Reducing Fluoroscopic Radiation Exposure During Endomyocardial Biopsy in Pediatric Transplant Recipients
| Autor: | Anya Agrawal, Karen Rychlik, Christina L. Sammet, David F. Wax, Jeffrey G. Gossett |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Pulmonary and Respiratory Medicine
Transplantation medicine.medical_specialty Pediatric transplant medicine.diagnostic_test business.industry Effective dose (radiation) Endomyocardial biopsy Radiation exposure Dose area product Angiography Medicine Fluoroscopy Vulnerable population Surgery Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Journal of Heart and Lung Transplantation. 34:S78-S79 |
| ISSN: | 1053-2498 |
| DOI: | 10.1016/j.healun.2015.01.206 |
| Popis: | Endomyocardial biopsy (EMB) with fluoroscopy is used for rejection surveillance in pediatric heart transplantation. Lowering frame rate may reduce radiation, but decreases temporal resolution and image quality. We undertook a quality initiative reducing frame rate from 10 frames per second (FPS) to 5 FPS. To assess whether lowering frame rate can reduce radiation exposure without compromising safety, data on EMBs from 9/2009 to 4/2013 without angiography or intervention were reviewed. Effective dose was calculated from dose area product (DAP) and fluoroscopy time. Complications were reviewed. Independent t test compared pre- and post-data and a general linear model were used to control for confounders. Paired t test of most proximate data was used for pts with EMB before and after our change. Eighty-six patients had 543 EMB. After adjusting for weight, attending, and presence of a fellow, the lower FPS group had a 60.3% reduction in DAP (p 1 grade by ECHO. There were no deaths or perforations. Lowering the frame rate reduces radiation exposure by >50% without compromising safety. Efforts to further minimize radiation exposure of this vulnerable population should be considered. |
| Databáze: | OpenAIRE |
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