Author + information
- Frank Corrigan1,
- Jose Miguel Iturbe2,
- Jessica Forcillo2,
- Ronnie Ramadan3,
- C. Jose Condado4,
- Norihiko Kamioka2,
- Vinod Thourani5 and
- Vasilis Babaliaros1
Structural heart interventions are increasing in complexity with reliance on Interventional Echocardiography (IE). Recent reports have demonstrated concerning exposure and higher radiation to IE. We investigated radiation exposure during structural heart interventions with the use of external shielding for IE and disposable radioprotective drapes for interventional cardiology (IC).
We monitored 32 structural interventions – 19 TAVR's (4 with TEE guidance, 15 with TTE guidance), 6 TMVR's, 5 PVL closures, and 2 ASD closures. Three members of both the IC and IE teams wore dosimeters on the chest, collar, ankle, wrist, and finger. The deep, lens, shallow dose and the assigned deep dose equivalent (DDE, LDE, SDE, ADDE) were reported. IE shielding was used for each case with room orientation as described in Figure 1. Disposable radioprotective drapes (RADPAD®) were used at the discretion of the primary IC.
Cumulative radiation dose was highest for the primary IC followed by the secondary IC and primary IE: IC#1 – 3.18, 7.11, 12.10; IC#2 – 1.96, 2.32, 8.80; IE#1 – 1.52, 1.66, 13.30 (ADDE, LDE, and finger SDE in mSv). Comparing 5 TAVR’s with and 5 without radioprotective drapes with similar fluoroscopy time, cumulative dose was reduced: IC#1 – 0.23 vs. 4.12, 1.10 vs. 4.90; IC#2 – 0.13 vs. 0.38, 1.40 vs. 2.90 (LDE and finger SDE in mSv. ADDE was low in both groups).
Radiation exposure during increasingly complex structural heart interventions is concerning. With shielding, IE’s received lower doses than IC’s. Radioprotective drapes may provide further protection for the IC.
STRUCTURAL: Congenital and Other Structural Heart Disease