Welcome to ICCVA

Time Table	Sept 8,9	Sept 10	Sept 11,12
Program	Sept 9	Sept 10	Sept 11,12

In the U.S., TEE Workshops and the certifying examination are being held to deepen the specialty. The National Board of Echocardiography (NBE) is well-organized and contributing to TEE’s dissemination. The Examination of Special Competence in Perioperative Transesophageal Echocardiography (PTEeXAM), taken mainly by cardiovascular anesthesiologists in North American countries, is recently spreading among cardiovascular anesthesiologists in European nations and Asian countries as well.
In Japan, TEE has become widely used and has gained acceptance as a useful diagnostic and monitoring tool for many patients under various conditions. In the operating room, anesthesiologists need the knowledge and skill of TEE to determine the cause of hemodynamic disorders. Cardiovascular surgeons have also asked that anesthesiologists have the knowledge and skill of TEE to confirm the adequacy of surgical repairs.The Japanese Society of Cardiovascular Anesthesiologists (JSCVA), in association with the NBE, will be introducing and organizing the TEE certifying examination called JB-POT (Japanese Board of Perioperative Transesophageal Echocardiography).
The first examination will be held on September 12, 2004, the final day of the 9th International Congress of Cardiothoracic and Vascular Anesthesia, in English and Japanese. JSCVA will hold a TEE workshop (in English) on September 11, 2004, to authorize successful JB-POT candidates.

Foreword

JB-POT has prepared the content outline for a certifying examination to test the required knowledge of a useful perioperative TEE application. This outline consists of broad information involving anatomy, physiology, pathophysiology, and acoustic technology. The final goal is to cultivate specialized cardiovascular diagnosticians especially in the field of perioperative TEE.
The examination, which consists of video and multiple-choice questions, is to be given annually in cooperation with the NBE.
JSCVA, as well as JB-POT, will authorize competent candidates, and expects those certified specialists to enhance the quality of perioperative TEE by making the effort to optimize their skill in the performance and interpretation of cardiac ultrasound, and furthermore to take a core position in the operation of TEE.

Purpose

JB-POT was established to enhance the quality of perioperative transesophageal echocardiography, to encourage individual professional growth in perioperative transesophageal echocardiography, and to coordinate social activity in the practice of perioperative transesophageal echocardiography.

	Assess the level of knowledge in the practice of perioperative transesophageal echocardiography and serve as a source for distribution of information concerning certifying examination in perioperative transesophageal echocardiography
	Give a certifying examination annually
	Organize TEE seminars
	Serve as a source for distribution of information concerning TEE
	Communicate with other oversea societies (e.g., National Board of Echocardiography)
	Coordinate social activities in perioperative transesophageal echocardiography

Executive Director:

Junzo Takeda

Financial Secretaries:

Ryo Ogawa

Keiichi Tada

Secretary General:

Minoru Nomura

Approval Committee Chairperson:

Minoru Nomura

Examination Design Committee Chairperson:

Yasuhiro Koide

Seminar Planning Committee Chairperson:

Hiroshi Kitahata

International Exchange Committee Chairperson:

Tatsuya Yamada

Directors:

Shintaro Beppu
Satoru Fukuda
Kazuo Hanaoka
Shiro Iwanaga
Yasuhiro Koide
Masakazu Kuro
Kiyoshi Morita
Akiyoshi Namiki
Kazumasa Orihashi
Koji Sumikawa

Riichiro Chuma
Hitoshi Furuya
Sumio Hoka
Osamu Kemmotsu
Teruo Kumazawa
Shunei Kyo
Shigeho Morita
Ryozou Omoto
Tsunehiko Shin
Shiro Yamachika

Advisors:

Solomon Aronson
Hiromi Kurosawa
Daniel M. Thys

Steven N. Konstadt
Yasu Oka

Examination date: Sunday, September 12, 2004

Time: Starts at 9:00 am (about for 3 or 4 hours)

Location: Hotel Nikko Tokyo, Daiba, Tokyo

Requirements for 2004 JB-POT exam candidates:

Attend TEE workshops (seminars) co-sponsored by the Japanese Society of Cardiovascular Anesthesiologists (JSCVA) (see Form A for application for TEE workshop.)

