Attendance at the Leeds TOE course

2016 CSANZ NZ Affiliate Scholarship Report

Steve White

At the time of applying for the 2016 Affiliate Scholarship I was performing TOE’s as an operator and had been for eight years. Unusual in New Zealand where sonographers typically assist with the TOE’s being performed by (usually) a Cardiologist or Cardiology registrar, this is not an usual situation in the UK for example.

Our Cardiologist numbers (in Nelson) have since increased with the addition of an Imaging Cardiologist meant the time was right for me to back away from performing the TOE’s and have an assisting role concentrating on image acquisition.

However, a small department is dependent on the skill level of the technical staff so it was decided that I would continue and attend the TOE course.

I have attended a few of the St George’s TOE courses and found them to be most helpful. My original application was to attend the St George’s TOE course; however the 2016 course was postponed until 2017, then at very late notice the 2017 was cancelled and indeed there are to be no more St George’s TOE courses. The Leeds TOE course seemed like a perfect replacement.

To be honest I was prepared to be somewhat underwhelmed with the Leeds TOE course having previously attended the London courses. How wrong I was!

The Leeds TOE course is very much a hands-on course and was impressive in every way.

Attendees are capped at six only. The course runs for four full days with lectures, time on the simulator and sessions in the cardiac theatres morning and afternoons.

The attendees were mostly Cardiac Anaesthetist Registrars with Cardiologists and myself a Cardiac Sonographer.

It is a requirement in the UK that Cardiac Anaesthetists are TOE accredited. TOE accreditation can be the European or British Society of Echocardiography.

The course was based in the old but beautiful original Leeds General Infirmary Hospital. Designed back in the day (1860’s) in the English Gothic revival style by Sir Gilbert Scott, think also Midland Grand Hotel St Pancras train station and Christchurch (NZ) cathedral.

The course lecturers were a mix of Cardiac Anaesthetists, Cardiologists and a Cardiac Surgeon. Lectures followed a path from introduction, standard views, simulator, physics (artefacts and pitfalls), mitral valve, aortic valve, prosthetic valves, CHD, to quantitative and haemodynamic measurements. Some 3D discussion also.

Each morning and afternoon at the beck of a phone call from theatres we donned appropriate theatre clothing and split into two groups of three to perform live TOE’s on patients undergoing cardiac surgery under the guidance of the Cardiac Anaesthetist.

We also had a session in the wet lab where we each had a pig’s heart to dissect under the tutorage of one of the Cardiac Surgeons.

The final day had a mock exam, and a mock practical, intensely competitive as was always going to be the way.

The Heartworks simulator was a great asset and a great help to those who hadn’t done any TOE’s until that point.

I can’t speak highly enough of this course, the hands-on nature of the course far superior to sitting in a lecture theatre listening to speakers.

I thank the CSANZ for the Affiliate Scholarship and financial contribution which helped me attend this course. I encourage any of the CSANZ Affiliates to apply for the annual scholarships on offer.