Stanton K. Shernan, MD, FAHA, FASE

The Council for Intraoperative Echocardiography of the ASE was established in 1994 as a result of the recognition of the importance of echocardiography as an imaging modality in the monitoring of cardiac performance and diagnosis of cardiac and vascular pathology in cardiac and noncardiac surgical patients. Currently there are over 1,400 members in the council.

The utility of echocardiography in facilitating perioperative clinical decision-making began over three decades ago, primarily with the use of epicardial probes in patients undergoing cardiac surgery for valvular heart disease. However, significant advances have enabled the expansion of echocardiography applications to the perioperative environment and include preoperative transthoracic (TTE) and transesophageal (TEE) echocardiography; intraoperative TEE, epicardial, epiaortic and surface echocardiography for central line placement; and postoperative TTE and TEE in the intensive care unit. In addition, a rapidly growing body of evidence continues to support the utility of perioperative echocardiography to facilitate risk stratification, improve perioperative medical management, and favorably influence clinical decision making. More recently, the role of interventional echocardiography has also developed to include the use of TTE, TEE, and intracardiac echocardiography (ICE) to guide interventions in the cardiac catheterization and electrophysiology laboratories. Thus, while initially focused primarily on intraoperative applications, the use of echocardiography in patients undergoing interventions and surgical procedures has now expanded to include the entire perioperative environment.

It is now evident that perioperative echocardiography has become an independent area of clinical expertise and research interest with its own vast body of literature. In addition, the ASE, the Society of Cardiovascular Anesthesiologists, and the American Society of Anesthesiologists have endorsed separate guidelines for quality assurance, as well as documents delineating the specific indications and recommendations for performing comprehensive intraoperative transesophageal, epicardial and epiaortic examinations. Furthermore, the National Board of Echocardiography (NBE) also provides separate certification in Advanced and Basic Perioperative Tranesophageal Echocardiography. Finally, the recognition of the need for specialized comprehensive training and education in the techniques required to perform and interpret perioperative echocardiographic examinations, as well as the cognitive skills necessary to integrate this imaging modality into the practice of medicine, served as a major reason for the ACGME to have eventually supported accreditation for Cardiothoracic Anesthesia Fellowships beginning in 2006. Thus, the field of perioperative echocardiography has acquired significant independent credibility. Consequently, the Council for Intraoperative Echocardiography recently asked the ASE Board of Directors to change its name to the more appropriate Council for Perioperative Echocardiography (COPE).

The Council also appreciated that the field of perioperative echocardiography has substantially benefited from the efforts of numerous committed anesthesiologists and cardiologists who recognized the importance of this imaging modality in this unique environment which extends beyond the conventional ambulatory patient setting. Therefore, the leadership within this council also proposed that an annual award be established which recognizes an individual who has made significant clinical, research and/or educational contributions towards the development of the field of perioperative echocardiography.

We are very grateful and proud to report that the ASE’s Board of Directors approved both proposals. Specific nomination criteria for the new award include requirements that candidates are: (1) physicians at the academic level of Associate Professor or Professor; (2) Fellows of the ASE; and (3) Diplomates of the NBE. Candidates also need to have obtained significant clinical, research, and/or education achievement in the field of perioperative echocardiography, with recognition at the regional, national, and international levels. Council members are invited to nominate recipients; all nominations must be received by Cathy Kerr ( ckerr@asecho.org ) by October 19 in order to be considered.

The leadership of COPE is looking forward to the presentation of the first award for Outstanding Achievement in Perioperative Echocardiography at the 2013 ASE Scientific Sessions.