Cardiology Structural Heart Imaging Survey

American College of Cardiology Imaging Council Structural Heart Disease Workgroup Imaging Survey

This survey is a large scale effort to characterize the current state of individuals involved in structural heart disease procedures, their backgrounds, practice patterns, training backgrounds and challenges. All answers will only be reported in aggregate with no individual or institutional information. We do ask for your name and institution to avoid duplicate entries of data. This survey should take approximately 15 minutes to complete.

Question Title

* 1. How many years removed are you from training?

1-5 years

6-10 years

11-15 years

16-20 years

20 or more years

Question Title

* 2. What is your training background?

Cardiology

Radiology

Anesthesiology

Other (please specify)

Question Title

* 3. What best describes your practice setting?

University affiliated hospital / medical system

Non-university affiliated hospital / medical system

Single specialty group practice

Multispecialty group practice

Government practice (VA/military)

Other (please specify)

Question Title

* 4. If you do practice SHD TEE, please select the amount of dedicated training you had for this modality.

1-3 months

4-6 months

7-12 months

More than 12 months

No formal training

I do not practice this modality

Question Title

* 5. If you do practice SHD CT, please select the amount of dedicated training you had for this modality.

1-3 months

4-6 months

7-12 months

More than 12 months

No formal training

I do not practice this modality.

Question Title

* 6. Please select all imaging modalities that you interpret/perform.

TTE

Interventional TTE (Post TAVR, ETOH septal ablation)

TEE

Interventional TEE (Primarily cath lab/hybrid OR transcatheter procedures)

Peri-operative TEE (Primarily operative procedures)

Coronary CT Angiography

Cardiac CTA for Structural Heart Disease Case Planning

Cardiac MRI

Cardiac MRI for Structural Heart Disease Case Planning

Nuclear Cardiology (including SPECT, PET, MUGA)

Vascular CT

Vascular MRI

Vascular Ultrasound

Question Title

* 7. What do you consider your primary imaging modalities? Please check all that apply.

Echocardiography

Cardiac CT

Cardiac MRI

Nuclear cardiology

Vascular Imaging

Other (please specify)

Question Title

* 8. Which statement best characterizes the makeup of those who perform intraprocedural interventional TEE services at your institution?

Cardiology

Anesthesia

Combination of both

Question Title

* 9. Which statement best characterizes the makeup of those who perform structural heart CT at your institution?

Cardiology

Radiology

Combination of both

Question Title

* 10. Which transcatheter structural interventions are performed at your practice/institution? Select all that apply.

TAVR

Percutaneous mitral valve repair (MitraClip, etc)

Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC)

Left atrial appendage occlusion

PVL closure

ETOH septal ablation

Transcatheter tricuspid valve repair or replacement

Atrial septal defect/PFO closure

VSD closure

Pulmonic valve replacement

Other (please specify)

Question Title

* 11. Approximately how many of each type of transcatheter structural interventions were performed in the past year at your practice/institution?

	1-50	51-100	101-150	151-200	201 or more	Does not perform procedure	I do not know
TAVR	TAVR 1-50	TAVR 51-100	TAVR 101-150	TAVR 151-200	TAVR 201 or more	TAVR Does not perform procedure	TAVR I do not know

Question Title

* 12. Approximately how many of each type of transcatheter structural interventions were performed in the past year at your practice/institution?

	1-25	26-50	51-75	76-100	101 or more	Does not perform procedure	I do not know
Percutaneous mitral valve repair (MitraClip, etc)	Percutaneous mitral valve repair (MitraClip, etc) 1-25	Percutaneous mitral valve repair (MitraClip, etc) 26-50	Percutaneous mitral valve repair (MitraClip, etc) 51-75	Percutaneous mitral valve repair (MitraClip, etc) 76-100	Percutaneous mitral valve repair (MitraClip, etc) 101 or more	Percutaneous mitral valve repair (MitraClip, etc) Does not perform procedure	Percutaneous mitral valve repair (MitraClip, etc) I do not know
Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC)	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 1-25	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 26-50	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 51-75	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 76-100	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 101 or more	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) Does not perform procedure	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) I do not know

Question Title

* 13. Approximately how many of each type of transcatheter structural interventions were performed in the past year at your practice/institution?

