Graduate School of Medicine in Tokyo, and obtained his PhD degree in 2018. His clinical interests include cardiac anesthesiology, perioperative coagulation management, and transesophageal echocardiography.
Jakob Labus MD
Staff Cardiovascular Anesthesiologist, Department of Anesthesiology and Intensive Care Medicine, University Hospital and Medical Faculty, Cologne University
Dr. Labus is a member of the German Society of Anesthesiology and Intensive Care Medicine (DGAI), the German Cardiac Anesthesia Scientific Working Group, the European Association of Cardiothoracic Anaesthesiology and Intensive Care (EACTAIC) and the EACTAIC Subspeciality Committee for Echocardiography. His clinical and scientific focus is perioperative echocardiography. In particular, he is interested in myocardial function imaging, diastolic dysfunction and their perioperative changes.
Massimilano Meineri MD PhD FASE
Co-Chair Department of Anesthesia, Herzzentrum Leipzig, Leipzig, Germany. Professor of Anesthesiology, University of Toronto.
Dr. Meineri completed Fellowship training in Cardiac Anesthesia from Toronto General Hospital, where he went on to become the director of perioperative echocardiography and founding director of the Lynn and Arnold Irwin Advanced Perioperative Imaging Lab. His academic focus is perioperative echocardiography. He is Diplomate in advanced Perioperative transesophageal echocardiography. He’s involved in development of on line echocardiography teaching resources for the Perioperative Interactive Education website (pie.med.utoronto.ca). He has organized and lead numerous point of care ultrasound courses around the world. His main research interest is 3D intraoperative echocardiography.
Fabio de Vasconcelos Papa MD MScCH FASE
Staff Anesthesiologist, St. Michael’s Hospital, Toronto. Assistant Professor, Department of Anesthesiology and Pain Medicine, University of Toronto.
Dr. Papa graduate from University of São Paulo at Ribeirão Preto School of Medicine where he also finished his anesthesia residency. He completed his clinical fellowship in Cardiovascular Anesthesiology at the University of Toronto. Dr. Papa is Fellow of the American Society of Echocardiography (FASE), Associated Editor of the Brazilian Journal of Anesthesiology (BJAN) and completed a Master in Health Practitioner in Clinical Education at Data Lana School of Public Health at the University of Toronto. Dr. Papa has a major clinical interest in perioperative transeophageal echocardiography, POCUS and Curriculum development.
Tonia Tauh MD
Clinical Instructor, Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, Canada.
Wendy Tsang MD FASE
Staff Cardiologist and Clinician Investigator, Toronto General Hospital, University Health Network.
Associate Professor, Department of Medicine, University of Toronto.
Dr. Tsang is the head of the Complex Valve clinic at Toronto General Hospital. She completed her medical degree at Queen’s University and went on to complete her Adult Cardiology fellowship at the University of Toronto. She then completed a CIHR-funded Multimodality Cardiac Imaging research fellowship at the University of Chicago. During that time, she also obtained a Master’s degree in Health Studies. She was a member of the writing groups for both the 2012 ASE/EACVI 3D Guidelines and the 2015 ASE/EACVI Chamber Quantification Guidelines. She also serves on the Editorial Board of the Journal of the American Society of Echocardiography and is a member of the Royal College of Physician and Surgeon’s Area of Focused Competency subcommittee in Adult Echocardiography. She currently holds a Heart and Stroke Foundation of Canada National New Investigator Award. Her research focuses on congenital and valvular heart disease, 3D echocardiography, and artificial intelligence.
Neville Burke MBBS, DM
Staff Cardiac Anesthesiologist, Assistant Professor, Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, Canada
Dr. Burke gained his medical degree from the University of Guyana, specialized in Anesthesia at the University of the West Indies (Jamaica) and holds fellowships in Adult Critical Care (University of Toronto) and Cardiac Anesthesia Western University, London, Ontario. He is certified as a Diplomate in Advanced Perioperative Transesophageal Echocardiography by the National Board of Echocardiography. His clinical and research interests are in perioperative infections, intraoperative cardiovascular anesthesia and critical care.
Braden Dulong MD
Assistant Professor, Staff Cardiovascular Anesthesiologist, Queen Elizabeth II Health Sciences Centre, Dalhousie University. Halifax, Canada.
Dr. Dulong graduated from Dalhousie Medical School. He completed residency training in anesthesiology at the University of Ottawa and went on to pursue fellowship training in cardiac anesthesiology at the University of Ottawa Heart Institute. He is certified in Advance Perioperative Echocardiography through the National Board of Echocardiography.
