Archives for February 2025
ASEF 2025 Winter Wrap-Up Newsletter
Contrasts of the Heart: February CASE
The latest issue of CASE is now available with intriguing reports, including “Patent Foramen Ovale With Asymmetric Pulmonary Venous Flow Reversal.”
CASE Editor-in-Chief Vincent Sorrell, MD, FASE, remarked, “Every issue of CASE offers readers an opportunity to discover novel insights into commonly seen echo-truths that in fact, turn out to be less specific than initially thought. Take for example the report from Wright et al., which discusses their finding of reversal of the systolic pulmonary vein flow seen with pulsed wave Doppler. The patient did not have mitral regurgitation as the mechanism for this finding, but instead, had an intermittently significant shunt across a PFO. The authors describe their Doppler finding, the literature surrounding the underlying proposed mechanisms, and the clinical correlations. Within their descriptions, they include the possibility that significant left to right shunts may cause a similar systolic flow reversal in the pulmonary vein. In their patient, the PFO flow was minimal at baseline but increased dramatically during deep inspiration. This phasic PFO flow was noted to directly coincide with the phasic pulmonary vein systolic reversal, leading to these authors’ conclusion and helping CASE readers build their differential diagnosis of this finding. They suspect that intermittent increases in LA volume and pressure, similar to previous reports with ASD, were driving this Doppler phenomenon. It is exciting to ponder what our amazing Journal readers will see tomorrow that will inform us to be better stewards of echocardiography.”
In addition to this Hemodynamic Corner report, this issue features some cases in the Rare But Deadly Findings and Sonographer Spotlight categories. Menon et al. highlight the importance of serial echo in their report on an infant with Kawasaki Disease, whose condition rapidly progresses in wake of early detection and available treatment. Aleem et al. utilize targeted neonatal echo in a critically ill neonate, evaluating cardiac function, ECMO cannulation, and development of a deadly coronary thrombus. Notably, this issue features two reports selected from our recent Sonographer Challenge—a report on caval valve implantation as an innovative approach for treating severe tricuspid regurgitation, and a report of preliminary findings on the use of an agitated saline delivery device in daily clinical practice.
Readers can look forward to Dr. Sorrell’s editorial, which dissects the vital role of contrast in diagnostic imaging. Be sure to check out the latest Unlock the CASE on the CASE homepage, which was the winning entry from the Cardio-oncology SIG Case Competition.
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ASE Publishes Updated Guideline on Ultrasound-Guided Vascular Access Procedures
FOR IMMEDIATE RELEASE
Contact: Natalie Costantino
919-297-7170
NCostantino@ASEcho.org
ASE Publishes Updated Guideline Offering Comprehensive, Evidence-Based Recommendations on Ultrasound-Guided Vascular Access Procedures
(DURHAM, NC, February 6, 2025)—A new guideline from the American Society of Echocardiography (ASE) aims to provide more detail for clinicians performing ultrasound-guided vascular cannulation, an essential skill utilized across various cardiovascular ultrasound specialties during diagnostic and medical procedures.
Guidelines for Performing Ultrasound-Guided Vascular Cannulation: Recommendations of the American Society of Echocardiography is published in the February 2025 Journal of the American Society of Echocardiography and replaces the original guideline published by the Society on this topic in 2011. This new document provides expert consensus on the best practices and techniques for using ultrasound in vascular access procedures.
“Ultrasound guidance is currently not a standard of care for all vascular access, but it is becoming increasingly common in daily clinical practice due to its ability to enhance success rates and reduce complications,” says lead Co-author Dr. Annette Vegas, an anesthesiologist and director of Perioperative Echocardiography at Toronto General Hospital in Ontario, Canada. “Adopting the recommendations in this guideline will help clinicians better minimize risks, maximize technical competencies and ultimately, improve patient outcomes.
The guideline uses descriptions, diagrams and ultrasound images to explain the general aspects of anatomic and ultrasound imaging of vessels, ultrasound-guided vascular cannulation techniques, and the identification of local vascular cannulation complications. Additionally, it emphasizes the fundamental roles of ultrasound during vascular access, including:
- Precannulation Vessel Assessment
- Dynamic Ultrasound Guidance
- Identification of Local Complications
The authors say this guideline will serve as a valuable resource for new and experienced clinicians, helping them deliver safer, more effective care. This document and all guidelines published by ASE are available at ASEcho.org/Guidelines.
About American Society of Echocardiography
The American Society of Echocardiography (ASE) is the Society for Cardiovascular Ultrasound Professionals™. ASE is the largest global organization for cardiovascular ultrasound imaging serving physicians, sonographers, nurses, veterinarians, and scientists and as such is the leader and advocate, setting practice standards and guidelines for the field. The Society is committed to advancing cardiovascular ultrasound to improve lives. In 2025, ASE is celebrating its milestone 50th anniversary. For more information, visit the ASE website ASEcho.org or social media pages on Facebook, X, LinkedIn, Instagram and Bluesky.
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From the Heart: February JASE
The February issue of JASE includes a new guideline titled, “Guidelines for Performing Ultrasound-Guided Vascular Cannulation: Recommendations of the American Society of Echocardiography.” Lead co-author Annette Vegas, MD, FASE, remarks, “Ultrasound
guidance is currently not a standard of care for all vascular access, but it is becoming increasingly common in daily clinical practice due to its ability to enhance success rates and reduce complications. Adopting the recommendations in this guideline will help clinicians better minimize risks, maximize technical competencies and ultimately, improve patient outcomes.”
This issue’s original investigations incorporate a variety of topics including ascending aortic aneurysm, left atrial function and heart failure development, and the right ventricle in pulmonary vascular disease. Editorial comments accompany two of these original investigations, addressing screening intervals and rates of expansion in ascending thoracic aortic aneurysm as well as a left atrial volumetric/mechanical coupling index. Rounding out this issue are a number of brief research communications—machine learning technology in automating thoracic aorta dimensions and stratifying risk in low-gradient aortic stenosis, the hemodynamic performance of some recent TAVR valves, clinical and echocardiographic features of individuals with cardiac amyloidosis at risk for future thrombus formation, and the use of left atrial appendage 3D echo to refine the prothrombotic state in atrial fibrillation.
Guest written by members of ASE’s Council on Pediatric and Congenital Heart Disease Steering Committee, Craig E. Fleishman, MD, FASE, and Pei-Ni Jone, MD, FASE, this month’s President’s Message highlights the ongoing work of this council and its future priorities to drive progress in this sector of the field.
A new call for papers is now open! A focus issue on chamber quantification is set for publication in early 2026. Papers that address any aspect of echocardiography in quantitative assessment of the cardiac chambers should be submitted by June 1, 2025. Please direct questions to JASE managing editor Debbie Meyer at dmeyer@asecho.org.
Tune into our Author Spotlight page for interviews between JASE Editor-in-Chief Patricia Pellikka, MD, FASE, and authors of recently published papers. January’s interview features Thomas H. Marwick, MBBS, PhD, MPH, discussing his paper, “Cardiac Function and Functional Capacity in Patients With Long COVID: A Comparison to Propensity-Matched Community Controls.”
Please see the February ASE Education Calendar for a listing of educational opportunities far and wide.