	1-10	11-20	21-30	31-40	41-50	51 or more	Does not perform procedure	I do not know
Left atrial appendage occlusion	Left atrial appendage occlusion 1-10	Left atrial appendage occlusion 11-20	Left atrial appendage occlusion 21-30	Left atrial appendage occlusion 31-40	Left atrial appendage occlusion 41-50	Left atrial appendage occlusion 51 or more	Left atrial appendage occlusion Does not perform procedure	Left atrial appendage occlusion I do not know
PVL closure	PVL closure 1-10	PVL closure 11-20	PVL closure 21-30	PVL closure 31-40	PVL closure 41-50	PVL closure 51 or more	PVL closure Does not perform procedure	PVL closure I do not know
ETOH septal ablation	ETOH septal ablation 1-10	ETOH septal ablation 11-20	ETOH septal ablation 21-30	ETOH septal ablation 31-40	ETOH septal ablation 41-50	ETOH septal ablation 51 or more	ETOH septal ablation Does not perform procedure	ETOH septal ablation I do not know
Tricuspid interventions	Tricuspid interventions 1-10	Tricuspid interventions 11-20	Tricuspid interventions 21-30	Tricuspid interventions 31-40	Tricuspid interventions 41-50	Tricuspid interventions 51 or more	Tricuspid interventions Does not perform procedure	Tricuspid interventions I do not know
Atrial septal defect/PFO closure	Atrial septal defect/PFO closure 1-10	Atrial septal defect/PFO closure 11-20	Atrial septal defect/PFO closure 21-30	Atrial septal defect/PFO closure 31-40	Atrial septal defect/PFO closure 41-50	Atrial septal defect/PFO closure 51 or more	Atrial septal defect/PFO closure Does not perform procedure	Atrial septal defect/PFO closure I do not know
VSD closure	VSD closure 1-10	VSD closure 11-20	VSD closure 21-30	VSD closure 31-40	VSD closure 41-50	VSD closure 51 or more	VSD closure Does not perform procedure	VSD closure I do not know
Pulmonic valve replacement	Pulmonic valve replacement 1-10	Pulmonic valve replacement 11-20	Pulmonic valve replacement 21-30	Pulmonic valve replacement 31-40	Pulmonic valve replacement 41-50	Pulmonic valve replacement 51 or more	Pulmonic valve replacement Does not perform procedure	Pulmonic valve replacement I do not know

Other (please specify)

Question Title

* 14. Cardiologists perform which percentage of the following intraprocedural TEE studies at your institution?

	1-25%	26-50%	51-75%	76-100%	Does not perform procedure	I do not know
TAVR	TAVR 1-25%	TAVR 26-50%	TAVR 51-75%	TAVR 76-100%	TAVR Does not perform procedure	TAVR I do not know
Percutaneous mitral valve repair (MitraClip, etc)	Percutaneous mitral valve repair (MitraClip, etc) 1-25%	Percutaneous mitral valve repair (MitraClip, etc) 26-50%	Percutaneous mitral valve repair (MitraClip, etc) 51-75%	Percutaneous mitral valve repair (MitraClip, etc) 76-100%	Percutaneous mitral valve repair (MitraClip, etc) Does not perform procedure	Percutaneous mitral valve repair (MitraClip, etc) I do not know
Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC)	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 1-25%	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 26-50%	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 51-75%	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 76-100%	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) Does not perform procedure	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) I do not know
Left atrial appendage occlusion	Left atrial appendage occlusion 1-25%	Left atrial appendage occlusion 26-50%	Left atrial appendage occlusion 51-75%	Left atrial appendage occlusion 76-100%	Left atrial appendage occlusion Does not perform procedure	Left atrial appendage occlusion I do not know
PVL closure	PVL closure 1-25%	PVL closure 26-50%	PVL closure 51-75%	PVL closure 76-100%	PVL closure Does not perform procedure	PVL closure I do not know
ETOH septal ablation	ETOH septal ablation 1-25%	ETOH septal ablation 26-50%	ETOH septal ablation 51-75%	ETOH septal ablation 76-100%	ETOH septal ablation Does not perform procedure	ETOH septal ablation I do not know
Peri-operative valve replacement (surgical)	Peri-operative valve replacement (surgical) 1-25%	Peri-operative valve replacement (surgical) 26-50%	Peri-operative valve replacement (surgical) 51-75%	Peri-operative valve replacement (surgical) 76-100%	Peri-operative valve replacement (surgical) Does not perform procedure	Peri-operative valve replacement (surgical) I do not know
Tricuspid interventions	Tricuspid interventions 1-25%	Tricuspid interventions 26-50%	Tricuspid interventions 51-75%	Tricuspid interventions 76-100%	Tricuspid interventions Does not perform procedure	Tricuspid interventions I do not know
Atrial septal defect/PFO closure	Atrial septal defect/PFO closure 1-25%	Atrial septal defect/PFO closure 26-50%	Atrial septal defect/PFO closure 51-75%	Atrial septal defect/PFO closure 76-100%	Atrial septal defect/PFO closure Does not perform procedure	Atrial septal defect/PFO closure I do not know
VSD closure	VSD closure 1-25%	VSD closure 26-50%	VSD closure 51-75%	VSD closure 76-100%	VSD closure Does not perform procedure	VSD closure I do not know
Pulmonic valve replacement	Pulmonic valve replacement 1-25%	Pulmonic valve replacement 26-50%	Pulmonic valve replacement 51-75%	Pulmonic valve replacement 76-100%	Pulmonic valve replacement Does not perform procedure	Pulmonic valve replacement I do not know

