ASE Guidelines and Standards - American Society of Echocardiography

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NOTICE AND DISCLAIMER: These reports are made available by ASE as a courtesy reference source for its members. The reports contain recommendations only and should not be used as the sole basis to make medical practice decisions or for disciplinary action against any employee. The statements and recommendations contained in these reports are primarily based on the opinions of experts, rather than on scientifically-verified data. ASE makes no express or implied warranties regarding the completeness or accuracy of the information in these reports, including the warranty of merchantability or fitness for a particular purpose. In no event shall ASE be liable to you, your patients, or any other third parties for any decision made or action taken by you or such other parties in reliance on this information. Nor does your use of this information constitute the offering of medical advice by ASE or create any physician-patient relationship between ASE and your patients or anyone else.

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3D Echocardiography

New Document ♦ Recommendations for Image Acquisition and Display Using Three-Dimensional Echocardiography, JASE, January 2012
Three dimensional echocardiographic imaging represents a major innovation in cardiovascular ultrasound. The main goal of this document is to provide a practical guide on how to acquire, analyze, and display the various cardiac structures using 3D echocardiography, as well as limitations of the technique. In addition, this document describes the current and potential clinical applications of 3D echocardiography along with their strengths and weaknesses. (01/12) Full-Text PDF

Other Published 3D Document (2007):
3D Echocardiography: A Review of the Current Status and Future Directions, JASE, March 2007
Ultrasound technology has improved markedly in the past 10 to 15 years, prompting echocardiographers to extend its use in studying cardiac structure and function. New ultrasound equipment and techniques offer superior image quality, greater accuracy, and expanding capabilities. As a result, more and improved imaging modalities are available for evaluating cardiac anatomy, ventricular function, blood flow velocity, and valvular diseases. Three dimensional (3D) echocardiography offers the ability to improve and expand the diagnostic capabilities of cardiac ultrasound.

Vascular

New Document ♦ Guidelines for Performing Ultrasound Guided Vascular Cannulation: Recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists, JASE, December 2011
Recommendations in this guideline are for ultrasound guided central venous access of the internal jugular vein, subclavian vein, and femoral vein on the basis of the strength of the scientific evidence present in the literature. The role of ultrasound for vascular cannulation of pediatric patients is discussed specifically, as well as the use ofultrasound to facilitate arterials cannulation and peripheral venous access. Recommendations are made for training, including the role of simulation. (12/11) Full-Text PDF

Use of Carotid Ultrasound to Identify Subclinical Vascular Disease and Evaluate Cardiovascular Disease Risk: A Consensus Statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force Endorsed by the Society for Vascular Medicine, JASE, February 2008
Echocardiography plays an evolving and important role in the care of heart failure patients treated with biventricular pacing, or cardiac resynchronization therapy (CRT). Numerous recent published reports have utilized echocardiographic techniques to potentially aide in patient selection for CRT prior to implantation and to optimized device settings afterwards. However, no ideal approach has yet been found. This consensus report evaluates the contemporary applications of chocardiography for CRT including relative strengths and technical limitations of several techniques and proposes guidelines regarding current and possible future clinical applications. Endorsed by the Heart Rhythm Society. (2/08)

Other Published Vascular Documents:

Clinical Application of Noninvasive Vascular Ultrasound in Cardiovascular Risk Stratification: A Report from the American Society of Echocardiography and the Society of Vascular Medicine and Biology, JASE, August 2006
Noninvasive measures of atherosclerosis have emerged as adjuncts to standard cardiovascular disease (CVD) risk factors in an attempt to refine risk stratification and the need for more aggressive preventive strategies. Two such approaches, carotid artery imaging and brachial artery reactivity testing (BART), are ultrasound based. Numerous carotid artery imaging protocols have been used, and methodologic aspects are described in detail in this review.

Guidelines for Noninvasive Vascular Laboratory Testing: A Report from the American Society of Echocardiography and the Society of Vascular Medicine and Biology, JASE, August 2006
The document summarizes principles integral to vascular duplex ultrasound–including color Doppler, spectral Doppler waveform analysis,power Doppler, and the use of contrast. Appropriate indications and interpretation of carotid artery, renal artery, abdominal aorta, and peripheral artery ultrasound imaging are described.

