Safety considerations during transapical aortic valve implantation

Area of Science:

• Cardiovascular Interventions
• Medical Radiation Physics
• Patient Safety

Background:

• Transcatheter aortic valve implantation (TAVI) is a crucial treatment for high-risk aortic stenosis patients.
• Radiation exposure during TAVI procedures for patients and staff is not well-documented.

Purpose of the Study:

• To quantify patient and heart team radiation doses during transapical TAVI (TA-TAVI).
• To compare these doses with established radiation safety limits.

Main Methods:

• Dose measurements using thermoluminescence and film dosimeters on 22 TA-TAVI patients.
• Dosimeters placed on seven body parts for surgeons, cardiologists, anesthesiologists, assistants, and nurses.
• Comparison with international recommended radiation dose limits.

Main Results:

• Mean radiation time was 6.1 minutes; mean patient dose-area product was 8.661 µGy·m².
• Effective doses per intervention ranged from 0.001 mSv (nurse) to 0.05 mSv (assistant).
• Maximum hand doses reached 0.7 mSv; lower leg and genital doses were also recorded.

Conclusions:

• TA-TAVI patients receive higher X-ray doses than during coronary interventions.
• Radiation exposure for heart team members after 100 procedures approximates an interventional cardiologist's annual dose.
• Optimal X-ray protection and safety measures for patients and staff are critical and require re-evaluation.