Other (please specify)

Question Title

* 15. The Anesthesiologists perform what percentage of the following intraprocedural TEE studies at your institution?

	1-25%	26-50%	51-75%	76-100%	Does not perform procedure	I do not know
TAVR	TAVR 1-25%	TAVR 26-50%	TAVR 51-75%	TAVR 76-100%	TAVR Does not perform procedure	TAVR I do not know
Percutaneous mitral valve repair (MitraClip, etc)	Percutaneous mitral valve repair (MitraClip, etc) 1-25%	Percutaneous mitral valve repair (MitraClip, etc) 26-50%	Percutaneous mitral valve repair (MitraClip, etc) 51-75%	Percutaneous mitral valve repair (MitraClip, etc) 76-100%	Percutaneous mitral valve repair (MitraClip, etc) Does not perform procedure	Percutaneous mitral valve repair (MitraClip, etc) I do not know
Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC)	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 1-25%	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 26-50%	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 51-75%	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 76-100%	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) Does not perform procedure	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) I do not know
Left atrial appendage occlusion	Left atrial appendage occlusion 1-25%	Left atrial appendage occlusion 26-50%	Left atrial appendage occlusion 51-75%	Left atrial appendage occlusion 76-100%	Left atrial appendage occlusion Does not perform procedure	Left atrial appendage occlusion I do not know
PVL closure	PVL closure 1-25%	PVL closure 26-50%	PVL closure 51-75%	PVL closure 76-100%	PVL closure Does not perform procedure	PVL closure I do not know
ETOH septal ablation	ETOH septal ablation 1-25%	ETOH septal ablation 26-50%	ETOH septal ablation 51-75%	ETOH septal ablation 76-100%	ETOH septal ablation Does not perform procedure	ETOH septal ablation I do not know
Peri-operative valve replacement (surgical)	Peri-operative valve replacement (surgical) 1-25%	Peri-operative valve replacement (surgical) 26-50%	Peri-operative valve replacement (surgical) 51-75%	Peri-operative valve replacement (surgical) 76-100%	Peri-operative valve replacement (surgical) Does not perform procedure	Peri-operative valve replacement (surgical) I do not know
Tricuspid interventions	Tricuspid interventions 1-25%	Tricuspid interventions 26-50%	Tricuspid interventions 51-75%	Tricuspid interventions 76-100%	Tricuspid interventions Does not perform procedure	Tricuspid interventions I do not know

Other (please specify)

Question Title

* 16. What is your role in echocardiography for structural heart imaging? Select all that apply.

TTE (review/interpret pre-procedural studies)

TTE (review/interpret post-procedural/follow-up studies)

TEE (perform/interpret pre-procedural studies)

TEE (perform/interpret intra-procedural studies)

I am not involved in echocardiography for SHD imaging

Question Title

* 17. What is the role of sonographers in your structural heart imaging program? Select all that apply.

Scan our pre and post-procedural TTEs

Perform intraprocedural TTEs

Operate the machine in our pre and post procedural TEE

Manipulate the probe in our intraprocedural TEE

Operate the machine in our intraprocedural TEE

None

Question Title

* 18. What is the role of computed tomography 3D techs in your structural heart imaging program? Select all that apply.

