Operator Radiation Exposure During Transfemoral Transcatheter Aortic Valve Replacement

Sunny Goel, MD; Richard Casazza, MAS, RT(R)(CI); Ravi Teja Pasam, MD; Enrico Montagna, MS; Joseph Gotesman, MD; Robert Frankel, MD; Elliot Borgen, MD; Gregory Crooke, MD; Paul Saunders, MD; Jacob Shani, MD

Structural Heart (Apr 2022)

Operator Radiation Exposure During Transfemoral Transcatheter Aortic Valve Replacement

Sunny Goel, MD,
Richard Casazza, MAS, RT(R)(CI),
Ravi Teja Pasam, MD,
Enrico Montagna, MS,
Joseph Gotesman, MD,
Robert Frankel, MD,
Elliot Borgen, MD,
Gregory Crooke, MD,
Paul Saunders, MD,
Jacob Shani, MD

Affiliations

Sunny Goel, MD: Department of Cardiology, Mount Sinai Medical Center, New York, New York, USA; Department of Cardiology, Maimonides Medical Center, Brooklyn, New York, USA; Address correspondence to: Sunny Goel, MD, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1030, New York, NY 10029
Richard Casazza, MAS, RT(R)(CI): Department of Cardiology, Maimonides Medical Center, Brooklyn, New York, USA
Ravi Teja Pasam, MD: Department of Internal Medicine, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA
Enrico Montagna, MS: Department of Cardiology, Maimonides Medical Center, Brooklyn, New York, USA
Joseph Gotesman, MD: Department of Cardiology, Maimonides Medical Center, Brooklyn, New York, USA
Robert Frankel, MD: Department of Cardiology, Maimonides Medical Center, Brooklyn, New York, USA
Elliot Borgen, MD: Department of Cardiology, Maimonides Medical Center, Brooklyn, New York, USA
Gregory Crooke, MD: Department of Cardiothoracic Surgery, Maimonides Medical Center, Brooklyn, New York, USA
Paul Saunders, MD: Department of Cardiothoracic Surgery, Maimonides Medical Center, Brooklyn, New York, USA
Jacob Shani, MD: Department of Cardiology, Maimonides Medical Center, Brooklyn, New York, USA

Journal volume & issue: Vol. 6, no. 1
p. 100002

Abstract

Read online

Background: The level of radiation exposure received by operators performing transcatheter aortic valve replacement (TAVR) is not well investigated. The aim of this study is to measure the amount of radiation received by operators performing transfemoral TAVR and to identify various patient and procedural characteristics associated with increased radiation exposure. Methods: Primary (operator 1) and secondary (operator 2) operators' equivalent radiation doses in micro Sieverts (µSv) were calculated prospectively using real-time radiation dosimeters for a total of 140 consecutive transfemoral TAVRs. Corresponding eye and thorax radiation exposures between the operators were compared. Associations between various patient and procedural characteristics and the radiation exposure were tested using the t-test and Wilcoxon Mann-Whitney rank-sum test with Monte Carlo estimation. Multivariable regression analysis was also conducted. Results: Operator 1 had significantly higher cumulative equivalent radiation exposure than operator 2 (86 µSv vs 38 µSv, p-value: <0.0001) which was consistent at the level of the thorax (67 µSv vs 22 µSv, p-value: <0.0001), but not at the level of the eye (16.5 µSv vs 15 µSv, p-value: 0.30). On multivariable analysis, patient obesity and intraprocedural complications were associated with higher radiation exposure to both operators. Ad hoc percutaneous coronary intervention led to excessive radiation exposure to the secondary operator. Conclusions: Transfemoral TAVR is associated with a modest amount of radiation exposure to operators and is significantly higher for the primary operator than for the secondary operator.

Published in Structural Heart

ISSN: 2474-8706 (Print); 2474-8714 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.sciencedirect.com/journal/structural-heart

About the journal

Abstract

Keywords