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Quantification of temporal, procedural, and hardware‐related factors influencing radiation exposure during pediatric cardiac catheterization
Author(s) -
Smith Benjamin G.,
Tibby Shane M.,
Qureshi Shakeel A.,
Rosenthal Eric,
Krasemann Thomas
Publication year - 2012
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.24359
Subject(s) - medicine , fluoroscopy , cardiac catheterization , radiation exposure , psychological intervention , catheter , retrospective cohort study , confidence interval , radiation protection , radiology , nuclear medicine , emergency medicine , surgery , psychiatry
Purpose To quantify the impact of relocation to a purpose built pediatric cardiac catheterization laboratory, on patient radiation dose and fluoroscopy time. To provide guide values for radiation exposure during common structural interventions. Material and methods Design: A retrospective review of common structural cardiac interventions performed over 10‐years. The era comprised two 5‐year periods before and after relocation using different catheter laboratories. Multivariable analysis adjusted for the following variables: era (pre‐ and post‐move), year, operator seniority, patient age, procedure type. Setting: A quaternary referral congenital cardiac centre. Patients: All patients <18 yrs ( n = 756) in whom one of 6 common structural interventions were undertaken between 2000 and 2009. Main outcome measures: Radiation dose and fluoroscopy time. Results The move to the new laboratory (latter era) was associated with a dramatic reduction in multivariable‐adjusted radiation dose, ranging from 64% (aortic coarctation stenting) to 87% (patent arterial duct closure). There was also a year upon year increase in radiation dose of 5.2% [95% confidence interval (CI): 0.6–10.0%], which persisted after the relocation. However, this was associated with a 5.1% yearly decrease in fluoroscopy time (95% CI: −7.9 to −2.2%). Conclusion Use of state‐of‐the‐art catheter equipment is associated with a dramatic reduction in radiation exposure. However, the surprising finding of year upon year increase in exposure (despite the new equipment) combined with decreased fluoroscopy time suggests a temporal decrease in hardware efficiency. This has major implications for hardware replacement. © 2012 Wiley Periodicals, Inc.