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SCIENTIFIC PROGRAM

JB-POT/TEE Examination

Japanese Board of Perioperative Transesophageal Echocardiography (JB-POT)
In the U.S., TEE Workshops and the certifying examination are being held to deepen the specialty. The National Board of Echocardiography (NBE) is well-organized and contributing to TEE’s dissemination. The Examination of Special Competence in Perioperative Transesophageal Echocardiography (PTEeXAM), taken mainly by cardiovascular anesthesiologists in North American countries, is recently spreading among cardiovascular anesthesiologists in European nations and Asian countries as well.
In Japan, TEE has become widely used and has gained acceptance as a useful diagnostic and monitoring tool for many patients under various conditions. In the operating room, anesthesiologists need the knowledge and skill of TEE to determine the cause of hemodynamic disorders. Cardiovascular surgeons have also asked that anesthesiologists have the knowledge and skill of TEE to confirm the adequacy of surgical repairs.The Japanese Society of Cardiovascular Anesthesiologists (JSCVA), in association with the NBE, will be introducing and organizing the TEE certifying examination called JB-POT (Japanese Board of Perioperative Transesophageal Echocardiography).
The first examination will be held on September 12, 2004, the final day of the 9th International Congress of Cardiothoracic and Vascular Anesthesia, in English and Japanese. JSCVA will hold a TEE workshop (in English) on September 11, 2004, to authorize successful JB-POT candidates.

JB-POT Basic Information
Foreword
JB-POT has prepared the content outline for a certifying examination to test the required knowledge of a useful perioperative TEE application. This outline consists of broad information involving anatomy, physiology, pathophysiology, and acoustic technology. The final goal is to cultivate specialized cardiovascular diagnosticians especially in the field of perioperative TEE.
The examination, which consists of video and multiple-choice questions, is to be given annually in cooperation with the NBE.
JSCVA, as well as JB-POT, will authorize competent candidates, and expects those certified specialists to enhance the quality of perioperative TEE by making the effort to optimize their skill in the performance and interpretation of cardiac ultrasound, and furthermore to take a core position in the operation of TEE.

Purpose
JB-POT was established to enhance the quality of perioperative transesophageal echocardiography, to encourage individual professional growth in perioperative transesophageal echocardiography, and to coordinate social activity in the practice of perioperative transesophageal echocardiography.

To accomplish this purpose, JB-POT shall
Assess the level of knowledge in the practice of perioperative transesophageal echocardiography and serve as a source for distribution of information concerning certifying examination in perioperative transesophageal echocardiography
Give a certifying examination annually
Organize TEE seminars
Serve as a source for distribution of information concerning TEE
Communicate with other oversea societies (e.g., National Board of Echocardiography)
Coordinate social activities in perioperative transesophageal echocardiography

Officers and Board of Directors
Executive Director:
Junzo Takeda

Financial Secretaries:
Ryo OgawaKeiichi Tada

Secretary General:
Minoru Nomura

Approval Committee Chairperson:
Minoru Nomura

Examination Design Committee Chairperson:
Yasuhiro Koide

Seminar Planning Committee Chairperson:
Hiroshi Kitahata

International Exchange Committee Chairperson:
Tatsuya Yamada

Directors:
Shintaro Beppu
Satoru Fukuda
Kazuo Hanaoka
Shiro Iwanaga
Yasuhiro Koide
Masakazu Kuro
Kiyoshi Morita
Akiyoshi Namiki
Kazumasa Orihashi
Koji Sumikawa
Riichiro Chuma
Hitoshi Furuya
Sumio Hoka
Osamu Kemmotsu
Teruo Kumazawa
Shunei Kyo
Shigeho Morita
Ryozou Omoto
Tsunehiko Shin
Shiro Yamachika

Advisors:
Solomon Aronson
Hiromi Kurosawa
Daniel M. Thys
Steven N. Konstadt
Yasu Oka