Performance of preliminary pre-procedural measurements (ie. annular sizing for TAVR, vascular access sizing, etc)

Performance of preliminary 3D visualizations (ie. volume rendered images for c-arm deployment, valve lines, etc)

Scan our pre and post-procedural CTA’s

Independently request ECG editing on CTA datasets

Independently performed ECG editing on CTA datasets

Our institution does not utilize dedicated techs for pre-procedural CTA processing

I am not familiar with institutional CT processing protocols

Question Title

* 19. What is your role in CT for structural heart disease? Select all that apply.

SHD Cardiac CT (review/interpret pre-procedural studies)

SHD Cardiac CT (review/interpret post-procedural studies)

I am not involved in CTA for SHD imaging

Question Title

* 20. What is your formal training/background in echocardiography?

COCATS Level 1 trained in echocardiography (or equivalent)

COCATS Level 2 trained in echocardiography (or equivalent)

COCATS Level 3 trained in echocardiography (or equivalent)

No COCATS level (Cardiologist with grandfathered competence in echocardiography)

No COCATS level (Not a Cardiologist)

I am not involved in echocardiography

Question Title

* 21. What statement best characterizes your training in interventional TEE?

I obtained competence in interventional TEE during a general cardiology fellowship.

I obtained competence in interventional TEE during a general advanced TEE fellowship.

I obtained competence in interventional TEE in a fellowship dedicated to learning interventional TEE skills.

I obtained competence in interventional TEE during a multimodality advanced imaging fellowship.

I obtained competence in interventional TEE on the job after completing fellowship training.

I do not perform interventional TEE

Question Title

* 22. What is your training/background in cardiac CT?

COCATS Level 1 trained in cardiac CT (or equivalent)

COCATS Level 2 trained in cardiac CT (or equivalent)

COCATS Level 3 trained in cardiac CT (or equivalent)

No COCATS level (Cardiologist with grandfathered competence in cardiac CT)

No COCATS level (Not a Cardiologist)

I am not involved in cardiac CT

Question Title

* 23. What statement best characterizes your training in CT for structural heart disease?

I obtained competence in structural heart CT during a general cardiology fellowship.

I obtained competence in structural heart CT during a general advanced CT fellowship.

I obtained competence in structural heart CT during a multimodality advanced imaging fellowship.

I obtained competence in structural heart CT in a fellowship dedicated to learning structural CT skills.

I obtained competence in structural heart CT on the job after completing fellowship training.

I do not perform structural heart CT

Question Title

* 24. How well integrated are you into the rest of the structural heart disease team?

Extremely. I am present at the majority of our group meetings (>76%)

I am moderately present at our group meetings (51-75%)

I sometimes am present at some of our group meetings (26-50%)

I rarely participate in the group meetings. (<25%)

Not at all. I do not participate in these meetings (0%)

Question Title

* 25. In your practice, please estimate the amount of physician time it takes on average to interpret the following studies inclusive of all 3D post processing and reporting

	5 minutes or less	6-10 minutes	11-15 minutes	16-20 minutes	21-25 minutes	26-30 minutes	31 minutes or greater	I do not interpret this kind of study
Routine TTE (not structural heart disease related)	Routine TTE (not structural heart disease related) 5 minutes or less	Routine TTE (not structural heart disease related) 6-10 minutes	Routine TTE (not structural heart disease related) 11-15 minutes	Routine TTE (not structural heart disease related) 16-20 minutes	Routine TTE (not structural heart disease related) 21-25 minutes	Routine TTE (not structural heart disease related) 26-30 minutes	Routine TTE (not structural heart disease related) 31 minutes or greater	Routine TTE (not structural heart disease related) I do not interpret this kind of study
Structural heart disease TTE (pre/post intervention)	Structural heart disease TTE (pre/post intervention) 5 minutes or less	Structural heart disease TTE (pre/post intervention) 6-10 minutes	Structural heart disease TTE (pre/post intervention) 11-15 minutes	Structural heart disease TTE (pre/post intervention) 16-20 minutes	Structural heart disease TTE (pre/post intervention) 21-25 minutes	Structural heart disease TTE (pre/post intervention) 26-30 minutes	Structural heart disease TTE (pre/post intervention) 31 minutes or greater	Structural heart disease TTE (pre/post intervention) I do not interpret this kind of study

Question Title

* 26. In your practice, please estimate the amount of physician time it takes on average to interpret the following studies inclusive of all 3D post processing and reporting.