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Valves

New Document ♦ Recommendations for the Use of Echocardiography in New Transcatheter Interventions for Valvular Heart Disease, JASE, September 2011
This document was written in collaboration with the European Association of Echocardiography, a registered branch of the European Society of Cardiology
Until recently, transcatheter therapy for valvular heart disease was limited to balloon valvuloplasty. However, the introduction of devices for transcatheter aortic valve implantation (TAVI), mitral repair, and closure of prosthetic paravalvular leaks has led to a greatly expanded armamentarium of catheter-based approaches to patients with regurgitant as well as stenotic valvular disease. Echocardiography plays an essential role in identifying patients suitable for these interventions and in providing intra-procedural monitoring. Moreover, echocardiography is the primary modality for post-procedure follow-up. The echocardiographic assessment of patients undergoing transcatheter interventions places demands on echocardiographers that differ from those of the routine evaluation of patients with native or prosthetic valvular disease. Consequently, anticipating growing use of transcatheter valve therapies and, along with it, expanding need for informed echocardiographic evaluation, ASE and EAE collaborated to develop these recommendations. It is intended that this document will complement the earlier ASE guideline for echocardiography-guided interventions and will serve as a reference for echocardiographers participating in any or all stages of new transcatheter treatments for patients with valvular heart disease. (9/11) Full-Text PDF

Other Published Valve Documents:

Recommendations for Evaluation of Prosthetic Valves With Echocardiography and Doppler Ultrasound, JASE, September 2009
This document was endorsed by the American College of Cardiology Foundation, American Heart Association, the European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography and the Canadian Society of Echocardiography.
This document offers a review of echocardiographic and Doppler techniques used in the assessment of prosthetic valves and provides recommendations and general guidelines for the evaluation of prosthetic valve function on the basis of the scientific literature and the consensus of an international panel of experts. ♦ A Chinese translation of this document is available at www.asecho.org/translations

ASE products illustrating measurements in the Recommendations for Evaluation of Prosthetic Valves With Echocardiography and Doppler Ultrasound guideline document are now available for purchase at ASE Marketplace.

Echocardiographic Assessment of Valve Stenosis: EAE/ASE Recommendations for Clinical Practice, JASE, January 2009
This document was written in collaboration with the European Association of Echocardiography, a registered branch of the European Society of Cardiology
Valve stenosis is a common heart disorder and an important cause of cardiovascular morbidity and mortality. Echocardiography has become the key tool for the diagnosis and evaluation of valve disease, and is the primary non-invasive imaging method for valve stenosis assessment. The aim of this paper was to detail the recommended approach to the echocardiographic evaluation of valve stenosis, including recommendations for specific measures of stenosis severity, details of data acquisition and measurement, and grading of severity.
Document Errata:
1. On Page 9, 3rd paragraph on left: The dose of dobutamine for dobutamine stress echo for evaluating low gradient aortic stenosis is mentioned as "2.5 or 5m/kg/min with an incremental increase in the infusion every 3-5 min to a maximum dose of 10-20 mg/kg/min." The mg is a typographical error and should be mcg/kg/min or ug/kg/min.
2. Page 14: The formula on left in section B.1.5: MVA = π (r² )(V...etc.) is incorrect. The correct formula is MVA = 2π (r² )(V...etc.).

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Recommendations for Evaluation of the Severity of Native Valvular Regurgitation with Two-Dimensional and Doppler Echocardiography, JASE, July 2003
This document offers a critical review of echocardiographic and Doppler techniques used in the evaluation of valvular regurgitation in the adult patient, and provides recommendations for the assessment of severity of valvular regurgitation.