The First JB-POT Certifying Examination
Examination date: Sunday, September 12, 2004
Time: Starts at 9:00 am (about for 3 or 4 hours)
Location: Hotel Nikko Tokyo, Daiba, Tokyo

Requirements for 2004 JB-POT exam candidates:
Attend TEE workshops (seminars) co-sponsored by the Japanese Society of Cardiovascular Anesthesiologists (JSCVA) (see Form A for application for TEE workshop.)
10 points credited by JSCVA are needed (2-hour lecture = 5 credits).
(A copy of the attendance verification cards must accompany the application.)
TEE workshops (seminars) prior to September 12, 2004 will be available and attendance verification cards will be checked at the examination desk on the examination date.

Language:
English or Japanese, as indicated on your application form (Form C)

Application fee: 25,000 yen
* Discount for attendants of 9th International Congress of Cardiothoracic and Vascular Anesthesia (15,000 yen)

Certification fee: 5,000 yen
* Successful candidate has to pay the certification fee. The details are to be provided by the secretariat.

How to apply:
1. Pay the examination fee using Form A (registration form) or on-line registration page.
2. Fill out the application form (Form C).
3. Send the fully completed form with the documentations (a, b, c) explained below by mail, UPS or FedEx to:

The Secretariat of the Japanese Society of Cardiovascular Anesthesiologists
Department of Anesthesiology, Tokyo Women’s Medical University, School of Medicine
8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan

Enclosure:
(a) A copy of attendance verification card if you have one.
(b) Picture (size: 3 x 4cm, taken within last three months; write your name and affiliation on the back of the picture)
(c) Certificate of payment
Please indicate your payment number on the application form (Form C), which will be issued after making payment.
* If you pay using Form A, the payment number will be issued by the ICCVA 2004 registration desk; if on-line, it will be automatically issued on the last screen and by confirmation e-mail.
* Please attach a copy of the bank receipt if you choose bank transfer.

Note:
* Please note that the secretariats for application and payment have separate contact addresses, so that payment and application need to be made separately.
Application: The Secretariat of the Japanese Society of Cardiovascular Anesthesiologists
Payment: The ICCVA 2004 registration desk
* Applications by e-mail and fax are not be accepted.
* The attendance verification card is explained on the application form.
* You cannot take the examination without submission of the attendance verification card.
* All applicants will receive an admission ticket at least two weeks before the examination. If you have not received the ticket by then, please contact the secretariat shown below.

JSCVA recommends that if mail is used you obtain proof of delivery. Please apply between the beginning of March and end of June 2004. We will close acceptance as soon as applications reach capacity. Early in March to late June, the application form will be appear on the web site of ICCVA 2004.

Results will be notified in writing by post two months after the examination.
The TEE Examination desk will open from 9:00 to 9:50 am. Tardiness will not be permitted.

For questions regarding the TEE Workshops and Examination, please contact:

The Secretariat of the Japanese Society of Cardiovascular Anesthesiologists Department of Anesthesiology, Tokyo Women's Medical University, School of Medicine 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan
Tel: +81-3-3353-8111 Fax: +81-3-3359-2517
E-mail:
jscva@anes.twmu.ac.jp


Content Outline for the Japanese Board of Perioperative Transesophageal Echocardiography
I. Principles of Ultrasound
Nature of ultrasound
Frequency, wavelength, penetration, tissue propagation velocity
Properties of ultrasound waves
Acoustic impedance

II. Transducers
Piezoelectric effect
Crystal
Damping material
Sound beam formation
Focusing
Axial and lateral resolution
Linear array/ Phased-array transducer

III. Equipment, Infection Control, and Safety
Biological effects of ultrasound
Electrical and mechanical safety
Infection control
TEE probe insertion and manipulation
Contraindications to transesophageal echocardiography
Complications of transesophageal echocardiography

