Radioprotective strategies for interventional echocardiographers during structural heart interventions.
Citation: Catheterization & Cardiovascular Interventions. 93(2):356-361, 2019 02 01.PMID: 30196578Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Echocardiography | *Heart Diseases/th [Therapy] | *Occupational Exposure/pc [Prevention & Control] | *Radiation Dosage | *Radiation Exposure/pc [Prevention & Control] | *Radiation Protection/mt [Methods] | *Radiography, Interventional | *Ultrasonography, Interventional | Echocardiography/ae [Adverse Effects] | Heart Diseases/dg [Diagnostic Imaging] | Humans | Occupational Exposure/ae [Adverse Effects] | Occupational Health | Occupational Injuries/et [Etiology] | Occupational Injuries/pc [Prevention & Control] | Radiation Exposure/ae [Adverse Effects] | Radiation Injuries/et [Etiology] | Radiation Injuries/pc [Prevention & Control] | Radiography, Interventional/ae [Adverse Effects] | Radiologists | Risk Assessment | Risk Factors | Time Factors | Ultrasonography, Interventional/ae [Adverse Effects]Year: 2019Local holdings: Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006ISSN:- 1522-1946
- Corrigan, Frank E 3rd Kamioka, Norihiko:
- http://orcid.org/0000-0002-1815-8813 http://orcid.org/0000-0001-7222-6197 http://orcid.org/0000-0002-1815-8813 http://orcid.org/0000-0001-7222-6197 Corrigan, Frank E 3rd Kamioka, Norihiko:
- http://orcid.org/0000-0002-1815-8813 http://orcid.org/0000-0001-7222-6197 http://orcid.org/0000-0002-1815-8813 http://orcid.org/0000-0001-7222-6197
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 30196578 | Available | 30196578 |
Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006
BACKGROUND: Structural heart interventions are expanding in complexity with increased reliance on IE. Recent reports have demonstrated concerning exposure and higher radiation to the IE.
CONCLUSIONS: Radiation exposure during structural heart interventions is concerning. With dedicated shielding, IE received lower doses to the body and lens than IC. Further optimization of structural suite design and shielding is needed.
Copyright (c) 2018 Wiley Periodicals, Inc.
METHODS: We monitored 32 structural interventions - 19 transcatheter aortic valve replacements (TAVR), 6 transcatheter mitral valve repairs, 5 paravalvular leak closures, and 2 atrial septal defect closures. Seventeen utilized transesophageal echocardiography (TEE) while 15 used transthoracic echocardiography (TTE). Members of the IC and IE teams wore multiple dosimeters on different sites of the body to measure radiation dose to the total body, lens of the eye, and hand. During each case, IE utilized dedicated radiation shielding.
OBJECTIVE: We investigated radioprotective strategies for the interventional echocardiographer (IE) during structural heart interventions in comparison with the interventional cardiologist (IC).
RESULTS: Mean doses were higher for the primary IC than the primary IE: IC#1-99, 222, 378; IE#1-48, 52, 416 (body, lens, and hand doses in muSv). IE radioprotective strategies were able to reduce body and lens doses compared to IC during both TTE and TEE-guided procedures. Hand equivalent dose remained higher for the IE driven by exposure during TEE-guided procedures (IC#1 294 vs. IE#1 676 muSv). In a subgroup using radioprotective drapes during TTE-guided TAVR, IC dose was reduced without effect on the IE.
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