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Multimodality Documents

Clinical Recommendations for Multimodality Cardiovascular Imaging of Patients with Hypertrophic Cardiomyopathy, JASE, May 2011. Endorsed by the American Society of Nuclear Cardiology, Society for Cardiovascular Magnetic Resonance, and Society of Cardiac Computed Tomography.
Advances in cardiac imaging have brought an increasing complexity of imaging choices for busy clinicians. Clininicians can image the heart using ultrasound, MRI, CT or nuclear cardiology techniques. Physicians need to make appropriate choices among the imaging options to avoid duplicate testing or getting studies which don't address the clinical question. For physicians caring for patients with Hypertrophic Cardiomyopathy (HCM), a new resource is available to assist this process. Unlike many guideline documents which focus on a specific type of cardiac imaging (CT, MRI, etc), this paper brings together experts across all types of cardiac imaging to focus on a specific clinical disorder. This guideline reviews the strengths and weaknesses of the different ways to image the heart in patients with HCM. By taking a critical look at the most commonly used cardiac imaging modalities and most common clinical questions in patients with HCM, this guide should prove to be a valuable resource. (5/11) Full Text PDF

Resynchronization/Mechanics

Current and Evolving Echocardiographic Techniques for the Quantitative Evaluation of Cardiac Mechanics: ASE/EAE Consensus Statement on Methodology and Indications, JASE, March 2011
Echocardiographic imaging is ideally suited for the evaluation of cardiac mechanics because of its intrinsically dynamic nature. Because for decades, echocardiography has been the only imaging modality that allows dynamic imaging of the heart, it is only natural that new, increasingly automated techniques for sophisticated analysis of cardiac mechanics have been driven by researchers and manufacturers of ultrasound imaging equipment. The goal of this document is to focus on the currently available techniques that allow quantitative assessment of myocardial function via image-based analysis of local myocardial dynamics, including Doppler tissue imaging and speckle-tracking echocardiography, as well as integrated back-scatter analysis. This document describes the current and potential clinical applications of these techniques and their strengths and weaknesses, briefly surveys a selection of the relevant published literature while highlighting normal and abnormal findings in the context of different cardiovascular pathologies, and summarizes the unresolved issues, future research priorities, and recommended indications for clinical use. (3/11) Full Text PDF

Other Published Resynchronization Documents:

Echocardiography for Cardiac Resynchronization Therapy: Recommendations for Performance and Reporting–A Report from the American Society of Echocardiography Dyssynchrony Writing Group, JASE, March 2008
Echocardiography plays an evolving and important role in the care of heart failure patients treated with biventricular pacing, or cardiac resynchronization therapy (CRT). Numerous recent published reports have utilized echocardiographic techniques to potentially aide in patient selection for CRT prior to implantation and to optimized device settings afterwards. However, no ideal approach has yet been found. This consensus report evaluates the contemporary applications of chocardiography for CRT including relative strengths and technical limitations of several techniques and proposes guidelines regarding current and possible future clinical applications. Endorsed by the Heart Rhythm Society.

Appropriate Use Criteria

ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 Appropriateness Use Criteria for Echocardiography document, JASE, March 2011
The American Society of Echocardiography, in partnership with the American College ofCardiology Foundation (ACCF) and along with key specialty and subspecialty societies, conducted a review of common clinical scenarios where echocardiography is frequently considered. This document combines and updates the original transthoracic and transesophageal echocardiography appropriateness criteria published in 2007 and the original stress echocardiography appropriateness criteria published in 2008. This revision reflects new clinical data, reflects changes in test utilization patterns, and clarifies echocardiography use where omissions or lack of clarity existed in the original criteria. Full-Text PDF

Other Published Appropriate Use Criteria Documents:

ACCF/ASE/ACEP/AHA/ASNC/SCAI/SCCT/SCMR 2008 Appropriateness Criteria for Stress Echocardiography
This document has been replaced by the 2011 Appropriateness Use Criteria for Echocardiography document.

ACCF/ASE/ACEP/ASNC/SCAI/SCCT/SCMR 2007 Appropriateness Criteria for Transthoracic and Transesophageal Echocardiography
This document has been replaced by the 2011 Appropriateness Use Criteria for Echocardiography document.

