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Radiation dose during percutaneous treatment of structural heart disease

John E Boland1, Louis W Wang1, Bernard J Love1

  • 1Cardiac Catheterisation Laboratories, St Vincent's Public and Private Hospitals, Sydney, Australia.

Heart, Lung & Circulation
|June 30, 2014
PubMed

Insights

Radiation doses from structural heart interventions are comparable to coronary angiography. This finding should reassure patients and staff during lengthy procedures, highlighting the safety of modern interventional cardiology.

Area of Science:

  • Interventional Cardiology
  • Medical Imaging
  • Radiation Safety

Background:

  • Increasing use of structural heart interventions raises concerns about patient and staff radiation exposure.
  • Prolonged procedure times in structural heart interventions contribute to cumulative radiation dose.

Purpose of the Study:

  • To compare radiation dose-area product (DAP) between various structural heart interventions and coronary angiography.
  • To assess if structural heart interventions result in significantly higher radiation doses compared to standard coronary procedures.

Main Methods:

  • Retrospective analysis of radiation data from 91 single-vessel percutaneous coronary interventions (PCIs).
  • Data collected from 69 patent foramen ovale closures, 25 atrial septal defect closures, 49 percutaneous transluminal mitral valvuloplasties, 57 balloon aortic valvuloplasties, 53 trans-catheter aortic valve implantations (TAVI), 21 left atrial appendage occlusions, and 7 MitraClip procedures.
  • Fluoroscopy times and dose-area product (DAP) were recorded and analyzed for each procedure type.

Main Results:

  • DAP for structural heart interventions, including TAVI and MitraClip, was generally comparable to single-vessel PCI.
  • Median DAP (Gycm²) ranged from 15.5 for atrial septal defect closure to 101.9 for Medtronic CoreValve TAVI.
  • Fluoroscopy times varied, with MitraClip procedures having the longest median duration (37.2 minutes).

Conclusions:

  • Radiation dose-area product for structural heart interventions is not significantly greater than for coronary angiography with single-vessel PCI.
  • Findings suggest that radiation exposure during prolonged structural heart interventions is within acceptable limits.
  • This data should be reassuring for patients and healthcare professionals involved in these procedures.
Abstract

Keywords:
Percutaneous coronary interventionPercutaneous left atrial appendage occlusionPercutaneous mitral valve interventionRadiationStructural heart interventionTranscatheter aortic valve

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