Skip to main content
Top
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 1/2011

01-01-2011 | Reports of Original Investigations

An interactive online 3D model of the heart assists in learning standard transesophageal echocardiography views

Authors: Angela Jerath, MD, Annette Vegas, MD, Massimiliano Meineri, MD, Candice Silversides, MD, Christopher Feindel, MD, Scott Beattie, MD, Michael Corrin, MSc, Gordon Tait, PhD

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 1/2011

Login to get access

Abstract

Purpose

Transesophageal echocardiography (TEE) is becoming a standard imaging tool during cardiac surgery as well as an important diagnostic tool in cardiology and in intensive care, resulting in an increasing demand for TEE training. To address the problem of limited time for learning during TEE studies, we have developed a novel online application that allows users to visualize each of the 20 standard diagnostic TEE views in conjunction with a three-dimensional (3D) heart model that can be rotated and “cut away” above the echo plane to reveal the internal cardiac structures. This study is an evaluation of the educational benefit of this application.

Methods

The application was evaluated using a pre-test/post-test design assessing the improvement of subjects’ test scores following three days of access to the application. The subjects were postgraduate fellows in anesthesia, cardiology, and cardiac surgery.

Results

Ten subjects showed a significant increase (31%) in their test scores after an average of 130 min of access to the application over a three-day period (P < 0.001, effect size = 1.9). Using five-point Likert scales, the users indicated that the application was a useful addition to their training (4.7), they would recommend the application to their colleagues (4.9), and they found the application easy to use (4.4).

