Abstract 11390: Ionising Radiation Exposure to Medical Personnel During Percutaneous Adult Structural Heart Disease Intervention
The number of percutaneous procedures for structural heart disease is increasing worldwide. Owing to the 3D nature of anatomical defects, these procedures frequently require both fluoroscopic and ultrasonic guidance by an operating team and an imaging team, respectively. Typically an operator and assistant perform the procedure standing on the right side of the patient whereas the imaging team stands on the left hand side. While all staff is required to wear protective lead aprons and thyroid collars, additional shielding is only provided for the operating team. The purpose of this ongoing study was to examine how the radiation dose received by operators differs from that received by the imaging team. A prospective observational study of consecutive structural heart disease cases over a 4-month period in a university hospital with more than 10 years of experience in structural heart interventions. Radiation exposure was measured by aluminium oxide (Al2O3:C) dosimeters read out by optically stimulated luminescence technology (Landauer Inc., Glenwood, IL). Each operator received a four-dosimeter badge. The badges were worn outside the lead apron at the level of the chest. Personal dose equivalent Hp(10) was estimated. Statistical analysis was carried out using SPSS 15 software (SPSS Inc, Chicago, IL). The personal dose equivalent for the two groups was calculated for 12 procedures (6 PFO closures, 2 ASD closures, 4 paravalvular leak closures). During PFO procedures (mean dose-area product (DAP)=20.6 Gy·cm2, mean fluoroscopy time (T)=5.8 min), the mean dose for operators on the right side was 0.02 mSv and for those on the left side was 0.05 mSv. For ASD and paravalvular intervention (mean DAP=215.9 Gy·cm2, mean T= 39.8 min), the mean dose for operators on the right side was found to be 0.11 mSv and for those on the left side 0.32 mSv. The differences observed between the two groups were statistically significant (p-value=0.001 and 0.024, respectively). Radiation exposure to an imaging team during structural heart disease intervention is higher than that of the operating team. Our Results suggest that additional radiation protection practices and more use of echocardiographic imaging, particularly during complex interventions, may be warranted.
- © 2010 by American Heart Association, Inc.