European Journal of Echocardiography Advance Access originally published online on March 19, 2008
European Journal of Echocardiography 2008 9(3):319; doi:10.1093/ejechocard/jen118
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Multidisciplinary approach in a case of successful surgical treatment of a voluminous intracardiac fungal mass in an infant: reply
Department of Cardiology
University of Foggia
viale L Pinto, 1
71100 Foggia
Italy
E-mail address: opsfco{at}tin.it
Department of Cardiology
University of Foggia
viale L Pinto, 1
71100 Foggia
Italy
Hospital OO.RR Foggia
Neonatal Intensive Care Unit
Foggia
Italy
Hospital OO.RR Foggia
Neonatal Intensive Care Unit
Foggia
Italy
Department of Cardiology
University of Foggia
viale L Pinto, 1
71100 Foggia
Italy
Tel: +39 088 173 3652
Fax: +39 088 173 5424
With great interest we read and appreciate the comments made by Dr Troise with regard to our report entitled ‘Voluminous mycetoma in a newborn with Down Syndrome: role of echocardiography’.1
He highlights positive collaboration they had set up, at that time, offering cardiac surgical treatment to the patient referred by Hospital OO.RR of Foggia. At that time, a tele-echocardiographic counselling was promptly requested. This opportunity existed thanks to the Italian Ministry of Health research funds, which permitted similar audio–video ISDN-based devices to be installed in the main paediatric institutions in the Province of Puglia and linked in a wide regional network. Today, moreover, the widespread availability of ADSL broad-band PC-based systems allows transmission of data in a more reliable and less complex way.
According to this report, the positive impact of telemedicine on health assistance has confirmed by the possibility to optimize the organization of transfer of the critical neonates, the better management of surgical activity, and the delicate phase of counselling. We highlight the concept, in full agreement with Dr Troise, that surgical ablation of the mass associated with anti-infectious medical treatment has been a winning strategy. But, we would like to comment on the common practice in many Neonatologic Units, due to the chronic lack of available paediatric cardiologists, the neonatologists with experience in ultra-sound practice echocardiogram.
Echocardiography of congenital and acquired paediatric heart disease is an operator-dependent imaging technique that requires high levels of technical and interpretive skills to maximize its diagnostic accuracy. In our opinion, the physicians who specialize in echocardiography of paediatric heart disease must undergo extended training in this domain. The American College of Cardiology (ACC) Pediatric Cardiology/Congenital Heart Disease Committee and the ACC Training Program Directors Committee have jointly developed new recommendations for training in paediatric cardiology.2 More recently, a framework of necessary knowledge and training for sonographers and physicians has been provided by the Task Force of the Pediatric Council of the American Society of Echocardiography.3
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- Correale M, Ieva R, Rinaldi M, Rinaldi G, Di Biase M. Voluminous mycetoma in a newborn with Down Syndrome: role of echocardiography. Eur J Echocardiogr (2006) 7:398–400.
[Abstract/Free Full Text] - Sanders SP, Colan SD, Cordes TM, Donofrio MT, Ensing GJ, Geva T, et al. ACC/AHA/AAP recommendations for training in pediatric cardiology Task force 2: pediatric training guidelines for noninvasive cardiac imaging endorsed by the American Society of Echocardiology and the Society of Pediatric Echocardiography. J Am Coll Cardiol (2005) 46:1384–8.
[Free Full Text] - Lai WW, Geva T, Shirali GS, Frommelt PC, Humes RA, Brook MM, et al. Task Force of the Pediatric Council of the American Society of Echocardiography; Pediatric Council of the American Society of Echocardiography. Guidelines and standards for performance of a pediatric echocardiogram: a report from the Task Force of the Pediatric Council of the American Society of Echocardiography. J Am Soc Echocardiogr (2006) 19:1413–30.[CrossRef][Web of Science][Medline]
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