Conclusion

The large improvement in test scores during a short period of study and the high level of satisfaction across all of the disciplines indicates that the application is a useful adjunctive tool for learning TEE. It is now being used in TEE training worldwide.
Literature
1.
go back to reference Corda DM, Caruso LJ, Mangano D. Myocardial ischemia detected by transesophageal echocardiography in a patient undergoing peripheral vascular surgery. J Clin Anesth 2000; 12: 491-7.CrossRefPubMed Corda DM, Caruso LJ, Mangano D. Myocardial ischemia detected by transesophageal echocardiography in a patient undergoing peripheral vascular surgery. J Clin Anesth 2000; 12: 491-7.CrossRefPubMed
2.
go back to reference Memtsoudis SG, Rosenberger P, Loffler M, et al. The usefulness of transesophageal echocardiography during intraoperative cardiac arrest in noncardiac surgery. Anesth Analg 2006; 102: 1653-7.CrossRefPubMed Memtsoudis SG, Rosenberger P, Loffler M, et al. The usefulness of transesophageal echocardiography during intraoperative cardiac arrest in noncardiac surgery. Anesth Analg 2006; 102: 1653-7.CrossRefPubMed
3.
go back to reference Karski JM. Transesophageal echocardiography in the intensive care unit. Semin Cardiothorac Vasc Anesth 2006; 10: 162-6.CrossRefPubMed Karski JM. Transesophageal echocardiography in the intensive care unit. Semin Cardiothorac Vasc Anesth 2006; 10: 162-6.CrossRefPubMed
4.
go back to reference Huttemann E, Schelenz C, Kara F, Chatzinikolaou K, Reinhart K. The use and safety of transoesophageal echocardiography in the general ICU–a minireview. Acta Anaesthesiol Scand 2004; 48: 827-36.CrossRefPubMed Huttemann E, Schelenz C, Kara F, Chatzinikolaou K, Reinhart K. The use and safety of transoesophageal echocardiography in the general ICU–a minireview. Acta Anaesthesiol Scand 2004; 48: 827-36.CrossRefPubMed
5.
go back to reference Fletcher SN. Echocardiography in cardiac anaesthesia and intensive care. Current Anaesth Crit Care 2009; 20: 164-9.CrossRef Fletcher SN. Echocardiography in cardiac anaesthesia and intensive care. Current Anaesth Crit Care 2009; 20: 164-9.CrossRef
6.
go back to reference Agricola E, Oppizzi M, Melisurgo G, Margonato A. Transesophageal echocardiography: a complementary view of the heart. Expert Rev Cardiovasc Ther 2004; 2: 61-75.CrossRefPubMed Agricola E, Oppizzi M, Melisurgo G, Margonato A. Transesophageal echocardiography: a complementary view of the heart. Expert Rev Cardiovasc Ther 2004; 2: 61-75.CrossRefPubMed
7.
go back to reference Peterson GE, Brickner ME, Reimold SC. Transesophageal echocardiography: clinical indications and applications. Circulation 2003; 107: 2398-402.CrossRefPubMed Peterson GE, Brickner ME, Reimold SC. Transesophageal echocardiography: clinical indications and applications. Circulation 2003; 107: 2398-402.CrossRefPubMed
8.
go back to reference Schroder JN, Williams ML, Hata JA, et al. Impact of mitral valve regurgitation evaluated by intraoperative transesophageal echocardiography on long-term outcomes after coronary artery bypass grafting. Circulation 2005; 112(9 Suppl): I293-8.PubMed Schroder JN, Williams ML, Hata JA, et al. Impact of mitral valve regurgitation evaluated by intraoperative transesophageal echocardiography on long-term outcomes after coronary artery bypass grafting. Circulation 2005; 112(9 Suppl): I293-8.PubMed
9.
go back to reference De Simone R, Wolf I, Mottl-Link S, et al. Intraoperative assessment of right ventricular volume and function. Eur J Cardiothorac Surg 2005; 27: 988-93.CrossRefPubMed De Simone R, Wolf I, Mottl-Link S, et al. Intraoperative assessment of right ventricular volume and function. Eur J Cardiothorac Surg 2005; 27: 988-93.CrossRefPubMed
10.
go back to reference Randolph GR, Hagler DJ, Connolly HM, et al. Intraoperative transesophageal echocardiography during surgery for congenital heart defects. J Thorac Cardiovasc Surg 2002; 124: 1176-82.CrossRefPubMed Randolph GR, Hagler DJ, Connolly HM, et al. Intraoperative transesophageal echocardiography during surgery for congenital heart defects. J Thorac Cardiovasc Surg 2002; 124: 1176-82.CrossRefPubMed
11.
go back to reference Klein AL, Grimm RA, Murray RD, et al. Use of transesophageal echocardiography to guide cardioversion in patients with atrial fibrillation. N Engl J Med 2001; 344: 1411-20.CrossRefPubMed Klein AL, Grimm RA, Murray RD, et al. Use of transesophageal echocardiography to guide cardioversion in patients with atrial fibrillation. N Engl J Med 2001; 344: 1411-20.CrossRefPubMed
12.
go back to reference Qaddoura FE, Abel MD, Mecklenburg KL, et al. Role of intraoperative transesophageal echocardiography in patients having coronary artery bypass graft surgery. Ann Thorac Surg 2004; 78: 1586-90.CrossRefPubMed Qaddoura FE, Abel MD, Mecklenburg KL, et al. Role of intraoperative transesophageal echocardiography in patients having coronary artery bypass graft surgery. Ann Thorac Surg 2004; 78: 1586-90.CrossRefPubMed