	15 minutes or less	16-30 minutes	31-45 minutes	46-60 minutes	61-75 minutes	76 minutes or greater	I do not interpret this kind of study
Routine TEE (not structural heart disease related)	Routine TEE (not structural heart disease related) 15 minutes or less	Routine TEE (not structural heart disease related) 16-30 minutes	Routine TEE (not structural heart disease related) 31-45 minutes	Routine TEE (not structural heart disease related) 46-60 minutes	Routine TEE (not structural heart disease related) 61-75 minutes	Routine TEE (not structural heart disease related) 76 minutes or greater	Routine TEE (not structural heart disease related) I do not interpret this kind of study
Structural heart disease TEE (pre/post intervention - NOT periprocedureal)	Structural heart disease TEE (pre/post intervention - NOT periprocedureal) 15 minutes or less	Structural heart disease TEE (pre/post intervention - NOT periprocedureal) 16-30 minutes	Structural heart disease TEE (pre/post intervention - NOT periprocedureal) 31-45 minutes	Structural heart disease TEE (pre/post intervention - NOT periprocedureal) 46-60 minutes	Structural heart disease TEE (pre/post intervention - NOT periprocedureal) 61-75 minutes	Structural heart disease TEE (pre/post intervention - NOT periprocedureal) 76 minutes or greater	Structural heart disease TEE (pre/post intervention - NOT periprocedureal) I do not interpret this kind of study

Question Title

* 27. In your practice, please estimate the amount of physician time it takes on average to interpret the following studies inclusive of all 3D post processing and reporting.

	45 minutes or less	46-90 minutes	91-135 minutes	136-180 minutes	181-225 minutes	226 minutes or greater	I do not interpret this kind of study
TAVR	TAVR 45 minutes or less	TAVR 46-90 minutes	TAVR 91-135 minutes	TAVR 136-180 minutes	TAVR 181-225 minutes	TAVR 226 minutes or greater	TAVR I do not interpret this kind of study
Percutaneous mitral valve repair (MitraClip, etc)	Percutaneous mitral valve repair (MitraClip, etc) 45 minutes or less	Percutaneous mitral valve repair (MitraClip, etc) 46-90 minutes	Percutaneous mitral valve repair (MitraClip, etc) 91-135 minutes	Percutaneous mitral valve repair (MitraClip, etc) 136-180 minutes	Percutaneous mitral valve repair (MitraClip, etc) 181-225 minutes	Percutaneous mitral valve repair (MitraClip, etc) 226 minutes or greater	Percutaneous mitral valve repair (MitraClip, etc) I do not interpret this kind of study
Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC)	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 45 minutes or less	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 46-90 minutes	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 91-135 minutes	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 136-180 minutes	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 181-225 minutes	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) 226 minutes or greater	Percutaneous mitral valve replacement (Valve-in-Valve, Valve-in-Ring, Valve-in-native MAC, Valve-in-native-non MAC) I do not interpret this kind of study
Left atrial appendage occlusion	Left atrial appendage occlusion 45 minutes or less	Left atrial appendage occlusion 46-90 minutes	Left atrial appendage occlusion 91-135 minutes	Left atrial appendage occlusion 136-180 minutes	Left atrial appendage occlusion 181-225 minutes	Left atrial appendage occlusion 226 minutes or greater	Left atrial appendage occlusion I do not interpret this kind of study
PVL closure	PVL closure 45 minutes or less	PVL closure 46-90 minutes	PVL closure 91-135 minutes	PVL closure 136-180 minutes	PVL closure 181-225 minutes	PVL closure 226 minutes or greater	PVL closure I do not interpret this kind of study
ETOH septal ablation	ETOH septal ablation 45 minutes or less	ETOH septal ablation 46-90 minutes	ETOH septal ablation 91-135 minutes	ETOH septal ablation 136-180 minutes	ETOH septal ablation 181-225 minutes	ETOH septal ablation 226 minutes or greater	ETOH septal ablation I do not interpret this kind of study
Tricuspid interventions	Tricuspid interventions 45 minutes or less	Tricuspid interventions 46-90 minutes	Tricuspid interventions 91-135 minutes	Tricuspid interventions 136-180 minutes	Tricuspid interventions 181-225 minutes	Tricuspid interventions 226 minutes or greater	Tricuspid interventions I do not interpret this kind of study

Question Title

* 28. How many hours per week do you spend on intraprocedural structural echo (TTE or TEE)?

