CASE Marches Onward

The latest issue of CASE is now available with intriguing reports, including “Mitral Regurgitation due to Entrapment of Cut Mitral Chordal Apparatus in a Bileaflet Disk Prosthesis” by Bansal & Rabkin. Editor-In-Chief Vincent L. Sorrell, MD, FASE, remarked, “The authors take the readers on a clinical tour of a 38-year-old man with endocarditis that will have many aspects similar to patients we see weekly in our hospitals. Transferred from another hospital to receive a higher level of care, the patient developed severe MR and heart failure requiring urgent valve surgery. Repair was not feasible, and the patient received a typical bileaflet mechanical mitral valve replacement (MVR). However, after coming off bypass circulation, the intraoperative TEE demonstrated severe MR of the brand-new MVR. The authors do a spectacular job of walking the readers through their discovery of this patient’s pathology – entrapment of some components of the subvalvular apparatus between the MVR housing and disk. Then, they further educate readers by providing a schematic representation of how to assess for valvular and paravalvular regurgitation after MVR. Their report includes 2D and 3D TEE examples as well as drawings and photographs to drive their messaging. I’m sure you will enjoy reading this as much as I enjoyed helping prepare this for CASE.”

This issue presents two additional cases in the Valvular Heart Disease category, including a rare instance of a mitral valve-in-valve-in-valve procedure, and a report with a series of characteristic images of a disease that uniquely impacts the pulmonic and tricuspid valves. Authors in a Multimodality Imaging case submit a varied imaging approach to diagnose biventricular endomyocardial fibrosis complicated by coexisting chronic myeloid leukemia. Finally, a report for Veterinary Clinical Cardiovascular Medicine uses TTE, radiology, gross and histo-pathology to reveal the correlation between diagnostic imaging and pathology in a dog living with severe pulmonary hypertension. Dr. Sorrell’s editorial encourages readers to share their own echo insights through their social media platforms, as these platforms can serve as a valuable educational tool to teachers and learners alike.

Looking for a journal to submit your case report to? We want to hear from you! Email us with questions or submit your report today.

ONE MONTH Left to Apply for an ASEF Council Travel Grant

Submission Deadline: April 15

ASE member trainees are invited to apply for an ASEF 2024 Council Travel Grant to support their attendance at the ASE 2024 Scientific Sessions in Portland, Oregon.

These $1,000 USD grants are part of an ongoing effort by the Foundation and the Council Steering Committees to encourage trainees in cardiovascular specialties to focus on the respective echocardiography subspeciality and to recruit enthusiastic new members to ASE Councils. Additionally, grant recipients benefit from a deeper understanding of the imaging field and have the opportunity to develop meaningful mentoring relationships with established imaging faculty. Full application details are available here. The application closes April 15, 2024.

This Month: ASEF’s Spring Giving Fundraiser

Join the ASE Foundation between March 17 – 23 for our Spring Giving fundraiser. Kick-start our 2024 Annual Appeal and help the next generation of cardiovascular ultrasound professionals bloom with a contribution to our Travel Grants and Scholarships initiative.

We set a goal to raise $5,000 and need your support. Every year, the ASE Foundation offers student, sonographer, and fellow travel grants and scholarships to support training and educational conference participation. Donations made to the Travel Grants and Scholarships initiative directly impact the number of scholarships and travel grants we are able to fund.

We hope you will plan to support ASEF and the next generation of our field March 17 – 23. Donations will be accepted online here and in the ASE Portal. If you donate in the Portal, make sure to allocate your contribution towards Travel Grants and Scholarships. Email Foundation@ASEcho.org to make an early pledge.

An Extra Special Issue of CASE

The CASE Special Issue on adult congenital heart disease (ACHD) is now available with over 30 high-quality reports, including “The Utility of Multimodality Imaging in a Patient with Ebstein Anomaly” by McClelland et al. Author Isla McClelland, MD, remarked, “Ebstein anomaly patients in the adult cardiology clinic present a unique challenge to providers as they can be repaired or unrepaired and can present with progressive symptoms after many years of feeling well.  Multimodality imaging gives providers the necessary tools to adequately follow and plan surgical intervention on these patients.  Our case report presents an example of how these imaging modalities all work in concert to provide a complete medical picture of a patient’s valve anatomy and associated lesions, without which an appropriate surgical plan cannot be created.”

