Operator Radiation Exposure During Transfemoral Transcatheter Aortic Valve Replacement.

Autor:	Goel S; Department of Cardiology, Mount Sinai Medical Center, New York, New York, USA.; Department of Cardiology, Maimonides Medical Center, Brooklyn, New York, USA., Casazza R; Department of Cardiology, Maimonides Medical Center, Brooklyn, New York, USA., Pasam RT; Department of Internal Medicine, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA., Montagna E; Department of Cardiology, Maimonides Medical Center, Brooklyn, New York, USA., Gotesman J; Department of Cardiology, Maimonides Medical Center, Brooklyn, New York, USA., Frankel R; Department of Cardiology, Maimonides Medical Center, Brooklyn, New York, USA., Borgen E; Department of Cardiology, Maimonides Medical Center, Brooklyn, New York, USA., Crooke G; Department of Cardiothoracic Surgery, Maimonides Medical Center, Brooklyn, New York, USA., Saunders P; Department of Cardiothoracic Surgery, Maimonides Medical Center, Brooklyn, New York, USA., Shani J; Department of Cardiology, Maimonides Medical Center, Brooklyn, New York, USA.
Jazyk:	angličtina
Zdroj:	Structural heart : the journal of the Heart Team [Struct Heart] 2022 Mar 25; Vol. 6 (1), pp. 100002. Date of Electronic Publication: 2022 Mar 25 (Print Publication: 2022).
DOI:	10.1016/j.shj.2022.100002
Abstrakt:	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. Competing Interests: The authors report no conflict of interest. (© 2022 The Author(s).)
Databáze:	MEDLINE
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