Fetal Echocardiography - Gold Edition

Greggory R. DeVore, MD

Review by Art Fougner, MD

Since his days at Yale, Dr. Greggory R. DeVore has been one of the acknowledged experts in the field of the evaluation of the developing fetal heart. Several years ago, Dr. DeVore developed a series of computer-based tutorials and made them available through the internet. This latest double CD-ROM set, Fetal Echocardiography - Gold Edition, is the latest iteration of this work. The first CD- The Screening Examination - concentrates on the normal four chamber view and the anatomy of the outflow tracts. An interactive tutorial on determining the orientation of the fetal heart in different presentations is especially useful. After completing this part of the program, one would be expected to evaluate the fetal heart in a way which would satisfy all published criteria and guidelines. Additionally, the examiner would be able to recognize deviations from the norm.

The second CD - Pathology - focuses on the identification and understanding of abnormal anatomy. This section is clearly aimed at those who practice in a referral setting or those who wish to refine their skills. Along with 2-D imaging, the additional modalities of color and pulsed doppler are added to enhance understanding of pathophysiology. When taken together, ! Fetal Echocardiography - Gold Edition contains over 500 video clips, about 5000 interactive activities, and multiple tutorials. Reference articles from the world literature are also included, reprinted in their entirety. Finally, CME credits are also available upon completion.

I thoroughly enjoyed reviewing Dr. DeVore's work, having been acquainted with his previous multimedia compilations from the Internet Fetal Echocardiography days. Although my library contains several texts, atlases and videotapes on the fetal heart, I found these CD ROM's the next best thing to looking over an expert's shoulder in the laboratory. Moreover, Dr. DeVore's extensive referral practice provides a truly remarkable array of pathology for review.

I do have a few gripes, however. The multiple choices of background music seem a bit "glitzy" and superfluous. Also, there is little guidance on system settings or "knobology" to assist in optimizing images and color doppler studies. This makes it difficult to quickly incorporate some of Dr. DeVore's techniques into one's own practice. One area which is not covered at all is the differentiation between the membranous VSD and artifactual dropout which may appear quite similar indeed. Perhaps in a subsequent edition, Dr. DeVore may help us make this crucial differentiation. These criticisms notwithstanding, Dr. DeVore's Fetal Echocardiography - Gold Edition is an excellent compilation for both reference and education which belongs in the library of every practitioner who evaluates the unborn fetus.

More information on this CD-ROM set is available at http://www.fetalecho.com/