Abstract 19683: Radiation Exposure in Children With Congenital Heart Disease at a Single, Large Center.
Introduction: Congenital heart disease (CHD) is a disease with life-long implications. Our objective is to characterize and quantify radiologic examinations in children requiring surgery for CHD on a diagnosis-specific basis in order to understand exposure risk in CHD patients.
Hypothesis: We hypothesize that cumulative radiation exposure during childhood for patients with CHD will be varied and significant, with differences based on diagnosis.
Methods: We conducted a retrospective cohort study of all patients under 18 years with CHD at the Children's Hospital of Philadelphia (CHOP) who underwent at least one cardiovascular operation from January 1, 2001 to July 22, 2009. We tallied all studies performed using ionizing radiation during the period of follow-up and calculated a cumulative effective biologic radiation exposure in millisieverts (mSv) using estimates of mSv dose for each study.
Results: The cohort consisted of 4162 patients, of whom 38.2% were neonates and 29.2% were infants at the time of surgery, was mostly male (56.4%) and white (66.7%). Chromosomal abnormalities were present in 13.8%. A total of 132,208 radiation-producing exams were performed, with a median cumulative exposure in the entire cohort of 1.01 mSv (range: 0.01 mSv to 518.72 mSv). The two highest cumulative doses for greater than 5 cases were for heart failure (n=23, mean=112.11 mSv, median=22.84 mSv, SD=150.54 mSv) and Ebstein's anomaly (n=16, mean=29.55 mSv, median=22.84 mSv, SD=150.54 mSv). The two lowest cumulative doses were for vascular ring (n=106, mean=2.81 mSv, median=0.67 mSv, SD=5.14 mSv) and aortic coarctation (n=286, mean=3.08 mSv, median=0.38 mSv, SD=6.02 mSv).
Conclusions: We have comprehensively calculated dosimetry and diagnosis-specific exposure data in a large population of patients undergoing surgery for CHD. We found that the total effective radiation exposure in this cohort was low, but highly variable. This dataset provides a robust dataset for predicting cumulative radiologic risk in patients with CHD.
- © 2010 by American Heart Association, Inc.