Reporting/Quality

American Society of Echocardiography Recommendations for Quality Echocardiography Laboratory Operations, JASE, January 2011
Ensuring a high level of quality in echocardiography is a primary goal of the American Society of Echocardiography (ASE). Establishing a definition of quality in cardiovascular imaging has been challenging, and there has been limited agreement on quality standards for imaging. Quality can be measured as adherence to established guidelines for the use of a technology to ensure patient satisfaction and outcomes. However, specific criteria to ensure quality must be established for each phase of the process, from considering a test for a patient to incorporating the results of the test appropriately into patient care. The purpose of this report is to provide a framework for echocardiographic quality assessment and improvement. Because this document establishes guidelines in the various components of quality in echocardiographic imaging services, the initial goal is to highlight general recommendations for minimum quality standards and provides some numerical or threshold values for compliance. Thus, the standards recommended in this document are realistic goals for the average practitioner. (1/11) Full Text PDF

Other Published Reporting Documents:

ASE Guidelines and Recommendations for Digital Echocardiography, JASE, March 2005
A Report from the Digital Echocardiography Committee of the American Society of Echocardiography Click here to be directed to the appendix materials for the NEW Guidelines and Recommendations for Digital Echocardiography

Recommendations for a Standardized Report for Adult Transthoracic Echocardiography, JASE, September 2001
The American Society of Echocardiography has published guidelines relating to standards for training (and certification); performance; nomenclature and measurement; and quality improvement related to echocardiography.

Recommendations for CQI in Echocardiography, JASE, September-October 1995 (See American Society of Echocardiography Recommendations for Quality Echocardiography Laboratory Operations, JASE, January 2011)

Emergency Medicine

Focused Cardiac Ultrasound in the Emergent Setting: A Consensus Statement of the American Society of Echocardiography and American College of Emergency Physicians, JASE, December 2010
The use of ultrasound has developed over the last 50 years into an indispensable first-line test for the cardiac evaluation of symptomatic patients. The technologic miniaturization and improvement in transducer technology, as well as the implementation of educational curriculum changes in residency training programs and specialty practice, have facilitated the integration of focused cardiac ultrasound into practice by specialties such as emergency medicine. In the emergency department, focused cardiac ultrasound has become a fundamental tool to expedite the diagnostic evaluation of the patient at the bedside and to initiate emergent treatment and triage decisions by the emergency physician. (12/10) Full-Text PDF

Other published documents related to Emergency Medicine:

Hand-carried Ultrasound Device: Recommendations Regarding New Technology, JASE, April 2002 [ASE Position Statement Addendum]

ASE Position Statement on HCU (4/03)

Echocardiography in Emergency Medicine: A Policy Statement by the ASE and the ACC, JASE, January 1999
A Policy Statement by the American Society of Echocardiography and the American College of Cardiology on the use of echocardiography in emergency situations.

Chamber Quantification

Guidelines for the Echocardiographic Assessment of the Right Heart in Adults: A Report from the American Society of Echocardiography, JASE, July 2010
This document was endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography
The right ventricle plays an important role in the morbidity and mortality of patients presenting with signs and symptoms of cardiopulmonary disease. However, the systematic assessment of right heart function is not uniformly carried out. This is due partly to the enormous attention given to the evaluation of the left heart, a lack of familiarity with ultrasound techniques that can be used in imaging the right heart, and a paucity of ultrasound studies providing normal reference values of right heart size and function.

Document Errata:
1. Page 686, last line should read "mm indicate at end-systole RA enlargement."
2. Page 699, section C, Mean PA Pressure, sentence beginning at line 8 of that section should read: "Generally, the shorter the AT (measured from the onset of flow on the pulsed Doppler envelope in the RVOT to the peak pulmonary flow velocity in the same envelope), the higher the PVR and hence the PA pressure, provided the heart rate is in the normal range of 60 to <100 beats/mins."

ASE products illustrating the Guidelines for the Echocardiographic Assessment of the Right Heart in Adults document are now available for purchase at ASE Marketplace.