Most children born with congenital heart disease live beyond 50 years of age, so there are more adults with congenital heart disease living today than there are children. However, data suggests that less than 10% of adults with CHD receive the recommended subspecialty cardiovascular care. CASE Editor-in-Chief Vincent L. Sorrell, MD, FASE noted, ““It’s difficult to isolate a single report from this special issue on ACHD that should be highlighted since they all provide unique educational value related to their selected congenital abnormality. I have learned over the years that no two patients with ACHD are exactly alike. Therefore, having CASE reports as teaching examples to expand your diagnostic acumen is critically important. Malone et al. do an exceptional job of providing Journal readers with a CASE series on patients with double-chambered right ventricles. If you work in a moderate sized echo lab, you have no doubt scanned a patient with this pathology. The important question, though, is did you recognize it for what it was? These authors give you 3 CASE examples which include the typical 2D and comprehensive Doppler TTE findings, but also include ECG, fluoroscopic ventriculography, cardiovascular MRI, cardiac computed tomography and even an intraoperative surgical photograph. Their CASE series should be read by everyone who performs echocardiography and wants to improve their skills on detecting the next patient with DCRV who comes through their lab.”

This special issue serves as an educational tool, compiling reports from the adult echocardiographic community to develop more expertise in understanding these complex diseases and post-operative complications, as well as how best to acquire the necessary comprehensive images to assist in diagnosis and management.

Advanced tomographic multimodality imaging (MMI) substantially contributes to the management of patients with CHD (ACHD), so the Multimodality Imaging category is quite robust with six reports, including a rare diagnosis of a unilateral absence of a pulmonary artery in an adult with recurrent bronchopneumonia. The Coronary Artery Disease category emphasizes the role that TEE offers in patients after a Ross procedure, highlights the development of coronary aneurysms after congenital heart surgery, and includes reports that highlight the careful imaging approaches taken to anomalous left and right coronary arteries originating from the pulmonary artery.

Since one of the most common CHD pathologies in the adult is a bicuspid aortic valve, Valvular Heart Disease is an important subsection, including an extraordinary report on an 80-year-old patient with undiagnosed L-TGA who presented for TAVI evaluation. Patients with CHD are encouraged to maintain a record of their medical and surgical history, so the Post-Operative Pathology section is included with reports on the complications that may arise in the adult after various corrective surgeries for D-TGA, Ebstein anomaly, and atrioventricular canal defect. The subsection titled Interventional Echocardiography contains reports on novel transcatheter approaches to treat a patient with a primum ASD, a ruptured sinus of Valsalva aneurysm, pulmonic stenosis, and a left SVC to LA fistula.

Just Another Day in the Echo Lab offers many imaging tips and tricks among its reports, including a case series on patients variably presenting with a double-chambered RV, two patients evaluated for arterial hypertension during pregnancy, and a patient with cor triatriatum. Veterinary Clinical Cardiovascular Medicine rounds out this issue with reports in which readers will see many commonalities between diagnostic assessment in humans and animals. In this issue’s editorial, Dr. Sorrell encourages readers to expand their differential diagnoses in adults to include both common and uncommon forms of congenital heart disease.

Looking for a journal to submit your case report to? We want to hear from you! Email us with questions or submit your report today. Be sure to check out the latest Sonographer Sound-Off and Unlock the CASE features on the CASE Homepage to view more extraordinary work from your colleagues.

Vote for New Officers and Board of Directors

Submit Your Ballot by March 24

Now is the time to select ASE’s 2024 Slate of Officers and DirectorsUse this ballot to vote for the person nominated or write-in a nominee in the blank space provided. You can only vote for one person for each position, and any write-in nominees must be active ASE members. Your ballot must be received by March 24, 2024.

