How One CRNA is Advancing Cardiac Ultrasound

Mark Gabot, DNP, CRNA, FAANA, FASE, has spent nearly two decades in nurse anesthesia. In December 2025, he became the first Certified Registered Nurse Anesthetist (CRNA) to be inducted as a Fellow of the American Society of Echocardiography (ASE)—and only the second advanced practice registered nurse to receive the distinction.

“It’s probably one of the biggest—if not the biggest—milestones in my career,” he said.

ASE fellowship has often been associated with cardiologists, echocardiographers, and cardiac anesthesiologists. Gabot views his induction as a sign that the circle can widen for CRNAs and other clinicians whose work is closely tied to cardiovascular and point-of-care ultrasound (POCUS).

The fellowship reflects years of clinical practice, teaching, and professional volunteer leadership. Gabot practices in a tertiary care setting, caring for high-acuity patients. He also serves as faculty at the Kaiser Permanente School of Anesthesia, where he has helped shape how Student Registered Nurse Anesthetists learn and apply POCUS in clinical decision-making. He has also remained active in professional organizations, including AANA, as his work in focused cardiovascular ultrasound has expanded.

“I hope this recognition inspires other CRNAs to pursue echocardiography or advanced ultrasound training,” he said. “I hope that it broadens the use of echocardiography in CRNA practice.”

For Gabot, cardiac POCUS brings ultrasound directly to the bedside, where clinicians often need immediate information to guide care.

He noted that it’s “not only applicable to in-patient perioperative services, but I believe that it helps provide better care to all patients, especially those in rural areas where their resources are very slim.”

In those settings, he described how a clinician can use ultrasound as “a quick bedside assessment to basically triage that patient” and determine whether to stabilize locally or transfer to a higher level of care.

In his view, POCUS also “helps CRNAs extend beyond the operating room into other avenues where advanced practice providers are vastly needed.” He added, “Echocardiography or point-of-care ultrasound is another way for us to show our true value.”

Gabot has seen how POCUS changes clinical decision-making. He recalled a patient who presented with preoperative hypotension (low blood pressure before surgery). With a history of heart failure, cardiac decompensation might have been assumed.

“It was not their heart failure per se that was causing them to have low blood pressure,” he explained. “They didn’t have enough volume in their heart to allow it to have adequate cardiac output, regardless of what their previous history of heart failure said.”

Using ultrasound guidance, he administered small amounts of fluid and reassessed repeatedly. “The wonderful thing about POCUS is that you take an image, do an intervention, and then you can always assess whether or not that intervention worked,” Gabot said. Ultimately, he was able to optimize the patient safely before anesthesia delivery.

He also noted how POCUS can strengthen patient communication.

“The great thing about POCUS is that it allows the patient to see what we’re seeing in real time,” Gabot said. Instead of waiting for results from a lab-based study, “you can provide patient education right then and there.”

Seeing what’s normal—and what isn’t—can make abstract diagnoses more concrete. “Hopefully that will help them make better health decisions.”

That belief is also part of why Gabot has prioritized ultrasound education. At Kaiser Permanente School of Anesthesia, he launched a longitudinal POCUS curriculum after the Council on Accreditation began tracking student exposure to POCUS.

“I looked at the structure of our program, and it didn’t have a POCUS component to it. So I said, how can I, as an educator, give my students the knowledge, skills, and abilities, and have them become competent in performing point-of-care ultrasound?”

Today, students are exposed to POCUS across all three years through simulation, live models, and case-based learning aligned with didactic content. Gabot has also developed objective structured clinical examinations to measure competency.

Feedback from his students has been overwhelmingly positive. “They love it. When you see it in real time, there’s a tangible component to it, which makes it come to life.”

He also hears from graduates once they enter clinical practice. “They’ve explained to me how other CRNAs or physician anesthesiologists are impressed by how well-prepared our students are,” he said. “They’re able to provide better care to our patients, which I think is awesome.”

For Gabot, the common thread through his clinical work, teaching, and involvement with ASE is curiosity.

“I’ve always been very curious about new technologies specifically and the ability to use something that truly helps your mind’s eye,” he said. That curiosity, combined with a willingness to learn from other disciplines, informs the advice he gives other CRNAs.

“If they’re really passionate about cardiac ultrasound, my advice is to join ASE and explore their resources,” he said.

Gabot joined ASE, became active in its POCUS special interest group, and eventually served as the advanced practice provider representative—steps he describes as pushing beyond comfort zones and building relationships with experts.

“Stay curious, put yourself out there, reach out to other professional organizations that are not within nurse anesthesia,” he advised. “And see where that takes you.”

Above all, he emphasizes humility and lifelong learning. That mindset has carried him to a historic fellowship and continues to shape how the next generation of CRNAs use cardiac POCUS to advance patient care.