Other Published Chamber Quantification Documents:

Recommendations for Quantification Methods During the Performance of a Pediatric Echocardiogram: A Report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council, JASE, May 2010
Echocardiographic quantification is crucial in the diagnosis and management of patients with acquired and congenital heart disease (CHD). ASE and the European Association of Echocardiography have published recommendations on how to measure the size and function of cardiovascular structures in adults, providing reference limits to distinguish normal from abnormal values. Identifying an abnormal measurement helps assess the effect of a disease on the size of a cardiovascular structure, determine when intervention may be necessary, and monitor the effect of the intervention. However, the size of cardiovascular structures is influenced not only by the hemodynamics of disease states and their treatments but also by confounding factors, such as growth, age, gender, race, body composition, basal metabolic rate, hematocrit, exercise, and altitude. (05/10) Full-Text PDF

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Recommendations for Chamber Quantification, JASE, December 2005
A Report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, Developed in Conjunction with the European Association of Echocardiography, a Branch of the European Society of Cardiology. Quantification of cardiac chamber size, ventricular mass, and function ranks among the most clinically important and most frequently requested tasks of echocardiography. Standardization of chamber quantification has been an early concern in echocardiography and recommendations on how to measure such fundamental parameters are among the most often cited articles in the field. (12/05) ♦ The Chinese and Spanish translations of this document are now available at www.asecho.org/translations

ASE products illustrating measurements in the Recommendations for Chamber Quantification guideline document are now available for purchase at ASE Marketplace.

New Document ♦ Current and Evolving Echocardiographic Techniques for the Quantitative Evaluation of Cardiac Mechanics: ASE/EAE Consensus Statement on Methodology and Indications, JASE, March 2011
(See description under "Resynchronization/Mechanics")

Research

Current and Evolving Echocardiographic Techniques for the Quantitative Evaluation of Cardiac Mechanics: ASE/EAE Consensus Statement on Methodology and Indications, JASE, March 2011
(See description under "Resynchronization/Mechanics")

Echocardiographic Imaging in Clinical Trials: American Society of Echocardiography Standards for Echocardiography Core Laboratories, JASE, July 2009
This document was endorsed by the American College of Cardiology Foundation
Imaging with cardiac ultrasound is a critical element of cardiovascular clinical research. The noninvasive assessment of cardiac structure, function, and hemodynamics using echocardiography can provide essential data on the safety and efficacy of drugs and devices, as well as insight into mechanisms of disease and therapeutic benefit. Echocardiography may also be used to assess enrollment eligibility, provide surrogate endpoints, suggest future research directions, and assist in determining optimal patterns of clinical surveillance. However, the value of this information is highly dependent on the quality of the planning and performance of imaging, the quality of data analysis, and the appropriate incorporation of results into overall trial analysis. A previous ASE document, "Recommendations for Use of Echocardiography in Clinical Trials," describes the importance of high-quality imaging for research. It recommends methods for some of the common applications of echocardiography, such as determinations of left ventricular ejection fraction and mass, but it does not extensively address the roles and responsibilities of core laboratories or other issues such as personnel, study design, imaging review charters, site management, information technology, and statistical analysis. No other document or guidelines statement exists to fill these gaps. Thus, there is a great need for a clear and universally accepted set of "best practices" in these areas, which form the core of this consensus-driven standards document. (07/09) Full-Text PDF

Other Published Research Documents:

ASE Recommendations for Use of Echocardiography in Clinical Trials, JASE, October 2004
A Report from the American Society of Echocardiography’s Guidelines and Standards Committee and The Task Force on Echocardiography in Clinical Trials. Echocardiography provides comprehensive evaluation of the cardiovascular structure, function, and hemodynamics that characterize disease processes. Hence, echocardiography has been used successfully to provide mechanistic insights on therapeutic outcomes, and in some cases to measure functional and structural changes that are considered to be of therapeutic importance.