10 points credited by JSCVA are needed (2-hour lecture = 5 credits).
(A copy of the attendance verification cards must accompany the application.)
TEE workshops (seminars) prior to September 12, 2004 will be available and attendance verification cards will be checked at the examination desk on the examination date.

Language:

English or Japanese, as indicated on your application form (Form C)

Application fee: 25,000 yen

Discount for attendants of 9th International Congress of Cardiothoracic and Vascular Anesthesia (15,000 yen)

Certification fee: 5,000 yen

Successful candidate has to pay the certification fee. The details are to be provided by the secretariat.

How to apply:

1. Pay the examination fee using Form A (registration form) or on-line registration page.

2. Fill out the application form (Form C).

3. Send the fully completed form with the documentations (a, b, c) explained below by mail, UPS or FedEx to:

The Secretariat of the Japanese Society of Cardiovascular Anesthesiologists
Department of Anesthesiology, Tokyo Women’s Medical University, School of Medicine
8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan

Enclosure:

(a) A copy of attendance verification card if you have one.

(b) Picture (size: 3 x 4cm, taken within last three months; write your name and affiliation on the back of the picture)

(c) Certificate of payment
Please indicate your payment number on the application form (Form C), which will be issued after making payment.

* If you pay using Form A, the payment number will be issued by the ICCVA 2004 registration desk; if on-line, it will be automatically issued on the last screen and by confirmation e-mail.

* Please attach a copy of the bank receipt if you choose bank transfer.

Note:

	*	Please note that the secretariats for application and payment have separate contact addresses, so that payment and application need to be made separately. Application: The Secretariat of the Japanese Society of Cardiovascular Anesthesiologists Payment: The ICCVA 2004 registration desk
	*	Applications by e-mail and fax are not be accepted.
	*	The attendance verification card is explained on the application form.
	*	You cannot take the examination without submission of the attendance verification card.
	*	All applicants will receive an admission ticket at least two weeks before the examination. If you have not received the ticket by then, please contact the secretariat shown below.

JSCVA recommends that if mail is used you obtain proof of delivery. Please apply between the beginning of March and end of June 2004. We will close acceptance as soon as applications reach capacity. Early in March to late June, the application form will be appear on the web site of ICCVA 2004.

Results will be notified in writing by post two months after the examination.
The TEE Examination desk will open from 9:00 to 9:50 am. Tardiness will not be permitted.

For questions regarding the TEE Workshops and Examination, please contact:

The Secretariat of the Japanese Society of Cardiovascular Anesthesiologists Department of Anesthesiology, Tokyo Women's Medical University, School of Medicine 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan
Tel: +81-3-3353-8111 Fax: +81-3-3359-2517
E-mail: jscva@anes.twmu.ac.jp

Principles of Ultrasound

Nature of ultrasound

Frequency, wavelength, penetration, tissue propagation velocity

Properties of ultrasound waves

Acoustic impedance

II.

Transducers

	Piezoelectric effect
	Crystal
	Damping material
	Sound beam formation
	Focusing
	Axial and lateral resolution
	Linear array/ Phased-array transducer

III.

Equipment, Infection Control, and Safety

	Biological effects of ultrasound
	Electrical and mechanical safety
	Infection control
	TEE probe insertion and manipulation
	Contraindications to transesophageal echocardiography
	Complications of transesophageal echocardiography

IV.

Imaging

	Instrumentation
	Displays
	B-mode, M-mode, and two-dimensional echocardiography
	Signal processing

Principles of Doppler Ultrasound

	Doppler effect
	Doppler equation
	Doppler shift frequencies and influencing factors
	Nyquist limit
	Spectral analysis and display characteristics
	Pulsed-wave Doppler / High pulse repetition frequency pulsed-wave Doppler
	Continuous-wave Doppler
	Color flow Doppler
	Color M-mode

VI.

