Performance of a Dedicated Radioprotection Cabin for the Interventional Echocardiographer During Structural Heart...

Structural heart procedures performed under fluoroscopy and transesophageal echocardiography guidance require the expertise of an interventional echocardiographer in the heart team. Due to the proximity with the radiation source, the physician might be exposed to high radiation doses. This study aims to assess the interventional echocardiographer radioprotection by means of a dedicated cabin and evaluate its ergonomic characteristics.

This is an observational nonrandomized study comparing cumulative radiation exposure between a control arm, consisting of a standard lead glass panel, and the experimental arm using the dedicated radioprotective Echosafe cabin. All structural heart procedures requiring transesophageal echocardiography between July 2021 and April 2022 were included. Cumulative radiation exposure of the interventional echocardiographer was collected by the body part and the satisfaction of the heart team with the cabin was assessed with a questionnaire.

A total of 64 procedures were included (24 controls and 40 with the cabin). The irradiation (as estimated by dose area product per procedure) was similar between the two groups (p = 0.94). The use of the cabin resulted in a numerically lower cumulative radiation dose to each body part. The mean overall reduction in radiation dose was estimated to be between 56 and 78% with the cabin. The most frequent negative aspects reported by the cabin users included difficulty moving the transesophageal echocardiography probe and the physical burden associated with initial installation.

This preliminary study suggests that radioprotection of the interventional echocardiographer can be increased during structural procedures by using a dedicated cabin. Further studies with larger sample sizes and different design will be needed to confirm the reduction in irradiation of the echocardiographer.