Fabio Guarracino MD
Chair and Staff Cardiothoracic Anesthesiologist, Department of Cardiothoracic and Vascular Anesthesia and Intensive Care at Azienda Ospedaliero Universitaria Pisana in Pisa, Italy.
Dr. Guarracino completed his medical degree at the University of Padova Medical School, Italy, and underwent
specialized training in Anesthesia and Intensive Care, as well as in Cardiology, at the same institution.
An active contributor to the field, Dr. Guarracino is a dedicated member of the European Society of Anaesthesiology
and Intensive Care (ESAIC), currently serving as the Chair of Intensive Care in the Forum Organs and Transplants.
Additionally, he is a member of the European Association of Cardiothoracic Anaesthesiology and Intensive Care
(EACTAIC), the European Society of Intensive Care (ESICM), and the Società Italiana di Anestesia Analgesia
Rianimazione e Terapia Intensiva (SIAARTI).
Having served as the President of the European Association of Cardiothoracic Anaesthesiology and Intensive Care
(EACTAIC) from 2022 to 2023, Dr. Guarracino has demonstrated leadership and commitment to advancing his field.
His research pursuits focus on the pathophysiology of shock states, exploring the intricate interplay between the heart
and circulation in both normal and diseased conditions. Dr. Guarracino is particularly interested in the extracorporeal
support of the heart and lungs, as well as the role of echocardiography in managing acutely altered cardiovascular
states.
Dr. Guarracino's contributions extend to the academic realm, with numerous manuscripts published in peer-reviewed
journals covering topics such as intensive care medicine, acute heart failure, echocardiography, and cardiothoracic
anesthesia. His dedication to both clinical practice and research underscores his commitment to advancing medical
knowledge and patient care in his specialized field.
Victor Neira MD DRCSPC
Professor, Staff Cardiovascular Anesthesiologist, Dalhousie University, Canada
Dr. Neira received his titles of Doctor in Medicine and Surgery at the Universidad Javeriana, Anesthesiologist at El Rosario University, and Cardiac Anesthesia Sub-Specialty at Central Military Hospital in Bogota-Columbia. With the collaboration of the Queen Silvia Children’s Hospital in Gothenburg (Sweden) he contributed to establishing the pediatric Cardiac Surgery service at the Fundacion Cardiovascular de Colombia, where he worked as Pediatric/Adult Cardiac Anesthesiologists, and was chief of Anesthesia and the Operating Rooms. He moved to Canada to pursue a Clinical Cardiac Anesthesia and Transesophageal Fellowship at McMaster University, and after that a Pediatric Anesthesia Fellowship at the University of Ottawa. He also performed a Master in Arts and Education at the University of Ottawa. He is currently staff Cardiac Anesthesiologists and Cardiac Anesthesia Fellowship Coordinator at Dalhousie University, in Halifax, NS.
Marcus Salvatori MD MSc FRCPC
Staff Cardiovascular Anesthesiologist & Critical Care Physician, Department of Anesthesia & Pain Management, Toronto General Hospital, University Health Network. Assistant Professor, Dept of Anesthesiology & Pain Medicine, University of Toronto.
Dr. Salvatori obtained a Master of Science, University of Toronto, Department of Physiology (2005) and his Bachelor of Medicine and Surgery (with Merit) from Newcastle University School of Medicine, Newcastle upon Tyne, UK (2013). Dr. Salvatori completed his anesthesia residency at the University of Toronto and obtained his Fellowship, Royal College of Physicians of Canada (FRCPC) in Anesthesiology (2019). He completed a fellowship in cardiovascular anesthesia and critical care medicine at the Toronto General Hospital, University Health Network. His clinical areas of focus are cardiovascular anesthesia, echocardiography and critical care medicine.
Annette Vegas MD FASE
Staff Cardiovascular Anesthesiologist & Critical Care Physician, Department of Anesthesia & Pain Management, Toronto General Hospital. Professor of Anesthesiology, University of Toronto.
Prof. Vegas graduated from medical school at McGill University (Montreal) and completed an anesthesia residency at the University of Toronto. She concluded a cardiac anesthesia fellowship at Toronto General Hospital, where she has practiced since 1994. She has an interest in echocardiography and has developed web-based educational materials (http://pie.med.utoronto.ca) for teaching both transesophageal and transthoracic echocardiography. Annette has extensively published journal articles and book chapters, authored textbooks and co-edited textbooks related to echocardiography. She is a professor of anaesthesiology and an elected fellow of the American Society of Echocardiography (FASE). In 2020 Dr. Annette Vegas reassumed the role of director of Perioperative TEE at Toronto General Hospital.
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