Imaging (Echocardiography) —
Training activity: 19

Details

Adapt protocol and report to cater for valve interventions

Type

Developmental training activity (DTA)

Evidence requirements

Evidence the activity has been undertaken by the trainee​.

Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.

An action plan to implement learning and/or to address skills or knowledge gaps identified.

Reflective practice guidance

The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.

Before action

• Before this activity, how is echocardiography used to assess patients before and after valve interventions (e.g., TAVI, surgical valve replacement/repair)?
• How does the imaging protocol need to be adapted to evaluate the outcome of these interventions?
• What specific parameters and measurements are crucial in assessing post-intervention valve function?
• What key elements should be included in the echo report when focusing on pre- or post-valve intervention assessment?

In action

• How are you modifying the standard echo protocol to assess the outcomes and complications of valve interventions (e.g., valve repair or replacement, TAVI)? Which specific views and measurements are you prioritising to evaluate valve function, prosthetic function, and any associated complications (e.g., paravalvular leak, stenosis, thrombus)? How are you planning to structure your report to clearly document the findings related to the intervention? Are you focusing on specific aspects of the intervened valve? Are you deciding which Doppler modalities are most appropriate for assessing prosthetic valve function or identifying regurgitation? Are you carefully measuring pressure gradients across the valve? Are you familiar with the echocardiographic assessment of different types of prosthetic valves and repaired native valves? Are you consciously applying specific guidelines for evaluating their function and identifying complications?

• Are you successfully visualising the intervened valve and obtaining the necessary measurements to assess its function? Are you encountering any difficulties in imaging due to shadowing from prosthetic materials? Are you gaining a better understanding of the echocardiographic appearances of successful and unsuccessful valve interventions? Are you learning to identify potential complications associated with different types of procedures? Are you applying your knowledge of valve anatomy, the principles of different valve interventions, and echocardiographic techniques for assessing valve function and identifying complications?

• Would transoesophageal echocardiography provide better visualisation of prosthetic valves or potential complications in certain cases? Is there a role for 3D echocardiography? If you are unsure about the interpretation of findings related to a specific valve intervention or the identification of a potential complication, would you seek advice from a senior colleague? Are the protocol adaptations and the interpretation of findings related to valve interventions within the scope of your current training?

On action

• Describe the specific considerations for imaging a patient who has undergone a valve intervention (pre- or post-procedure). Outline how you adapted the standard echo protocol, including any specific views or measurements taken to assess the intervention. Note the key features you focused on in the report.
• Reflect on your understanding of the echocardiographic assessment of valve interventions. Did you gain a better understanding of the specific imaging findings relevant to different types of interventions? Were there any challenges in adapting the protocol or interpreting the findings? How does this relate to acquiring and interpreting cardiac images for pathological conditions?
• Identify any specific types of valve interventions where you need to enhance your knowledge of imaging protocols and reporting. How will you approach adapting protocols in the future? What resources will you use to further your understanding?

Beyond action

• Have you encountered patients pre- and post- various valve interventions (e.g., transcatheter aortic valve implantation (TAVI), surgical valve replacement) requiring specific echo protocols and reporting? Have your subsequent experiences broadened your understanding of the echocardiographic assessment of these interventions?
• How has your ability to tailor echo protocols to assess valve function and identify potential complications before and after valve interventions improved? Are you now more proficient in obtaining and interpreting the specific measurements and parameters required in these cases?
• How will your understanding of echocardiography in the context of valve interventions inform your role in the pre-procedural assessment and post-procedural follow-up of these patients? How will this experience support your ability to identify and report potential complications of valve interventions?

Relevant learning outcomes

#	Outcome
# 1	Outcome Acquire and interpret cardiac images for a range of normal and pathological conditions.
# 2	Outcome Explain imaging results to patients and other health care professionals.
# 3	Outcome Distinguish and justify actions based on clinical and ECG findings.
# 5	Outcome Appraise new guidelines and evidence to inform practice.
# 6	Outcome Demonstrate safe practice in line with local, national and international guidelines and standards.
# 7	Outcome Assess and evaluate a patient’s clinical presentation and make recommendations for cardiac imaging.
# 8	Outcome Evaluate cardiac care pathways.
# 9	Outcome Summarise complex information into a concise and logical reports for specialist and non-specialist audiences.