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Radiation reduction in pediatric and adult congenital patients during cardiac catheterization
Author(s) -
Mauriello Daniel A.,
Fetterly Kenneth A.,
Len Ryan J.,
Reeder Guy S.,
Taggart Nathaniel W.,
Hagler Donald J.,
Cetta Frank,
Cabalka Allison K.
Publication year - 2014
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.25533
Subject(s) - medicine , cardiac catheterization , kerma , ionizing radiation , pediatrics , nuclear medicine , surgery , dosimetry , irradiation , physics , nuclear physics
Objectives Our objective was to determine if technical changes combined with radiation safety initiatives reduced the radiation dose delivered to patients during congenital catheterization. Background Use of ionizing radiation is necessary during cardiac catheterization. Minimizing radiation dose, while maintaining clinically useful image quality, is an important safety issue. In our congenital heart center intentional practice changes, including technical changes and provider awareness initiatives, were implemented to decrease radiation dose. Methods Data were retrospectively collected for all procedures involving children and adults with congenital heart disease (CHD) undergoing catheterization over 45 months. Cases were divided into three categories including: noninterventional (NI), simple intervention (SI), and complex intervention (CI). The change in dose was modeled as log of cumulative air kerma ( K a,r ). The change in K a,r was evaluated for each procedural category as well as changes occurring as a function of age and weight. Results Considering all procedures ( n = 1,082), K a,r decreased by 61%. In the NI group ( n = 481), K a,r decreased by 71%. In the SI group ( n = 424), K a,r decreased by 74%. The K a,r for the 10–17 year old group ( n = 125) and those ≥18 years ( n = 709) decreased 74 and 67%, respectively. The K a,r decreased 72 and 66% for those 20–60 kg and ≥60 kg, respectively. Groups not showing significant change in K a,r included CI, age ≤9 years, and weight ≤20 kg. Conclusions Through technical changes and provider awareness initiatives, our institution dramatically reduced the radiation dose in the majority of pediatric and adult CHD patients undergoing cardiac catheterization. © 2014 Wiley Periodicals, Inc.