TABLE 2.

Patient Care and Procedural Skills Competency Domain for Level III-Structural Heart Disease Training in Echocardiography

1. Skill to perform and interpret a basic and comprehensive transthoracic echocardiographic examination as per Level II training, including 2-dimensional and 3D imaging and advanced quantitation of valvular heart disease severity

2. Skill to perform and interpret a basic and comprehensive transesophageal echocardiographic examination as per Level II training, including 2-dimensional and 3D imaging and advanced quantitation of valvular heart disease severity

3. Skill to supervise and interpret stress echocardiograms performed to assess patients with valvular heart disease

4. Skill to perform and interpret echocardiographic imaging for pre-procedural planning and post-procedural assessment of cardiac function (including ventricular and valvular function).

5. Skill to perform and interpret rapid assessment of echocardiographic imaging for intra-procedural guidance of structural valvular transcatheter procedures (including aortic, mitral, tricuspid, and pulmonic valve procedures)

6. Skill to perform and interpret rapid assessment of echocardiographic imaging for intraprocedural guidance of structural nonvalvular procedures (including LAA occlusion and septal closure devices)

7. Skill to perform and interpret rapid assessment of hemodynamically unstable (undifferentiated shock) patients including but not limited to the assessment of volume status, valvular function, ventricular function, and tamponade physiology

8. Skill to perform, render and interpret basic and advanced 3D echocardiography during guidance of procedures and/or surgery

9. Skill to incorporate risk/benefit, safety, and cost considerations in the use of ultrasound techniques and structural interventions

10. Skill to communicate effectively in the interventional environment

Evaluation tools include direct observation, logbook, and simulation.

Abbreviations as in Table 1.