Question Title

* 29. How many hours per week do you spend on structural heart CT?

Question Title

* 30. In your practice, on average, what percentage of physician time / FTE percentage is spent on the following tasks (1 day = 20% of your time):

	0%	1-20%	21-40%	41-60%	61-80%	81-100%	I do not perform these tasks
Structural heart disease TTE	Structural heart disease TTE 0%	Structural heart disease TTE 1-20%	Structural heart disease TTE 21-40%	Structural heart disease TTE 41-60%	Structural heart disease TTE 61-80%	Structural heart disease TTE 81-100%	Structural heart disease TTE I do not perform these tasks
Structural heart disease TEE (non-procedural)	Structural heart disease TEE (non-procedural) 0%	Structural heart disease TEE (non-procedural) 1-20%	Structural heart disease TEE (non-procedural) 21-40%	Structural heart disease TEE (non-procedural) 41-60%	Structural heart disease TEE (non-procedural) 61-80%	Structural heart disease TEE (non-procedural) 81-100%	Structural heart disease TEE (non-procedural) I do not perform these tasks
Structural heart disease TEE (peri-procedural)	Structural heart disease TEE (peri-procedural) 0%	Structural heart disease TEE (peri-procedural) 1-20%	Structural heart disease TEE (peri-procedural) 21-40%	Structural heart disease TEE (peri-procedural) 41-60%	Structural heart disease TEE (peri-procedural) 61-80%	Structural heart disease TEE (peri-procedural) 81-100%	Structural heart disease TEE (peri-procedural) I do not perform these tasks
Structural heart disease CT	Structural heart disease CT 0%	Structural heart disease CT 1-20%	Structural heart disease CT 21-40%	Structural heart disease CT 41-60%	Structural heart disease CT 61-80%	Structural heart disease CT 81-100%	Structural heart disease CT I do not perform these tasks

Question Title

* 31. If applicable, how much protected time/effort (as a percentage) are you given for the following tasks?

	0%	1-20%	21-40%	41-60%	61-80%	81-100%	I do not perform these tasks
Structural heart disease TTE	Structural heart disease TTE 0%	Structural heart disease TTE 1-20%	Structural heart disease TTE 21-40%	Structural heart disease TTE 41-60%	Structural heart disease TTE 61-80%	Structural heart disease TTE 81-100%	Structural heart disease TTE I do not perform these tasks
Structural heart disease TEE (non-procedural)	Structural heart disease TEE (non-procedural) 0%	Structural heart disease TEE (non-procedural) 1-20%	Structural heart disease TEE (non-procedural) 21-40%	Structural heart disease TEE (non-procedural) 41-60%	Structural heart disease TEE (non-procedural) 61-80%	Structural heart disease TEE (non-procedural) 81-100%	Structural heart disease TEE (non-procedural) I do not perform these tasks
Structural heart disease TEE (peri-procedural)	Structural heart disease TEE (peri-procedural) 0%	Structural heart disease TEE (peri-procedural) 1-20%	Structural heart disease TEE (peri-procedural) 21-40%	Structural heart disease TEE (peri-procedural) 41-60%	Structural heart disease TEE (peri-procedural) 61-80%	Structural heart disease TEE (peri-procedural) 81-100%	Structural heart disease TEE (peri-procedural) I do not perform these tasks
Structural heart disease CT	Structural heart disease CT 0%	Structural heart disease CT 1-20%	Structural heart disease CT 21-40%	Structural heart disease CT 41-60%	Structural heart disease CT 61-80%	Structural heart disease CT 81-100%	Structural heart disease CT I do not perform these tasks

Question Title

* 32. How are interventional TEE duties divided in your group?

Responsibilities shared by a large group of individuals

A small group of individuals who focus on these cases

Interventional TEE cases not performed at institution

I am not sure how these duties are organized

Please write the number of individuals who actively participate in interventional TEE duties

Question Title

* 33. Is there a dedicated structural heart imaging team for Cardiac CT at your practice/institution?

