Patient radiation exposure during transcatheter aortic valve replacement procedures

Benoit Daneault, Stephen Balter, Susheel K. Kodali, Mathew R. Williams, Philippe Genereux, George R. Reiss, Jean Michel Paradis, Philip Green, Ajay J. Kirtane, Craig Smith, Jeffrey W. Moses, Martin B. Leon

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Aims: To describe patient radiation utilisation during transcatheter aortic valve replacement (TAVR) on a series of consecutive patients. Methods and results: Data on radiation exposure were prospectively collected for consecutive patients undergoing TAVR and percutaneous coronary interventions at our centre. Radiation dose during the procedure was recorded using the US Food and Drug Administration (FDA) reference point (Ka,r) and the dose area product (PKA). In addition to quantifying overall radiation doses during TAVR, radiation exposure during transfemoral (TF) (n=79) and transapical (TA) (n=26) cases was compared. The median radiation dose during TAVR was 1,639 mGy (983-2,420), or 188 (106-321) Gy*cm2. Radiation dose was significantly lower among TA patients using either the reference point (TA: 946 [777-1,261] vs. TF: 1,932 [1,383-2,614] mGy; p<0.001) or the dose area product (TA: 89 [60-115] vs. TF: 236 [164-338] Gy*cm2; p<0.001). Fluoroscopy time was lower for TA patients (TA: 10 [8-11] vs. TF: 30 [24-34] minutes; p<0.001). Operators experience did not affect radiation exposure for TF cases. Conclusions: Radiation exposure during TAVR appears similar to other percutaneous coronary interventions of moderate complexity. Radiation doses were significantly lower for TA procedures. A higher dose of radiation in TF patients may be related to additional imaging requirements to optimise percutaneous vascular access and closure.

Original languageEnglish (US)
Pages (from-to)679-684
Number of pages6
JournalEuroIntervention
Volume8
Issue number6
DOIs
StatePublished - Oct 1 2012
Externally publishedYes

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Radiation
Percutaneous Coronary Intervention
Fluoroscopy
United States Food and Drug Administration
Radiation Exposure
Transcatheter Aortic Valve Replacement
Blood Vessels

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Daneault, B., Balter, S., Kodali, S. K., Williams, M. R., Genereux, P., Reiss, G. R., ... Leon, M. B. (2012). Patient radiation exposure during transcatheter aortic valve replacement procedures. EuroIntervention, 8(6), 679-684. https://doi.org/10.4244/EIJV8I6A106
Daneault, Benoit ; Balter, Stephen ; Kodali, Susheel K. ; Williams, Mathew R. ; Genereux, Philippe ; Reiss, George R. ; Paradis, Jean Michel ; Green, Philip ; Kirtane, Ajay J. ; Smith, Craig ; Moses, Jeffrey W. ; Leon, Martin B. / Patient radiation exposure during transcatheter aortic valve replacement procedures. In: EuroIntervention. 2012 ; Vol. 8, No. 6. pp. 679-684.
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abstract = "Aims: To describe patient radiation utilisation during transcatheter aortic valve replacement (TAVR) on a series of consecutive patients. Methods and results: Data on radiation exposure were prospectively collected for consecutive patients undergoing TAVR and percutaneous coronary interventions at our centre. Radiation dose during the procedure was recorded using the US Food and Drug Administration (FDA) reference point (Ka,r) and the dose area product (PKA). In addition to quantifying overall radiation doses during TAVR, radiation exposure during transfemoral (TF) (n=79) and transapical (TA) (n=26) cases was compared. The median radiation dose during TAVR was 1,639 mGy (983-2,420), or 188 (106-321) Gy*cm2. Radiation dose was significantly lower among TA patients using either the reference point (TA: 946 [777-1,261] vs. TF: 1,932 [1,383-2,614] mGy; p<0.001) or the dose area product (TA: 89 [60-115] vs. TF: 236 [164-338] Gy*cm2; p<0.001). Fluoroscopy time was lower for TA patients (TA: 10 [8-11] vs. TF: 30 [24-34] minutes; p<0.001). Operators experience did not affect radiation exposure for TF cases. Conclusions: Radiation exposure during TAVR appears similar to other percutaneous coronary interventions of moderate complexity. Radiation doses were significantly lower for TA procedures. A higher dose of radiation in TF patients may be related to additional imaging requirements to optimise percutaneous vascular access and closure.",
author = "Benoit Daneault and Stephen Balter and Kodali, {Susheel K.} and Williams, {Mathew R.} and Philippe Genereux and Reiss, {George R.} and Paradis, {Jean Michel} and Philip Green and Kirtane, {Ajay J.} and Craig Smith and Moses, {Jeffrey W.} and Leon, {Martin B.}",
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Daneault, B, Balter, S, Kodali, SK, Williams, MR, Genereux, P, Reiss, GR, Paradis, JM, Green, P, Kirtane, AJ, Smith, C, Moses, JW & Leon, MB 2012, 'Patient radiation exposure during transcatheter aortic valve replacement procedures', EuroIntervention, vol. 8, no. 6, pp. 679-684. https://doi.org/10.4244/EIJV8I6A106