13.
go back to reference Couture P, Denault AY, McKenty S, et al. Impact of routine use of intraoperative transesophageal echocardiography during cardiac surgery. Can J Anesth 2000; 47: 20-6.CrossRefPubMed Couture P, Denault AY, McKenty S, et al. Impact of routine use of intraoperative transesophageal echocardiography during cardiac surgery. Can J Anesth 2000; 47: 20-6.CrossRefPubMed
14.
go back to reference American Society of Anesthesiologists and Society of Cardiovascular Anesthesiologists Task Force on Transesophageal Echocardiography. Practice guidelines for perioperative transesophageal echocardiography. An updated report by the American Society of Anesthesiologists and the Society of Cardiovascular Anesthesiologists Task Force on Transesophageal Echocardiography. Anesthesiology 2010; 112: 1084-96. American Society of Anesthesiologists and Society of Cardiovascular Anesthesiologists Task Force on Transesophageal Echocardiography. Practice guidelines for perioperative transesophageal echocardiography. An updated report by the American Society of Anesthesiologists and the Society of Cardiovascular Anesthesiologists Task Force on Transesophageal Echocardiography. Anesthesiology 2010; 112: 1084-96.
15.
go back to reference Finegan BA. Progress through cooperation: securing a sound training pathway for perioperative transesophageal echocardiography. Can J Anesth 2006; 53: 969-72.CrossRefPubMed Finegan BA. Progress through cooperation: securing a sound training pathway for perioperative transesophageal echocardiography. Can J Anesth 2006; 53: 969-72.CrossRefPubMed
16.
go back to reference Beique F, Ali M, Hynes M, et al. Canadian guidelines for training in adult perioperative transesophageal echocardiography. Recommendations of the Cardiovascular Section of the Canadian Anesthesiologists’ Society and the Canadian Society of Echocardiography. Can J Anesth 2006; 53: 1044-60.CrossRefPubMed Beique F, Ali M, Hynes M, et al. Canadian guidelines for training in adult perioperative transesophageal echocardiography. Recommendations of the Cardiovascular Section of the Canadian Anesthesiologists’ Society and the Canadian Society of Echocardiography. Can J Anesth 2006; 53: 1044-60.CrossRefPubMed
17.
go back to reference Mathew JP, Glas K, Troianos CA, et al. ASE/SCA recommendations and guidelines for continuous quality improvement in perioperative echocardiography. Anesth Analg 2006; 103: 1416-25.CrossRefPubMed Mathew JP, Glas K, Troianos CA, et al. ASE/SCA recommendations and guidelines for continuous quality improvement in perioperative echocardiography. Anesth Analg 2006; 103: 1416-25.CrossRefPubMed
18.
19.
go back to reference Shanewise JS, Cheung AT, Aronson S, et al. ASE/SCA guidelines for performing a comprehensive intraoperative multiplane transesophageal echocardiography examination: recommendations of the American Society of Echocardiography Council for Intraoperative Echocardiography and the Society of Cardiovascular Anesthesiologists Task Force for Certification in Perioperative Transesophageal Echocardiography. Anesth Analg 1999; 89: 870-84.CrossRefPubMed Shanewise JS, Cheung AT, Aronson S, et al. ASE/SCA guidelines for performing a comprehensive intraoperative multiplane transesophageal echocardiography examination: recommendations of the American Society of Echocardiography Council for Intraoperative Echocardiography and the Society of Cardiovascular Anesthesiologists Task Force for Certification in Perioperative Transesophageal Echocardiography. Anesth Analg 1999; 89: 870-84.CrossRefPubMed
21.
go back to reference Bose R, Matyal R, Panzica P, et al. Transesophageal echocardiography simulator: a new learning tool. J Cardiothorac Vasc Anesth 2009; 23: 544-8.CrossRefPubMed Bose R, Matyal R, Panzica P, et al. Transesophageal echocardiography simulator: a new learning tool. J Cardiothorac Vasc Anesth 2009; 23: 544-8.CrossRefPubMed
22.
go back to reference Cook DA, Levinson AJ, Garside S, Dupras DM, Erwin PJ, Montori VM. Internet-based learning in the health professions. JAMA 2009; 300: 1181-96.CrossRef Cook DA, Levinson AJ, Garside S, Dupras DM, Erwin PJ, Montori VM. Internet-based learning in the health professions. JAMA 2009; 300: 1181-96.CrossRef
Metadata
Title
An interactive online 3D model of the heart assists in learning standard transesophageal echocardiography views
Authors
Angela Jerath, MD
Annette Vegas, MD
Massimiliano Meineri, MD
Candice Silversides, MD
Christopher Feindel, MD
Scott Beattie, MD
Michael Corrin, MSc
Gordon Tait, PhD
Publication date
01-01-2011
Publisher
Springer-Verlag
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 1/2011
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-010-9410-5

Other articles of this Issue 1/2011

Canadian Journal of Anesthesia/Journal canadien d'anesthésie 1/2011 Go to the issue