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Reducing radiation dose in paediatric interventional cardiac catheterisation

Published online by Cambridge University Press:  09 July 2019

Jiarong Bai ,
Feng Wang ,
Haosheng Yang ,
Ying Lu  and
Lin Wu Open the ORCID record for Lin Wu [Opens in a new window]
Jiarong Bai
Affiliation:
Department of Cardiology, Cardiovascular Center, Children’s Hospital of Fudan University, Shanghai 201102, P.R. China
Feng Wang
Affiliation:
Department of Cardiology, Cardiovascular Center, Children’s Hospital of Fudan University, Shanghai 201102, P.R. China
Haosheng Yang
Affiliation:
College of Natural Sciences, The University of Texas at Austin, Austin 78705, TX, USA
Ying Lu
Affiliation:
Department of Cardiology, Cardiovascular Center, Children’s Hospital of Fudan University, Shanghai 201102, P.R. China
Lin Wu*
Affiliation:
Department of Cardiology, Cardiovascular Center, Children’s Hospital of Fudan University, Shanghai 201102, P.R. China
*
Author for correspondence: Lin Wu, Department of Cardiology, Cardiovascular Center, Children’s Hospital of Fudan University, 399 Wanyuan Road, Shanghai 201102, P.R China. Tel: +86-21-6493-2800; Fax: +86-21-6493-1901; E-mail: wulin0609@foxmail.com
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Abstract

Objective:

Radiation exposure during paediatric cardiac catheterisation procedures should be minimised to “as low as reasonably achievable”. The aim of this study was to evaluate the effectiveness of a modified radiation safety protocol in reducing patient dose during paediatric interventional cardiac catheterisation.

Methods:

Radiation dose data were retrospectively extracted from January 2014 to December 2015 (Standard group) and prospectively collected from January 2016 to December 2017 (Low-dose group) after implementation of a modified radiation safety protocol. Both groups included five most common procedures: atrial septal defect closure, patent ductus arteriosus closure, perimembranous ventricular septal defect closure, pulmonary valvuloplasty, and supraventricular tachycardia ablation.

Results:

Median air Kerma was 48.4, 50.5, 29.75, 149, 218, and 12.9 mGy for atrial septal defect closure, pulmonary valvuloplasty, patent ductus arteriosus closure <20 kg, ventricular septal defect closure <20 kg, ventricular septal defect closure ≧20 kg, and supraventricular tachycardia ablation in Standard group, respectively, which significantly decreased to 18.75, 20.7, 11.5, 41.9, 117, and 3.3 mGy in Low-dose group (p < 0.05). This represents a reduction in dose to each patient between 46 and 74%. Among five procedural types in Low-dose group, dose of ventricular septal defect closure was the highest with median air Kerma of 62.5 mGy, dose area product of 364.7 μGy.m2, and dose area product per body weight of 21.5 μGy.m2/kg, respectively, along with the longest fluoroscopy time of 9.9 minutes.

Conclusion:

We provided a feasible radiation safety protocol with specific settings on a case-by-case basis. Increasing awareness and adequate training of a practical radiation dose reduction program are essential to improve radiation protection for children.

Keywords

Fluoroscopyradiation dosepaediatriccardiac catheterisationpaediatric intervention
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 7 , July 2019 , pp. 967 - 971
Copyright
© Cambridge University Press 2019 

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Footnotes

*

Jiarong Bai and Feng Wang contributed equally to this work.

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