Quantitative M-Mode and Two-Dimensional Echocardiography

	Edge recognition/ Cardiac cycle
	Fixed and floating axis
	Center-line method
	Global function; measurements and calculations

VII.

Quantitative Doppler

	Types of velocity measurements
	Proximal isovelocity surface area
	Valve gradients, and valve area measurements
	Cardiac chamber and great vessel pressures
	Tissue Doppler

VIII.

Doppler Profiles and Assessment of Diastolic Function

	Tricuspid valve and right ventricular inflow
	Pulmonary valve and right ventricular outflow
	Mitral valve and left ventricular inflow
	Aortic valve and left ventricular outflow
	Non-valvular flow profiles

IX.

Cardiac Anatomy

	Imaging planes
	Cardiac chambers and walls
	Cardiac valves
	Cardiac cycle and relation of events relative to ECG

Pericardium and Extracardiac Structures

Pericardium and pericardial space

Pulmonary arteries

Pulmonary veins

Vena cavae and hepatic veins

Coronary arteries

Aorta and Great Vessels

Anatomy/ Atherosclerosis/ Aneurysm/ Dissection and traumatic injury of the aorta

Pleural space

XI.

Pathology of the Cardiac Valves

Acquired valve diseases

Endocarditis/ Rheumatic/ Myxomatous/ Calcific / degenerative/ Traumatic

Tricuspid

Pulmonary

Mitral

Mitral regurgitation/ Ischemic mitral valve dysfunction/ Mitral stenosis/ Systolic anterior motion of mitral valve (SAM)

Aortic

Aortic regurgitation/ Aortic stenosis

XII.

Intracardiac Masses and Devices

	Tumors
	Thrombi
	Devices and foreign bodies

XIII.

Global Ventricular Systolic Function

Normal left ventricular systolic function

Abnormal left ventricular systolic function

Etiologies including ischemia/ Assessment/ ejection fraction/ Confounding factors

Right ventricular systolic function

Cardiomyopathies

Hypertrophic/ Restrictive/ Dilated

XIV.

Segmental Left Ventricular Systolic Function

Myocardial segment identification

Coronary artery distribution and flow

Normal and abnormal segmental function

Assessment and methods/ Differential diagnosis/ Confounding factors

XV.

Assessment of Perioperative Events and Problems

Hypotension and causes of cardiovascular instability

Cardiac surgery; techniques, and problems

Assessment of bypass and cardioplegia/ Cannulae and devices commonly used during cardiac surgery/ Circulatory assist devices/ Intracavity air/ Minimally invasive cardiopulmonary bypass/ Off pump cardiac surgery

Coronary surgery; techniques and assessment

Valve surgery; techniques and assessment

Valve replacement (mechanical, bioprosthetic)/ Valve repair

Transplantation surgery

Heart/ Lung/ Liver

XVI.

Congenital Heart Disease

	Identification and situs of morphologically left and right structures
	Atrial septal defects
	Ventricular septal defects
	Pulmonary valve and infundibular stenosis
	Left atrial and mitral valve conditions
	Aortic valve and left ventricular outflow tract abnormalities
	Coronary artery anomalies
	Patent ductus arteriosus
	Coarctation of the aorta
	Ebstein's anomaly
	Persistent left superior vena cava
	Tetralogy of Fallot
	Transposition of great arteries
	Atrioventricular septal defect - "AV canal"
	Conditions with single ventricle physiology

XVII.

Artifacts and Pitfalls

	Imaging artifacts
	Doppler artifacts and pitfalls
	Structures mimicking pathology

XVIII.

Related Diagnostic Modalities

	Stress echocardiography
	Myocardial perfusion imaging
	Epicardial scanning
	Contrast echocardiography
	Utility of TEE relative to other diagnostic modalities