Midway through my second, and final, year as chair of the Pediatric and Congenital Heart Disease (PCHD) Council Board, I’m struck by how many things have been accomplished, and also by how many tasks remain. What remains unfinished is a reflection of how difficult our goals are to achieve given our limited resources, both in personnel and finances. Below are updates on the priorities that we set for ourselves a year ago.
Quantitative writing group —With Dr. Leo Lopez heading the effort, we have published the guidelines, “Recommendations for Quantification Methods during the Performance of a Pediatric Echocardiogram.” This document outlines the methodology that will be used to create an updated normal database for pediatric echocardiography. It will take into account potentially confounding factors, such as body surface area, age, gender, and race. We are in the process of applying for funds to carry out the project. This project will be a multi-center effort, lasting 3 to 4 years. Our goal is to incorporate some of the newer techniques, such as three-dimensional echocardiography and deformation imaging, into the normative data project.
Echocardiography in the neonatal intensive care unit —A writing group, led by Dr. Luc Mertens, has a final version nearly ready for submission to the ASE Guidelines & Standards Committee. The writing group consisted of pediatric cardiologists and neonatologists from both the United States and Europe. Representatives to the committee were sought from the European Association of Echocardiography and the Association for European Paediatric Cardiology. In its current form, the document covers the practical aspects of a targeted neonatal echocardiogram, indications for the examination, and training recommendations. This document will stimulate a great deal of discussion, and should serve as a model for the use of cardiovascular ultrasound assessment in other pediatric sub-specialties.
Multi-modality, lesion-specific protocols —A writing group for multi-modality imaging tetralogy of Fallot has been formed, and one for transposition of the great arteries is being formed. The process of involving other societies to participate in the guidelines development has been time-consuming. Both writing groups should be active soon, and a third one is anticipated on the topic of single ventricles.
Regarding our secondary goals, we have formed a PCHD Committee on Laboratory Organization and Productivity, led by Dr. Vivek Allada. The goal of this committee is to determine the staffing situation at pediatric echocardiography laboratories across the country, and to look further into the issues of laboratory set-up and personnel productivity. The committee has created a new survey to gather this information, which should provide us with data that will lead to improvements in the daily function of our laboratories. This past year we have also revised our Council Rules of Governance to better reflect our activities, and we have published a listing of senior non-invasive imaging fellowship positions on our Website.
Besides the work of the council board, many pediatric representatives have been busy working within the committees of the ASE. The pediatric (and adult congenital) representatives provide unique perspectives to the deliberations and policies generated by these committees. The work of ASE committees—in the areas of education, guidelines, and advocacy, just to name a few—has the potential to tremendously influence the practice of pediatric and congenital echocardiography.
We should all be proud of how hard we’ve worked to raise the profile of pediatric and congenital echocardiography within ASE. We can take some of the credit for the successful nomination of Dr. Jack Rychik as the 2009 Feigenbaum Lecturer. His topic, “Born with Half a Heart: An Echocardiographic Journey of Single Ventricle Type of Congenital Heart Disease from the Fetus to the Adult,” was the first on a subject directly related to congenital heart disease. With the upcoming elections, we expect to increase the number of pediatric cardiologists elected to the ASE Board of Directors to three. These elected board members sit along with the PCHD chair, who has a designated spot on the ASE board.
Finally, the number of ASE courses related to congenital heart disease has never been greater. The ASE Education & Research Foundation Learning Lab, Morrisville, NC will sponsor a computer-based course on “Echocardiography in Adult Congenital Heart Disease” on March 25-26, 2011. “Essential Echocardiography with Experts: Congenital Heart Disease” will be the topic of E3 2011 at the ACC meeting in New Orleans on April 2, 2011. The 2011 Annual Scientific Sessions will deliver the usual excellent pediatric/congenital program, put together by Drs. Mark Lewin and Will Border, beginning with an echocardiography-pathology-surgery correlation symposium on June 11, 2011. The sessions will include the presentation of the 2011 Pediatric Founders award to Dr. James Huhta, and a much-anticipated fireside chat with Dr. Norman Silverman interviewing Dr. Abe Rudolph.
Whether on the PCHD Board, on committees, or as part of the educational activities of the ASE, there are many ways for individuals to be involved. I look forward to working with all ASE members this year as we try to achieve our goals. If there are any matters that you wish to have addressed by the PCHD Council, please feel free to contact me at wyman.lai@columbia.edu .