April 2007

The epicardial approach is unique among the readily used echocardiographic imaging windows in that it requires a collaborative effort with the cardiac surgeon to either allow the echocardiographer to guide them in obtaining images, or alternatively permit the echocardiographer to have direct access to the epicardial surface within the operative field. Experience in epicardial echocardiography is an important component of advanced, rather than basic perioperative echocardiographic training as defined by the ASE and SCA Task Force Guidelines for Training in Perioperative Echocardiography. Epicardial echocardiographic training should include the study of 25 epicardial examinations of which 5 are personally directed under the supervision of an advanced echocardiographer, before a trainee should pursue independent interpretation and application of the information to perioperative clinical decision-making