Case Study Requirements – Pediatric Echocardiography

Pediatric Transthoracic

The required pediatric TTE case studies are based on the total number of staff (medical and technical that perform and interpret pediatric transthoracic echocardiograms) in an applicant facility. The following are the required number of pediatric TTE case studies per base facility:

5 or fewer = 4 cases per facility (2 shunts, 1 simple obstruction, 1 complex defect)
6 to 8 staff = 6 cases per facility (2 shunts, 2 simple obstructions, 2 complex defects)
9 to 15 staff = 8 cases per facility (4 shunts, 2 simple obstructions, 2 complex defects)
16 to 25 staff = 10 cases per facility (4 shunts, 3 simple obstructions, 3 complex defects)
>25 staff = 12 cases per facility (4 shunts, 4 simple obstructions, 4 complex defects)

  • All cases must be abnormal.
  • When submitting case studies try to represent as many CURRENT staff members as possible without duplicating.
  • Cases submitted with the application must not be independently performed by sonographer or physician trainees.
  • One case study must be submitted from the Technical Director.
  • Medical Director must be represented.
  • All cases must be complete examinations.
  • Initial studies demonstrating un-repaired defects are preferred. However, repaired defects will be accepted if the facility is unable to submit initial studies.
  • All cases must be selected from within the past 12 months from the date of application filing.
  • The same case may not be submitted twice within a testing section.

Types of Cases to be Submitted:

  • Shunt lesions (i.e., atrial septal defects, ventricular septal defects or patent ductus arteriosus)
  • Complex defects (i.e., shunt lesions plus an obstruction, mitral or tricuspid atresia, atrioventricular canal defect, Tetralogy of Fallot, ventricular hypoplasia, anomalous coronary artery, truncus arteriosus, interrupted aortic arch)
  • Simple obstruction (i.e., aortic and/or pulmonary valve stenosis, coarctation of the aorta)

Pediatric Transesophageal

First-Time Application: 1 case per physician that includes a complete examination (not focused/limited) including all the views listed in the Standards.

  • Cases submitted with the application must not be independently performed by physician trainees.
  • All cases must be selected from within the past 36 months from the date of application filing.
  • The same case may not be submitted twice within a testing section.

Reaccreditation Application: It is recognized that many TEEs are performed in situations (i.e., in the OR or interventional catheterization suite) that may limit or prevent complete evaluation due to time constraints or are focused studies to answer specific clinical questions. For these reasons, physicians in facilities that are applying for reaccreditation may submit:

  • 1 case per physician which may be a focused examination, (if represented with a complete examination on the previous application) or
  • 1 case per physician which must be a complete examination (if physician is new to the facility and not represented with a complete examination performed in the facility as part of a previous application)
  • All cases must be selected from within the past 36 months from the date of application filing.

Fetal

The required fetal case studies are based on the total number of staff (medical and technical) in an applicant facility. The following are the required number of fetal case studies per facility:

5 or fewer = 4 cases per facility (1 shunt, 1 simple obstruction, 1 case with an indication or finding of fetal arrhythmia and 1 case of hypoplastic ventricle)
6 to 8 staff = 6 cases per facility (2 shunts, 2 simple obstructions, 1 case with indication or finding of fetal arrhythmia and 1 case of hypoplastic ventricle)
9 to 15 staff = 8 cases per facility (4 shunts, 2 simple obstructions, 1 case with an indication or finding of fetal arrhythmia and 1 case of hypoplastic ventricle)
16 to 25 staff = 10 cases per facility (4 shunts, 3 simple obstructions, 1 complex defect, 1 case with an indication or finding of fetal arrhythmia and 1 case of hypoplastic ventricle)
>25 staff = 12 cases per facility (4 shunts, 4 simple obstructions, 2 complex defects, 1 case with an indication or finding of fetal arrhythmia and 1 case of hypoplastic ventricle)

  • Cases submitted with the application must not be independently performed by sonographer or physician trainees.
  • All cases must be selected from within the past 12 months from the date of application filing.
  • The same case may not be submitted twice within a testing section.