The new officers and directors will be introduced at the 35th ASE Scientific Sessions during the State of ASE Presidential Address on Saturday, June 15. This session is open to all Scientific Sessions registrants and will be streamed live for virtual attendees.

Congratulations to ASE’s Newest FASE!

In February, ASE welcomed 37 distinguished Fellows of the American Society of Echocardiography (FASE) recipients! These members exemplify excellence in the field of cardiovascular ultrasound through education, research, leadership, and volunteerism. They are ambassadors for ASE and recognized experts in their field. Join us in congratulating the newest FASE recipients

  • Amanda M. Ball, PharmD, BCPS, BCCP, FASE
  • Leighton Brady, FASE
  • Nadine Deacy, BS, RDCS, RVT, FASE
  • Mehran Ebadi-Tehrani, MD, FASE
  • Benjamin Gerhardy, PhD, FASE
  • Carson Homuth, RDCS, BS, FASE
  • Olusegun Oladele Olusanya, MD, FASE
  • Michekka C. Robinson, MBA, ACS, RDCS, FASE
  • Shubha Deep Roy, MD, FACC, FASE, FSCAI
  • Madhava T. Pally, MD, FASE
  • Justin Nadeem Tawil, MD, FASE
  • Kacy Taylor, MAH, RDCS, FASE
  • Nathan Tehrani, MD, FASE
  • Gabriel Altit, MD, MSc, FRCPC, FAAP, FASE
  • Jennifer Chen, MD, FASE
  • Oung Savly, MD, FASE
  • Jacob Elliott Schaff, MD, FASE
  • Xiu Tang, B.Sc, ACS, RDCS, FASE
  • Bianca Judy Coelho, FASE
  • Katharine Marie Belfrage, BS, RDCS, FASE
  • Dayana S. Haro, BS, FASE
  • Mitalee Patel, BS, RVT, RDCS, RDMS, FASE
  • Divyanshu Mohananey, MD, FASE
  • Wendy Tsang, MD, FASE
  • Joel Dykstra, FASE
  • Arif Albulushi, MD, FASE
  • Josheau Scott Doucet, RDCS (AE,FE,PE), FASE
  • Emma Bowcokc, MBBS, FASE
  • Sean R. McMahon, MD, FASE
  • Nasim Dana, BS, RCS, FASE
  • Neda Dianati Maleki, MD, MSc, FACC, FASE
  • James Michael Hodovan, PhD, RDCS, (AE,PE)
  • Candice S. Vacher, FASE
  • Danielle Gravlin, RDCS, FASE
  • Muhammad Waheed Raja, MBBS, FASE
  • Reinaldo Luis Pineiro, RCS, FASE
  • Jamel Peter Ortoleva, MD, FASE

A complete list of FASE members can be found at SeeMyHeart.org. To apply for FASE, or learn more, visit ASEcho.org/FASE. The next deadline to apply is April 1, 2024.

March on with a New Issue of JASE

The March issue of JASE is now online with much to showcase including a variety of clinical investigations ranging from safety of ultrasound enhancement agents, noninvasive testing for coronary heart disease, Doppler in valvular heart disease, 3D TEE after transcatheter mitral valve repair and outcome, septal perforator flow in HCM, and LV function in children with chronic kidney disease. A handful of editorials and letters to the editor accompany two brief research communications to round out this issue.

Dr. Pellikka’s editorial outlines the artificial intelligence content of particular interest to JASE for authors interested in submitting on this topic. Finally, Dr. Eidem’s President’s Message highlights congenital heart disease and ASE’s efforts to bring education and awareness to this important patient population during his presidency. Be sure to check out March’s Author Spotlight that features Mays T. Ali, MD, and Jeremy J. Thaden, MD, FASE, discussing their recent paper on adverse drug reactions to ultrasound enhancement agents.

Learn more here about the March issue and read what author Idan Roifman, MD, MSc, had to say about highlighted paper, “Comparing Costs of Noninvasive Cardiac Diagnostic Tests—a Population-Based Study.”

