2021 Toronto Perioperative Echo Symposium & Course

Recording & reference are now posted! 


The 2020 publication of the Guidelines for the Use of Transesophageal Echocardiography to Assist with Surgical Decision-Making in the Operating Room ( doi: 10.1016/j.echo.2020.03.002 ) by the American Society of Echocardiography marked a significant milestone in the development of TEE as an integral component of clinical decision-making in acute care settings.

Demographic shifts, technical developments in surgery and imaging, as well as the challenges of the current pandemic are contributing to a significant expansion of the use of TEE for point-of-case decision-making.

In this one-day virtual symposium our faculty will illustrate the application of TEE to address critical point-of-care decisions in a variety of acute-care setting including cardiac and non-cardiac OR, the cathlab and the intensive care unit.

Upon completion of this session, participants should be able to

  1. Describe recent updates to practice guidelines related to intra-operative decision-making as they apply to assessment of valvular heart disease in the OR or Cathlab.
  2. Critically discuss the role and limitations of TEE in the management of patients on extra-corporeal life support.
  3. Integrate pre- and intra-operative imaging findings into a structured assessment of adult congenital heart disease patients undergoing non-cardiac surgery.
  4. Describe common sources of cognitive bias and frequent errors in perio-operative echocardiography for cardiac surgery and structural heart disease interventions. 


The course and symposium are Accredited Group Learning Activity (Section 1) as defined by the Maintenance of Certification program of The Royal College of Physicians and Surgeons of Canada and approved by the Canadian Anesthesiologists’ Society. You may claim a maximum of 6.5 hours for each day (credits are automatically calculated) .

Through an agreement between the Royal College of Physicians and Surgeons of Canada and the American Medical Association, physicians may convert Royal College MOC credits to AMA PRA Category 1 Credits™. Information on the process to convert Royal College MOC credit to AMA credit can be found at https://edhub.ama‐assn.org/pages/applications.


CME Planning Committee

Course Directors: Azad Mashari, Jacobo Moreno, Marcus Salvatori, Elmari Neethling

Planning Committee: Bilal Ansari, Christopher Hudson, Ahmad Omran, Vivek Rao, Wendy Tsang, Annette Vegas, Bill Wong, Han Kim, Sarah Russell (Conference Coordinator)


Virtual Symposium: Saturday November 6, 2021

8:30 Opening Remarks and Introduction – Azad Mashari

Session 1: Procedural Decision-Making in the OR and Cathlab (Moderator Bilal Ansari)

9:00 Surgical Decision-Making Guidelines: Updates & Translation to practice – Annette Vegas

9:25 Case-Based Decision-Making: Ischemic MR – Aidan Sharkey

9:50 Case-Based Decision-Making: Incidental TR – Michael Lee

10:15 Case-Based Decision-Making: Structural Heart Disease Interventions – Massimiliano Meineri

10:40 Q & A Panel

11:00 Break (15:00)

Session 2: Decision-Making in the ICU (Moderator Elmari Neethling)

11:15 TEE Guidance for Management of ARDS and ECLS: The COVID Experience – Ghislaine Doufle

11:40 TEE for RAMP Studies to Guide ECLS Weaning – Phyllis Billia

12:05 Rescue TEE in the Perioperative Setting – Pablo Perez d’Empaire

12:30 Q & A Panel

12:45 Lunch (30:00)

Session 3: Decision-Making: Non-Cardiac Surgery and ACHD (Moderator Marcus Salvatori)

13:15 TEE for Management of Non-Cardiac Transplant – Jacobo Moreno

13:40 Case-Based Decision-Making: Non-Cardiac Surgery in ACHD Patients – Marjan Jariani

14:05 The Segmental Approach for Intraoperative ACHD Assessment – Nelson Burbano

14:30 Q & A Panel

14:45 Break (15:00)

Session 4: Unmaking-Decisions (Moderator Azad Mashari)

15:00 Cognitive Errors in Perioperative Decision Making – Carolyn LoBue

15:25 Common Errors: Lessons from 3 years of PTE QI Reviews at Toronto General Hospital – Ahmad Omran

15:50 Common Errors: Challenges & Pitfalls of TEE Guidance for Structural Heart Disease Interventions – Wendy Tsang

16:15 Q & A Panel

16:30 PEG Award & Closing Remarks – Azad Mashari

17:00 Adjournment

3D TEE Virtual Course: Friday November 5, 2021

8:30 Introduction to 3D TEE Course and Faculty – Jacobo Moreno

Introduction to 3D TEE (Moderator Annette Vegas)

9:00 Echo Anatomy: 3D models & imaging correlation – Azad Mashari

9:20 Introduction to 3D TEE – Wendy Tsang

9:40 3D Image optimization – Jacobo Moreno

10:00 Q&A

3D Acquisition: Theory (Moderator Azad Mashari)

10:15 LV/RV – Jacobo Moreno

10:35 MV – Annette Vegas

10:55 AV – Joerg Ender

11:15 TV – Wendy Tsang

11:35 Q&A

11:50 Break (10:00)

12:00 Other Structures – Ahmad Omran

12:20 Paravalvular Leak – Wendy Tsang

12:40 Mitra Clip – Massimiliano Meineri

13:00 Q&A

13:15 Lunch (20:00)

3D Clinical applications (Moderator Elmari Neethling)

13:35 LV and RV – Jacobo Moreno

13:55 MV – Annette Vegas

14:15 AV – Joerg Ender

14:35 TV – Wendy Tsang

14:55 Q&A

15:10 Break (10:00)

15:20 Other Structures – Ahmad Omran

15:40 Paravalvular Leak – Jacobo Moreno

16:00 Mitra Clip – Massimiliano Meineri

16:20 Q&A

16:35 Summary & Concluding Remarks – Jacobo Moreno

17:00 Adjournment

Competing Interests Policy

Faculty will declare all relevant relationships and potential competing interests during their presentation.

Faculty COI statements can be found here: November 5 Course. November 6 Symposium.

Should a conflict of interest be identified a variety of strategies will be employed for mitigation, as recommended by the Royal College of Physicians and Surgeons of Canada (https://www.royalcollege.ca/rcsite/cpd/accreditation/toolkit/faqs-on-accreditation-e ). These include revision of the presentation topic or focus; peer review of the content in question to ensure scientific integrity and balance. If the concern raised is not addressed by these methods, an alternate speaker for the topic will be sought out, or the topic removed from the program