Radiation Dose During Percutaneous Treatment of Structural Heart Disease

BackgroundWith the increased application of structural heart intervention techniques, there is concern over increasing radiation dose, especially during lengthy procedures.MethodsWe compared data from 91 consecutive single-vessel percutaneous coronary interventions, 69 patent foramen ovale closures, 25 atrial septal defect closures, 49 percutaneous transluminal mitral valvuloplasties, 57 balloon aortic valvuloplasties, 53 trans-catheter aortic valve implantations (TAVI), 21 left atrial appendage occlusions and 7 MitraClip® procedures.ResultsThe following fluoroscopy times and dose-area product (median, interquartile range) were recorded: patent foramen ovale closure (7.8, 5.3-10.9 minutes; 16.9, 7.5-30.6 Gycm2), atrial septal defect closure (10.1, 7.3-13 minutes; 15.5, 11.6-30.5 Gycm2), percutaneous transluminal mitral valvuloplasty (14.3, 11.4-24.2 minutes; 37.4, 19.8-87.0 Gycm2), balloon aortic valvuloplasty (8.4, 5.2-13.2 minutes; 19.8, 10.2-30.0 Gycm2), Edwards Sapien™ TAVI (24.0, 19.3-34.4 minutes; 86.4, 64.0-111.4 Gycm2), Medtronic CoreValve® TAVI (19.4, 15.0-26.0 minutes; 101.9, 52.6-143.2 Gycm2), left atrial appendage occlusion (18.5, 15.7-29.1 minutes; 84.1, 36.4-140.0 Gycm2), Mitraclip® procedures (37.2, 14.2-59.9 minutes; 89.1, 26.2-118.7 Gycm2), coronary angiography and single vessel percutaneous coronary intervention (6.6, 5.1-11.0 minutes; 62.5, 37.0-95.8 Gycm2).ConclusionFor structural heart interventions, dose-area product was not significantly greater than for coronary angiography with single-vessel percutaneous coronary artery intervention. This should be reassuring to patients and staff attending prolonged structural heart interventions.