Patient radiation exposure during transcatheter aortic valve replacement procedures. / Daneault, Benoit; Balter, Stephen; Kodali, Susheel K.; Williams, Mathew R.; Genereux, Philippe; Reiss, George R.; Paradis, Jean Michel; Green, Philip; Kirtane, Ajay J.; Smith, Craig; Moses, Jeffrey W.; Leon, Martin B.

In: EuroIntervention, Vol. 8, No. 6, 01.10.2012, p. 679-684.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Patient radiation exposure during transcatheter aortic valve replacement procedures

AU - Daneault, Benoit

AU - Balter, Stephen

AU - Kodali, Susheel K.

AU - Williams, Mathew R.

AU - Genereux, Philippe

AU - Reiss, George R.

AU - Paradis, Jean Michel

AU - Green, Philip

AU - Kirtane, Ajay J.

AU - Smith, Craig

AU - Moses, Jeffrey W.

AU - Leon, Martin B.

PY - 2012/10/1

Y1 - 2012/10/1

N2 - Aims: To describe patient radiation utilisation during transcatheter aortic valve replacement (TAVR) on a series of consecutive patients. Methods and results: Data on radiation exposure were prospectively collected for consecutive patients undergoing TAVR and percutaneous coronary interventions at our centre. Radiation dose during the procedure was recorded using the US Food and Drug Administration (FDA) reference point (Ka,r) and the dose area product (PKA). In addition to quantifying overall radiation doses during TAVR, radiation exposure during transfemoral (TF) (n=79) and transapical (TA) (n=26) cases was compared. The median radiation dose during TAVR was 1,639 mGy (983-2,420), or 188 (106-321) Gy*cm2. Radiation dose was significantly lower among TA patients using either the reference point (TA: 946 [777-1,261] vs. TF: 1,932 [1,383-2,614] mGy; p<0.001) or the dose area product (TA: 89 [60-115] vs. TF: 236 [164-338] Gy*cm2; p<0.001). Fluoroscopy time was lower for TA patients (TA: 10 [8-11] vs. TF: 30 [24-34] minutes; p<0.001). Operators experience did not affect radiation exposure for TF cases. Conclusions: Radiation exposure during TAVR appears similar to other percutaneous coronary interventions of moderate complexity. Radiation doses were significantly lower for TA procedures. A higher dose of radiation in TF patients may be related to additional imaging requirements to optimise percutaneous vascular access and closure.

AB - Aims: To describe patient radiation utilisation during transcatheter aortic valve replacement (TAVR) on a series of consecutive patients. Methods and results: Data on radiation exposure were prospectively collected for consecutive patients undergoing TAVR and percutaneous coronary interventions at our centre. Radiation dose during the procedure was recorded using the US Food and Drug Administration (FDA) reference point (Ka,r) and the dose area product (PKA). In addition to quantifying overall radiation doses during TAVR, radiation exposure during transfemoral (TF) (n=79) and transapical (TA) (n=26) cases was compared. The median radiation dose during TAVR was 1,639 mGy (983-2,420), or 188 (106-321) Gy*cm2. Radiation dose was significantly lower among TA patients using either the reference point (TA: 946 [777-1,261] vs. TF: 1,932 [1,383-2,614] mGy; p<0.001) or the dose area product (TA: 89 [60-115] vs. TF: 236 [164-338] Gy*cm2; p<0.001). Fluoroscopy time was lower for TA patients (TA: 10 [8-11] vs. TF: 30 [24-34] minutes; p<0.001). Operators experience did not affect radiation exposure for TF cases. Conclusions: Radiation exposure during TAVR appears similar to other percutaneous coronary interventions of moderate complexity. Radiation doses were significantly lower for TA procedures. A higher dose of radiation in TF patients may be related to additional imaging requirements to optimise percutaneous vascular access and closure.

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