Responsibilities shared by a large group of individuals

A small group of individuals who focus on these cases

Interventional Cardiac CT cases not performed at institution

I am not sure how these duties are organized.

Please write the number of individuals who actively participate in structural heart CT duties.

Question Title

* 34. How would you best describe your current compensation model for structural heart imaging in echocardiography? Select all that apply

Primarily salaried income without RVU offset for SHD imaging time

Primarily salaried income with RVU offset for SHD imaging time

Primarily productivity without RVU offset for SHD imaging time

Primarily productivity with RVU offset for SHD imaging time

I am not involved in SHD cardiography

Other (please specify)

Question Title

* 35. How would you best describe your current compensation model for the interpretation and 3D processing of cardiac CTA for Structural Heart Disease Case Planning? Select all that apply

Primarily salaried income without RVU offset for SHD imaging time

Primarily salaried income with RVU offset for SHD imaging time

Primarily productivity without RVU offset for SHD imaging time

Primarily productivity with RVU offset for SHD imaging time

I am not involved in SHD CT

Other (please specify)

Question Title

* 36. Is your current compensation periodically adjusted/reviewed for increased/decreased efforts spent in structural imaging?

Yes

Other (please specify)

Question Title

* 37. Please rate the importance of the following issues current practice of interventional TEE. (1=Unimportant, 2=Slightly Important, 3=Moderately Important, 4=Important, 5=Very Important, 6=Not Applicable)

	Unimportant	Slightly Important	Moderately Important	Important	Very Important	Not Applicable
Reimbursement not commensurate with time, effort and complexity of decision making	Reimbursement not commensurate with time, effort and complexity of decision making Unimportant	Reimbursement not commensurate with time, effort and complexity of decision making Slightly Important	Reimbursement not commensurate with time, effort and complexity of decision making Moderately Important	Reimbursement not commensurate with time, effort and complexity of decision making Important	Reimbursement not commensurate with time, effort and complexity of decision making Very Important	Reimbursement not commensurate with time, effort and complexity of decision making Not Applicable
Lack of protected time/effort or salary support	Lack of protected time/effort or salary support Unimportant	Lack of protected time/effort or salary support Slightly Important	Lack of protected time/effort or salary support Moderately Important	Lack of protected time/effort or salary support Important	Lack of protected time/effort or salary support Very Important	Lack of protected time/effort or salary support Not Applicable
Lack of recognition of advanced imaging as a formal Cardiology subspecialty	Lack of recognition of advanced imaging as a formal Cardiology subspecialty Unimportant	Lack of recognition of advanced imaging as a formal Cardiology subspecialty Slightly Important	Lack of recognition of advanced imaging as a formal Cardiology subspecialty Moderately Important	Lack of recognition of advanced imaging as a formal Cardiology subspecialty Important	Lack of recognition of advanced imaging as a formal Cardiology subspecialty Very Important	Lack of recognition of advanced imaging as a formal Cardiology subspecialty Not Applicable
Inadequate formal training programs in SHD specific imaging skills	Inadequate formal training programs in SHD specific imaging skills Unimportant	Inadequate formal training programs in SHD specific imaging skills Slightly Important	Inadequate formal training programs in SHD specific imaging skills Moderately Important	Inadequate formal training programs in SHD specific imaging skills Important	Inadequate formal training programs in SHD specific imaging skills Very Important	Inadequate formal training programs in SHD specific imaging skills Not Applicable
Orthopedic (back) and repetitive strain injury from performing interventional TEE	Orthopedic (back) and repetitive strain injury from performing interventional TEE Unimportant	Orthopedic (back) and repetitive strain injury from performing interventional TEE Slightly Important	Orthopedic (back) and repetitive strain injury from performing interventional TEE Moderately Important	Orthopedic (back) and repetitive strain injury from performing interventional TEE Important	Orthopedic (back) and repetitive strain injury from performing interventional TEE Very Important	Orthopedic (back) and repetitive strain injury from performing interventional TEE Not Applicable
Radiation exposure during interventional TEE cases	Radiation exposure during interventional TEE cases Unimportant	Radiation exposure during interventional TEE cases Slightly Important	Radiation exposure during interventional TEE cases Moderately Important	Radiation exposure during interventional TEE cases Important	Radiation exposure during interventional TEE cases Very Important	Radiation exposure during interventional TEE cases Not Applicable
Psychological distress for adverse outcomes during interventional TEE cases	Psychological distress for adverse outcomes during interventional TEE cases Unimportant	Psychological distress for adverse outcomes during interventional TEE cases Slightly Important	Psychological distress for adverse outcomes during interventional TEE cases Moderately Important	Psychological distress for adverse outcomes during interventional TEE cases Important	Psychological distress for adverse outcomes during interventional TEE cases Very Important	Psychological distress for adverse outcomes during interventional TEE cases Not Applicable
Inadequate training programs in interventional TEE specific skills	Inadequate training programs in interventional TEE specific skills Unimportant	Inadequate training programs in interventional TEE specific skills Slightly Important	Inadequate training programs in interventional TEE specific skills Moderately Important	Inadequate training programs in interventional TEE specific skills Important	Inadequate training programs in interventional TEE specific skills Very Important	Inadequate training programs in interventional TEE specific skills Not Applicable
Insufficient sonographer training for complex valve cases	Insufficient sonographer training for complex valve cases Unimportant	Insufficient sonographer training for complex valve cases Slightly Important	Insufficient sonographer training for complex valve cases Moderately Important	Insufficient sonographer training for complex valve cases Important	Insufficient sonographer training for complex valve cases Very Important	Insufficient sonographer training for complex valve cases Not Applicable