ASE 2024 Schedule at a Glance is Now Online!

The countdown to ASE’s 35th Annual Scientific Sessions has officially started! In just 100 days, the premier cardiovascular ultrasound event of the year will begin, and now is the time to make your plans to attend.

Download the Schedule at a Glance, which offers a first look at all sessions and times available during the conference. The new format this year will focus on short cases with panel discussions, more audience participation, and less didactic presentations. We can’t wait for you to experience this new way of learning June 14-16 in Portland, OregonRegister and reserve your hotel room early to save.

March on With a New Issue of JASE

The March issue of JASE includes, “Comparing Costs of Noninvasive Cardiac Diagnostic Tests—a Population-Based Study.” Author Idan Roifman, MD, MSc, remarks, “In a large population-based cohort consisting of >2 million people from Ontario, Canada who were evaluated for chest pain, we report that receipt of any non-invasive test (NIT) for the diagnosis of coronary artery disease was associated with a 12% reduction in downstream costs when compared to no testing. Graded exercise stress testing (GXT) and stress echocardiography were associated with the least downstream costs (approximately 20% reductions), whereas CCTA and MPI were associated with the highest relative costs (approximately 30% and 25% increased costs, respectively). Our findings are important from a health policy perspective for the following reasons. First, we demonstrated that receipt of any NIT was associated with reductions in downstream costs when compared to no testing despite the added initial costs of the test itself. This is significant as it indicates that the initial cost of testing is more than offset by downstream healthcare cost savings. Second, given that stress imaging and anatomical testing have been demonstrated to be similar in terms of their related downstream clinical outcomes, our results reporting that stress echocardiography is the least expensive modality are important, as they may lead to prioritization of this test. This is especially important in healthcare systems that do not require pre-approval for stress echocardiography, but may require it for other types of NIT, such as many systems in the United States.”

This issue includes numerous clinical investigations reporting on safety of ultrasound enhancement agents, noninvasive testing for coronary heart disease, Doppler use in valvular heart disease, 3D TEE after transcatheter mitral valve repair and outcome, septal perforator flow in HCM, and LV function in children with chronic kidney disease. Don’t miss a Special Report on multimodality appropriate use criteria for the detection and risk assessment of chronic coronary disease. Additionally, there are two brief research communications—one explores low-dose application of ultrasound-enhancing agents without flush and the other reports on reproducibility of echocardiographic measures of aortic stenosis severity and its impact on severity grading. Five editorials accompany these reports, and a handful of letters to the editor on the topics of mitral regurgitation phenotype and moderate aortic stenosis conclude this issue.

With contributions from Rickey E. Carter, PhD, and David Ouyang, MD, FASE, Dr. Pellikka’s editorial outlines the artificial intelligence content of particular interest to JASE for authors interested in submitting on this topic. In accordance with International Congenital Heart Defects Awareness Day, Dr. Eidem’s President’s Message highlights congenital heart disease and ASE’s efforts to bring education and awareness to this important population during his presidency.

Be sure to check out March’s Author Spotlight to learn more from lead authors Mays T. Ali, MD, and Jeremy J. Thaden, MD, FASE, as they discuss their recent paper, Incidence of Severe Adverse Drug Reactions to Ultrasound Enhancement Agents in a Contemporary Echocardiography Practice. Please see the March ASE Education Calendar for a listing of educational opportunities far and wide.

Upcoming ASE Webinar: March 12

Register Now

Register now to attend ASE’s Women Leading in Echocardiography Laboratories: Challenges and Solutions webinar, taking place March 12, 7:00 – 8:00 PM ET. An expert panel of accomplished women leaders in echocardiography will share their success stories and discuss the specific challenges women encounter in echocardiography laboratories, including gender bias, work-life balance, and professional development hurdles. Attendees will discuss and propose effective strategies for overcoming these challenges and focus on mentorship, skill development, supportive work environments, and diversity and inclusion.