Echo-Guided Interventions

ASE Recommendations for Clinical Practice: Echocardiography-Guided Interventions, JASE, March 2009
The treatment of many types of structural heart disease is moving away from pure surgical approaches and emphasizing less invasive techniques. These techniques include procedures done in the heart catheterization and arrhythmia laboratories. When working on the heart with these less invasive techniques, imaging the procedure as it is being performed (in real time) with echocardiography has taken on a central role in selecting the right patients to work on, guiding the procedures as they are being performed, and monitoring their safety during the procedure. The use of echo to guide a variety of procedures has made it safer, tfaster, improved results, and allowed physicians to treat an increasing complex group of patients without open heart surgery. This document explains and illustrates how physicians can use echocardiography in a wide variety of procedures. The document discusses all modalities of echocardiography, including "intracardiac echocardiography" or ICE, which is anewer type of echo that places the imaging probe within the heart during these procedures. Benefits of each mode of echocardiography are considered as it relates to each procedure, and recommendations are made to help guide the selection of the "right" mode of echo for the specific procedure being performed. This is the first document of its kind that sets the standard for imaging during procedures, and serves as an important reference to a wide variety of physicians. (3/09) Full Text PDF

Left Ventricular Diastolic Function

Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography, JASE, February 2009
This document was written in collaboration with the European Association of Echocardiography, a registered branch of the European Society of Cardiology
The assessment of left ventricular (LV) diastolic function should be an integral part of a routine examination, particularly in patients presenting with dyspnea or heart failure. About half of patients with new diagnoses of heart failure have normal or near normal global ejection fractions (EFs). These patients are diagnosed with "diastolic heart failure" or "heart failure with preserved EF." The assessment of LV diastolic function and filling pressures is of paramount clinical importance to distinguish this syndrome from other diseases such as pulmonary disease resulting in dyspnea, to assess prognosis, and to identify underlying cardiac disease and its best treatment. The purpose of this document is to provide a comprehensive review of the techniques and the significance of diastolic parameters, as well as recommendations for nomenclature and reporting of diastolic data in adults. The recommendations are based on a critical review of the literature and the consensus of a panel of experts. (2/09) Full-Text PDF (1463 KB) ♦ A Chinese translation of this document is available at www.asecho.org/translations

ASE products illustrating measurements in the Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography guideline document are now available for purchase at ASE Marketplace.

Contrast Echocardiography

ASE Consensus Statement on the Clinical Applications of Ultrasonic Contrast Agents in Echocardiography, JASE, November 2008
Ultrasound contrast agents, used with contrast-specific imaging techniques, have an established role for diagnostic cardiovascular imaging in the echocardiography laboratory. This document focuses on when and how contrast agents are used to enhance the diagnostic capability of echocardiography. It also reviews the role of physicians, sonographers, and nurses, as well as ways to integrate the use of contrast agents into the echocardiography laboratory most efficiently. (11/08) Full-Text PDF (2999 KB)

ASE products illustrating measurements in the ASE Consensus Statement on the Clinical Applications of Ultrasonic Contrast Agents in Echocardiography document are now available for purchase at ASE Marketplace.

Other Published Contrast Documents:

Guidelines for the Cardiac Sonographer in the Performance of Contrast Echocardiography: Recommendations of the ASE Council on Cardiac Sonography, JASE, May 2001
Contrast echocardiography requires a high level of competence and expertise in addition to the skills frequently required in standard cardiac sonography practice. The American Society of Echocardiography highly recommends that cardiac sonographers take the appropriate steps to become trained in the administration of the contrast agents used in echocardiography.

Pediatric/Fetal/Congenital/Neonatal
Visit all ASE pediatric/fetal/congenital/neonatal guideline documents at www.asecho.org/pedguidelines

Intraoperative/TEE

Guidelines for the Performance of a Comprehensive Intraoperative Epiaortic Ultrasonographic Examination, JASE, November 2007
Recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists; Endorsed by the Society of Thoracic Surgeons. (11/07) Full-Text PDF PLEASE NOTE: The link to the video on page 1228 is temporarily broken. In the meantime, you can access that video here.

