The ASE Foundation’s 2019 global health outreach events are supported by donor contributions to the Annual Appeal and a grant from the Edwards Lifesciences Foundation Every Heartbeat Matters program.
CHINA 2019
Yan’an • Ganquan • Zhidan
September 2 – 6, 2019
Team Leaders:
Cynthia C. Taub, MD, FASE – Montefiore Medical Center, New York, New York, USA
Liwen Liu, MD – Xijing Hospital, Xi’an, China
Medical Team:
Robin Billman, RN, BS, RDCS, CHFN – St. Joseph’s Medical Center, Brainerd, MN, USA; Nancy Cutler, MD, FASE – University of Michigan, West Bloomfield Township, MI, USA; Rajesh Janardhanan, MD, FASE – University of Arizona, Tucson, AZ, USA; Yan Wang, RDCS, FASE – The Children’s Hospital of Philadelphia, Philadelphia, PA, USA; Neil Weissman, MD, FASE – MedStar Health and Georgetown University, Washington DC, USA; Feng Xie, MD – University of Nebraska Medical Center, La Vista, NE, USA; Staff Liaisons: Mary Carmody and Robin Wiegerink, MNPL
Institutional Partners:
♥ Xijing Hospital, Xi’an
♥ Dongguan Cardiovascular and Cerebrovascular Disease Specialist Ward of the First Affiliated Hospital of Yan’an University
Industry Supporters:
♥ Siemens Healthineers
♥ Phillips China
♥ Hitachi
During the first week of September, a team of 7 ASE Foundation volunteers participated in free patient scanning and physician training events spanning multiple sites in central China. The week concluded with the 3rd Xijing International Summit Forum on Cardiovascular Ultrasound. The team presented lectures on various heart ultrasound topics alongside Chinese physicians from the across the country. The two and a half days of free scanning events were held at a children’s welfare home in Yan’an, the Ganquan People’s Hospital, and the Zhidan People’s Hospital. Our team of volunteers worked side by side with the local clinicians which provided the perfect opportunity to collaborate and share knowledge.
By the numbers:
Patient Outreach – 2 ½ days, 3 sites, 625 patients scanned
Training – 1 day, over 300 in attendance on site, over 11,000 live streamed online
Day 1
The team was welcomed to the Dongguan Cardiovascular and Cerebrovascular Disease Specialist Ward of the First Affiliated Hospital of Yan’an University. A 
large screen on top of the hospital displayed a welcome message to ASE. We were given a tour of the ultrasound department and saw three translated ASE guideline posters on tables in a work room! The plan for the morning was to tour the hospital and present two lectures to clinicians, but once news of the team’s presence had spread through social media, five patients had traveled to the hospital in the hopes of receiving second opinions on their diagnosis from our experts. 
At the conclusion of the planned tour, and without a moment’s hesitation, our team went to work. Yan Wang, RDCS, FASE, sat at the echo machine and began scanning the first patient. Robin Billman, RN, BS, RDCS, CHFN, Drs. Cutler, Janardhanan, Taub, Weissman, Xie, and hospital clinicians filled the room, all eyes on the echo screen. After the last patient was scanned, the team moved to a lecture room where Yan Wang, RDCS, FASE, and Robin Billman, RN, BS, RDCS, CHFN, presented lectures on basic TTE views, TTE measurements and work flow, basic measurements for aortic stenosis, and Mitral regurgitation quantification. Clinicians trickled in and out as their schedules permitted to hear from our expert sonographers.
The later part of the day was spent at a children’s welfare home in Yan’an. Upon our arrival, we were greeted with the smiling faces of kids waiting for the school
bus. These children had been pre-screened to avoid missing any school. The director welcomed our team and expressed immense gratitude. He dedicated his life’s work to helping children and his passion was very moving. The youngest children living in the home were the target audience for the afternoon. Echo machines donated by Phillips Healthcare had been delivered for our use that day and set up in rooms of one of the buildings.
The halls were filled with smiling kids who ran in and out of rooms, snacking on treats, and demanding the attention of their ‘mommas’ (welfare home care takers). 
94 pediatric patients were scanned in total and congenital heart disease was found in 28 cases. At the conclusion of the scanning, we were lucky enough to tour the living quarters of the home. Bright colored murals covered the walls and pretty banners hung from the ceilings. The kids were very excited to have visitors and warmed to us, even holding their arms out, motioning to be picked up. Needless to say it was hard saying goodbye when the time came to leave.
Day 2
The next morning we boarded our bus bright and early to travel about an hour to the Ganquan People’s Hospital. Dr. Pingan Zhou, director of the ultrasound 
department at the First Affiliated Hospital of Yan’an University, had arranged a full day of scanning. Upon our arrival, what felt like the entire hospital staff was waiting outside and clapping! We were in awe of the reception. As we made our way through the hospital, people were already lining the hallways. The team was divided into sonographer-physician pairs and assigned their room for the day. 40 hospital staff handled the triage alone and in total, 242 patients were scanned with pathology found in 158 cases. Seeking follow up treatment, if recommended, is on the onus of the patient. All patients were provided a copy of their report within hours of being scanned.
Day 3
Our third and final day of scanning took place at Zhidan People’s Hospital, roughly 1 ½ hours northwest of Yan’an. As with the two previous hospitals, the staff 
from Zhidan People’s greeted our team outside and we were once again humbled by the reception. Making our way through the halls of the hospital we saw patients lining the hallways, waiting their turn. Our volunteers paired off in teams and were assigned their room. This arrangement of having a sonographer-physician team worked very well. Every room was also staffed by Chinese clinicians who transcribed the medical reports and communicated with the patients. The patients’ scans were analyzed in real time and dictated to the scribe for inclusion in the report. This arrangement provided a great environment for sharing knowledge and the opportunity to ask questions. At the conclusion of the day, a total of 284 patients had been scanned and each was provided a copy of their medical report just hours after being seen.
3rd Xijing International Summit Forum on Cardiovascular Ultrasound
The US-based volunteer team had the great fortune to participate in the 3rd Xijing International Summit Forum on Cardiovascular Ultrasound alongside our 
colleagues in China. Sponsored by the Shaanxi Association of Ultrasound in Medicine and Engineering and organized by the Ultrasound Department of Cardiovascular and Cerebrovascular Ward of the First Affiliated Hospital of Yan’an University and ASEF, this day of lectures showcased the latest international ideas of medicine and innovated results of medical research. The aim of the forum was to improve the abilities of ultrasound practitioners and to promote development in the field of echocardiography. There were over 300 attendees on site and the lectures were live-streamed to over 11,000 viewers! During the afternoon break, translated copies of the Evaluation of Mitral Regurgitation poster from the Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation guideline document (Zoghbi, et al) were given away to attendees.
Presentations
Scanning
For Fun
The expected long-term, residual impact of this specific event is a deepening relationship with a potential long-term partner in China, advanced training for attendees in China, improved patient care in rural areas, cultural and educational exchange, and a unique volunteer opportunity for ASE members.
The ASE Foundation’s global health outreach program is designed to bring humanitarian adult and pediatric cardiac care to developing countries, teaching local clinicians and providing direct services to those in need. These efforts not only impact the lives and well-being of countless patients in under-served populations, but they also serve to spotlight the versatility and adaptability of cardiovascular ultrasound while advancing practice standards to uniform treatment and improve patient care worldwide.
