Occupational Pelvic and Chest-Level Radiation Exposure Among Interventional Echocardiographers During Percutaneous...

Area of Science:

• Cardiology
• Radiology
• Occupational Health

Background:

• Transcatheter structural heart interventions are rapidly expanding.
• This expansion has led to increased occupational radiation exposure for interventional echocardiographers (IEs).

Purpose of the Study:

• Quantify real-time under-lead pelvic and chest radiation exposure in IEs during left atrial appendage occlusion (LAAO), transcatheter mitral valve intervention (TMVI), and transcatheter tricuspid valve intervention (TTVI).
• Estimate implications for fetal safety.
• Identify predictors of higher chest radiation dose.

Main Methods:

• Prospective, single-center study of 118 LAAO, 59 TMVI, and 53 TTVI procedures.
• Radiation exposure was quantified using dosimeters.
• Multivariable linear regression identified predictors of chest dose.

Main Results:

• Pelvic dose was negligible (<0.1% cases), with estimated fetal dose well below limits.
• Median chest exposure was significantly higher for TMVI (18.0 μSv) and TTVI (36.0 μSv) compared to LAAO (9.0 μSv).
• Higher chest doses were linked to head-of-bed positioning, TMVI/TTVI procedures, and partial shielding.

Conclusions:

• Standard lead apparel and shielding ensure reproductive safety for IEs.
• Chest radiation exposure is significantly higher during TMVI and TTVI compared to LAAO.
• Optimizing shielding protocols and positional awareness are crucial for reducing IE radiation exposure.