Other Published Intraoperative/TEE Documents:

Guidelines for Performing a Comprehensive Epicardial Echocardiography Examination: Recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists, JASE, April 2007
During the last few decades, the utility of intraoperative echocardiography has become increasingly evident as anesthesiologists, cardiologists, and surgeons continue to appreciate its potential application as an invaluable tool for monitoring cardiac performance and diagnosing pathology in patients undergoing cardiac surgery.The essential information provided by intraoperative echocardiography regarding hemodynamic management, cardiac valve function, congenital heart lesions, and great vessel pathology has contributed to its widespread popularity.

ASE/SCA Recommendations and Guidelines for Continuous Quality Improvement in Perioperative Echocardiography, JASE, November 2006
Recommendations and guidelines for a CQI program specific to the perioperative environment. Using the prior ASE publication on CQI as the foundation, we will: (1) present a rationale for CQI in the perioperative period; (2) define the components of a perioperative echocardiography service; (3) establish the principles of CQI as they relate to the practice of perioperative echocardiography; and (4) assess whether CQI programs are effective in the perioperative period.

ASE Indications and Guidelines for Performance of Transesophageal Echocardiography in the Patient with Pediatric Acquired or Congenital Heart Disease, JASE, January 2005
A Report from the Task Force of the Pediatric Council of the American Society of Echocardiography

ASE and SCA Task Force Guidelines for training in Perioperative Echocardiography, JASE, June 2002.

ASE/SCA Guidelines for Performing a Comprehensive Intraoperative Multiplane Transesophageal Examination, JASE, October 1999
This document outlines recommendations performing a comprehensive TEE with descriptions of equipment, provision for developing skills, and mechanisms for assessing the technical quality and completeness of individual studies.

ASE products illustrating measurements in the ASE/SCA Guidelines for Performing a Comprehensive Intraoperative Multiplane Transesophageal Examination document are now available for purchase at ASE Marketplace.

Stress Echocardiography

American Society of Echocardiography Recommendations for Performance, Interpretation, and Application of Stress Echocardiography, JASE, September 2007
Advances since the 1998 publication of the Recommendations for Performance and Interpretation of Stress Echocardiography include improvements in imaging equipment, refinements in stress testing protocols and standards for image interpretation,and important progress toward quantitative analysis. Moreover, the roles of stress echocardiography for cardiac risk stratification and for assessment of myocardial viability are now well documented. ♦ A Spanish translation of this document is available at www.asecho.org/translations

ASE products illustrating measurements in the ASE Recommendations for Performance, Interpretation, and Application of Stress Echocardiography guideline document are now available for purchase at ASE Marketplace.

Cardiovascular Sonography

ASE Minimum Standards for the Cardiac Sonographer: A Position Paper, November 2005
A Report from the Council of Cardiac Sonography of the American Society of Echocardiography

Other Cardiovascular Sonography Documents:

Proposed Local Coverage Determination (LCD) Language Relating To Laboratory Accreditation and Physician and Sonographer Qualifications for Transthoracic Echocardiography, April 2005
The accuracy of a transthoracic echocardiogram depends on the knowledge, skill, and experience of both the individual performing the study and the physician interpreting the study.

Guidelines for Cardiac Sonography Education, JASE, January 2001
Recommendations of the American Society of Echocardiography Sonographer Training and Education Committee.

Training

ASE Minimum Standards for the Cardiac Sonographer: A Position Paper, November 2005
A Report from the Council of Cardiac Sonography of the American Society of Echocardiography

PROPOSED LOCAL COVERAGE DETERMINATION (LCD) LANGUAGE RELATING TO LABORATORY ACCREDITATION AND PHYSICIAN AND SONOGRAPHER QUALIFICATIONS FOR TRANSTHORACIC ECHOCARDIOGRAPHY
The accuracy of a transthoracic echocardiogram depends on the knowledge, skill, and experience of both the individual performing the study and the physician interpreting the study.

Hand-carried Ultrasound Device: Recommendations Regarding New Technology, April 2002 [ASE Position Statement Addendum]

Documents Endorsed by ASE
Visit documents endorsed by ASE at www.asecho.org/endorsed

PLEASE NOTE: All ASE guideline documents are copyrighted. Materials may not be used for commercial purposes and are solely for use for educational purposes.