Abstract 18312: Cumulative Radiation Exposure in Pediatric Patients with Congenital Heart Disease
Introduction: The purpose of our study is to look at cumulative radiation exposure in a contemporary cohort of patients with congenital heart disease undergoing single ventricle palliation.
Methods: This is a single center, retrospective study of pediatric patients undergoing Fontan completion between May 2005 and May 2010. Radiation exposure from all procedures including cardiac catheterizations, CT scans, plain film radiography, and nuclear medicine scans were evaluated. Radiation dose was calculated as the dose area product (μ Gy.m2)and was measured in all cardiac catheterizations and CT scans. Radiation exposure from chest radiography was estimated based on age at the time of exposure. Patients that died prior to reaching Fontan completion or who underwent cardiac transplantation were excluded from the study.
Results: Ninety-nine patients who underwent Fontan completion at a mean age of 3.6±1.5 years (range 1.4 - 8 years) were included in the study. There were 41 females and 58 males. Fifty-four patients had a diagnosis of hypoplastic left heart syndrome and 68 of the total cohort had a dominant morphologic right ventricle. Mean number of chest x-rays was 32±8 (range 10 - 285) with a mean cumulative total exposure of 1,536 μ Gy.m2 per patient. Mean number of cardiac catheterizations was 3.6±1.3 (range 1-8), mean fluoroscopy and cine angiography exposures per case were 1103±245 and 1412±273 μ Gy.m2 giving a mean cumulative exposure of 9,054 μ Gy.m2 per patient for all catheterizations. Mean number of CT scans performed was 0.44±0.4 (0-11); the mean exposure was 352 μ Gy.m2 giving a mean cumulative total of 154 μ Gy.m2 per person. A total of 5 lung perfusion scans were carried out. The mean cumulative total exposure for all procedures was 10,744 μ Gy.m2.
Conclusion: Radiation exposure in patients with congenital heart disease undergoing single ventricle palliation is quite variable. Cardiac catheterization and chest radiography account for most of the radiation exposure. The level of exposure is below threshold levels however given the age of these patients this should be interpreted with caution. Consideration should be given to the introduction of patient radiation monitoring, notification and surveillance for long-term side effects from exposure.
- © 2012 by American Heart Association, Inc.