IV. Imaging
Instrumentation
Displays
B-mode, M-mode, and two-dimensional echocardiography
Signal processing

V. Principles of Doppler Ultrasound
Doppler effect
Doppler equation
Doppler shift frequencies and influencing factors
Nyquist limit
Spectral analysis and display characteristics
Pulsed-wave Doppler / High pulse repetition frequency pulsed-wave Doppler
Continuous-wave Doppler
Color flow Doppler
Color M-mode

VI. Quantitative M-Mode and Two-Dimensional Echocardiography
Edge recognition/ Cardiac cycle
Fixed and floating axis
Center-line method
Global function; measurements and calculations

VII. Quantitative Doppler
Types of velocity measurements
Proximal isovelocity surface area
Valve gradients, and valve area measurements
Cardiac chamber and great vessel pressures
Tissue Doppler

VIII. Doppler Profiles and Assessment of Diastolic Function
Tricuspid valve and right ventricular inflow
Pulmonary valve and right ventricular outflow
Mitral valve and left ventricular inflow
Aortic valve and left ventricular outflow
Non-valvular flow profiles

IX. Cardiac Anatomy
Imaging planes
Cardiac chambers and walls
Cardiac valves
Cardiac cycle and relation of events relative to ECG

X. Pericardium and Extracardiac Structures
Pericardium and pericardial space
Pulmonary arteries
Pulmonary veins
Vena cavae and hepatic veins
Coronary arteries
Aorta and Great Vessels
Anatomy/ Atherosclerosis/ Aneurysm/ Dissection and traumatic injury of the aorta
Pleural space

XI. Pathology of the Cardiac Valves
Acquired valve diseases
Endocarditis/ Rheumatic/ Myxomatous/ Calcific / degenerative/ Traumatic
Tricuspid
Pulmonary
Mitral
Mitral regurgitation/ Ischemic mitral valve dysfunction/ Mitral stenosis/ Systolic anterior motion of mitral valve (SAM)
Aortic
Aortic regurgitation/ Aortic stenosis

XII. Intracardiac Masses and Devices
Tumors
Thrombi
Devices and foreign bodies

XIII. Global Ventricular Systolic Function
Normal left ventricular systolic function
Abnormal left ventricular systolic function
Etiologies including ischemia/ Assessment/ ejection fraction/ Confounding factors
Right ventricular systolic function
Cardiomyopathies
Hypertrophic/ Restrictive/ Dilated

XIV. Segmental Left Ventricular Systolic Function
Myocardial segment identification
Coronary artery distribution and flow
Normal and abnormal segmental function
Assessment and methods/ Differential diagnosis/ Confounding factors

XV. Assessment of Perioperative Events and Problems
Hypotension and causes of cardiovascular instability
Cardiac surgery; techniques, and problems
Assessment of bypass and cardioplegia/ Cannulae and devices commonly used during cardiac surgery/ Circulatory assist devices/ Intracavity air/ Minimally invasive cardiopulmonary bypass/ Off pump cardiac surgery
Coronary surgery; techniques and assessment
Valve surgery; techniques and assessment
Valve replacement (mechanical, bioprosthetic)/ Valve repair
Transplantation surgery
Heart/ Lung/ Liver

XVI. Congenital Heart Disease
Identification and situs of morphologically left and right structures
Atrial septal defects
Ventricular septal defects
Pulmonary valve and infundibular stenosis
Left atrial and mitral valve conditions
Aortic valve and left ventricular outflow tract abnormalities
Coronary artery anomalies
Patent ductus arteriosus
Coarctation of the aorta
Ebstein's anomaly
Persistent left superior vena cava
Tetralogy of Fallot
Transposition of great arteries
Atrioventricular septal defect - "AV canal"
Conditions with single ventricle physiology

XVII. Artifacts and Pitfalls
Imaging artifacts
Doppler artifacts and pitfalls
Structures mimicking pathology

XVIII. Related Diagnostic Modalities
Stress echocardiography
Myocardial perfusion imaging
Epicardial scanning
Contrast echocardiography
Utility of TEE relative to other diagnostic modalities