Patient radiation dose during percutaneous interventional closure of interatrial communications

To determine fluoroscopy time (FT) and radiation dose (RD) applied in percutaneous closure of interatrial septal communications (IAC).

Percutaneous closure of IAC, namely patent foramen ovale (PFO) and atrial septal defect (ASD) is increasingly performed. In this often young population in full reproductive age, radiation dosage should be an important issue, yet consistent data on applied radiation dose have not been available to date.

A single center observational cohort study in 50 consecutive patients undergoing closure of a PFO or ASD. RD and FT as recorded by the cardiac catheter laboratory were determined to be the main outcome measures. Secondary outcome measures were determined to be major adverse events.

FT averaged 6.3 (+/-4, 1.4-21.1) min, whereas RD measured as dose area product averaged 325.5 (+/-271.1; 11.6-1103.4) dGray x cm(2). The latter is equivalent to an effective dose of 6.5 milliSievert (0.24-22 mSv).

Whereas closure of IAC can be associated with a low radiation exposure of 0.24 mSv, sometimes appreciably higher doses are applied, mandating more careful consideration of radiation safety issues in this patient population, especially the subset younger than 45 years. Analogous to data and recommendations published for radiation dose in coronary angiography, there is a need for binding reference values which would serve as guidelines for closure of IAC.