Question Title

* 38. Please rate the importance of the following issues to your current practice of SHD CT. (1=Unimportant, 2=Slightly Important, 3=Moderately Important, 4=Important, 5=Very Important 6=Not Applicable)

	Unimportant	Slightly Important	Moderately Important	Important	Very Important	Not Applicable
Reimbursement not commensurate with time, effort and complexity of decision making	Reimbursement not commensurate with time, effort and complexity of decision making Unimportant	Reimbursement not commensurate with time, effort and complexity of decision making Slightly Important	Reimbursement not commensurate with time, effort and complexity of decision making Moderately Important	Reimbursement not commensurate with time, effort and complexity of decision making Important	Reimbursement not commensurate with time, effort and complexity of decision making Very Important	Reimbursement not commensurate with time, effort and complexity of decision making Not Applicable
Lack of protected time/effort or salary support	Lack of protected time/effort or salary support Unimportant	Lack of protected time/effort or salary support Slightly Important	Lack of protected time/effort or salary support Moderately Important	Lack of protected time/effort or salary support Important	Lack of protected time/effort or salary support Very Important	Lack of protected time/effort or salary support Not Applicable
Lack of recognition of advanced imaging as a formal Cardiology subspecialty	Lack of recognition of advanced imaging as a formal Cardiology subspecialty Unimportant	Lack of recognition of advanced imaging as a formal Cardiology subspecialty Slightly Important	Lack of recognition of advanced imaging as a formal Cardiology subspecialty Moderately Important	Lack of recognition of advanced imaging as a formal Cardiology subspecialty Important	Lack of recognition of advanced imaging as a formal Cardiology subspecialty Very Important	Lack of recognition of advanced imaging as a formal Cardiology subspecialty Not Applicable
Inadequate training programs in SHD CT specific skills	Inadequate training programs in SHD CT specific skills Unimportant	Inadequate training programs in SHD CT specific skills Slightly Important	Inadequate training programs in SHD CT specific skills Moderately Important	Inadequate training programs in SHD CT specific skills Important	Inadequate training programs in SHD CT specific skills Very Important	Inadequate training programs in SHD CT specific skills Not Applicable
Insufficient 3D tech training for SHD procedural planning	Insufficient 3D tech training for SHD procedural planning Unimportant	Insufficient 3D tech training for SHD procedural planning Slightly Important	Insufficient 3D tech training for SHD procedural planning Moderately Important	Insufficient 3D tech training for SHD procedural planning Important	Insufficient 3D tech training for SHD procedural planning Very Important	Insufficient 3D tech training for SHD procedural planning Not Applicable

Question Title

* 39. Please detail additional areas of concern that you feel are facing imagers specializing in structural heart disease.

Question Title

* 40. Please provide your name, institution and email address to help us ensure that we do not have any duplication in our responses.

Name

Institution

Email Address

Question Title

* 41. Are you interested in having your name, institution and email included in an internal database to use for networking, SHD related advocacy efforts and education? (No survey information will be stored in this database).

Yes